17 posts tagged “labor”

I have written so few birth stories in the last few months, passing through the 50 births attended mark and on to my 60th without writing about any of them! I've had some really wonderful births in the last months and I need to catch up with some story telling.

Two recent VBACs really stick in my mind because of the overwhelming joy of both of the laboring moms, but also because of the triumph expressed by the people who love them, and were so proud of them for having the birth they wanted. For example, at one of these births, the mom labored slowly throughout the day, calling me to join them in the middle of the night. After several hours in the hospital, she was able to push her baby out, crying "I did it!" as he entered the world. Minutes later her mother appeared outside the door and we waved her in to join us. She came through the door with an enormous smile on her face, tears on her cheeks and scooped her daughter up into a big hug, exclaiming, "You did it! You did exactly what you wanted!" Her mother had been nervous about her daughter trying for a VBAC but was overcome with joy and filled with pride when she accomplished it. I almost never cry at births, but these two women embracing and marveling at the accomplishment of having her baby the way she wanted brough tears to my eyes.

Two months later I attended another VBAC with a similar sense of triump, this time from the proud father. This mother began laboring and called me in the morning to let me know. A few hours later the contractions picked up in intensity and she asked me to join her. We labored in her home for several hours and then transferred to the hospital to meet with her midwife. She continued to labor in the hospital until her baby was down low and ready to be born. She was strong and focused, pushing her baby down with each contraction. When her husand first heard the mdwife report being able to see the baby, her husband traded places with me so that he could get his camera and have a better view of the the birth. A few pushes later, the baby made a turn during a contraction and made a dramatic amount of progress. The father, with tears in his eyes was cheering for his wife, telling her how amazing she was as she pushed their baby out. It was wonderful to see how proud he was and what a transformative and triumphant experience it was not only for the mom, but also for her partner.

Denise Spatafora, a mom of two, business/life coach, and creator of the BornClear childbirth education course, just released her new book, Better Birth: The Ultimate Guide to Childbirth from Home Births to Hospitals. In this book she details her approach to having an empowering and satisfying birth. In her introduction is states: "My gift is that I can feel, hear, and see all that is limiting a person and/or business as well as their gifts" and she reports that through coaching she helps people to "uncover and actualize their commitments and dreams" (4). She writes that has both individual and global goals for this text, stating that she wants this book to be a comprehensive resource to help women become fully prepared for childbirth and also that she wants the book to help people to 'grow personally' (6). In addition to these individual goals, she states that her global goal is to change how people around the world are talking about and understanding childbirth, a goal she explains is "nothing short of creating a movement" (8).

In Better Birth, she lays out how she has approached this goal in her BornClear method, stating that the core values of this program are to prepare you for childbirth emotionally, intellectually, spiritually and physically through seven basic lessons. The text reads largely as an explanation of these seven lessons:

1. Understanding the mind-body connection and how it relates to pregnancy.
2. Determining what you deeply desire for you own birth experience.
3. Having tools (called "the BornClear toolbox") to help you through conception, pregnancy and childbirth.
4. Connecting and aligning with your baby during pregnancy to create emotional, spiritual and health bonds that will last a lifetime.
5. Learning how your body works during pregnancy and childbirth.
6. Having the ability to plan ahead for every contingency.
7. Envisioning the first year after birth through learning your options.
(p. 6-7)

The chapters of her book largely follow this order, guiding parents-to-be through the seven basic lessons. For example, chapter four lays out a variety of options to experiment with including visualizations, meditations, affirmations, writing and art projects, breathing techniques, and physical and personal growth exercises. With pictures and descriptions, these sections offer a variety of methods that parents can try to find things that fit with their own needs.

In birth, I find that having a variety of options that you have tried out and found to work well for you is the most useful. I encourage parents to try out different techniques, positions, and options together so that they can discover, for example, that they hate visualizations but love massage and supportive words or that they find great relief from yoga positions but feel distracted by massage. Many of the relaxation techniques listed, such as feng shui, relaxation tapes, guided visualizations, candles and scents in your home, and collage making, are not those I found most useful as a pregnant and laboring woman, nor those I see most often in my own clients. That said, she offer options to pick and choose from, many of which I have found more useful, such as seeking acupressure or acupuncture, massage, yoga and movement, and breathing/relaxation techniques. By laying them all out, she offers a wide range such that parents-to-be can begin to personalize for their own pregnancy and in preparation for their birth experience.

In Chapters 6 and 7 she details the signs and stages of labor, possible interventions or augmentations offered in hospitals, and an exhaustive series of questions to guide planning for every stage of labor in a variety of contexts. This provides a great foundation for understanding what is going on in your body during labor, what possible augmentations (like pitocin) could be suggested and how they work, and the types of preferences you might consider for labor itself. I disagree with Spatafora that all moms-to-be need to "not only create but expertly write out" their "new context" for birthing so that everyone knows exactly what they want and I also don't think that partners must be "completely aligned" in order to get the birth you want. I do, however, think that planning for and consciously considering the available options, the possible constraints on those options, and the ideals for you birth are really helpful exercises. Her lists of questions about what you might or might not want for you birth are more comprehensive than I might consider necessary, but they provide a foundation for considering what you do or do not care about planning out in advance of your labor and birth.

As well, in this text Spatafora also describes what hospitals, birth centers, home births, OBs, midwives, and doulas have to offer, giving parents a clear perspective about the choices in childbirth they can make and how those choices impact the options available and the types of care they will receive. She includes lists such what to pack in your birth bag for the hospital, foods to consider having on hand for after the birth, things she wishes she had known before, and a list of what to buy for your baby. Like all of these sorts of lists, parents should take from them what is useful for themselves and not consider them as blueprints for parenting. I don't agree, for example, that a crib, breastpump, bottles, stroller, highchair, two diaper bags, and a baby rocking chair are necessarily essential parenting gear that should be purchased by all. Instead, I typically encourage parents to state with the basic (clothing, a blanket for swaddling, some diapers, a sling or carrier of some sort, and a car seat) and then expand from there as they get to know their child and their child's needs.

Spatafora's new book, Better Birth, is a comprehensive text for new parents, covering all the basics about choices in childbirth, the processes in the body, techniques for labor, and preparing for a new baby, and as such, I think it is wonderful to have this new resource. Her own lovely homebirths are available as videos on her website and I think her preference for homebirths and midwifery models of care are apparent throughout the book. Her book reads to me like a self-help manual, with incredible focus on using pregnancy as a time for emotional and spiritual growth, and it might not surprise readers to know that this is not typically my style. That said, I support women and their partners through childbirth who come from a wide range of perspectives and who draw on the gamut of tools through their pregnancy, labor, and postpartum period and I do so without judgment about the types of support needed or the approaches taken for enjoying pregnancy, coping with childbirth, and adjusting in the postpartum period. For many women, this book might be incredibly useful, providing insights and options from conception and throughout the first year and for others, it might not be a good match for their personality or needs.

I think as birth professionals, we always walk a fine line between giving women information and tools that might be helpful and burdening people with guilt or unneeded pressure. It is not uncommon in my practice for women to worry that the stress they feel or their emotional state is having a negative impact on their baby. They have read and heard that they need to be relaxed, peaceful, clam, and filled with joy in order to have a healthy baby and a satisfying birth. And yet, I have been in prenatal appointments with women in tears, with partners who are fighting, and recently, in a house with a ceiling that had collapsed. These women all have beautiful, satisfying births and happy, healthy babies despite fears that their emotional states might wreck them. So, to the extent that this book empowers women to take control of their pregnancies and birth experiences, making choices that work for them and building trust in their bodies and in their birth partners, I applaud it. For women who are draw to books about personal growth, mind-body connection, and emotional and spiritual exploration, I think it is a wonderful match. Like all things in life, what works for some people is not the right answer for all people and the availability of options is key - thanks Denise for giving us one more option!

Picking up from where I left off in the last entry ...

I came home and snuggled with my kids. My older son likes to hear about the births I attend, so I tell him the stories and he, sweetly, always offers congrats on a job well done. We put on PJs early and watched a movie together in bed, with me half asleep but managing to laugh at a few of the jokes. I went to bed early that night with the news that my client had lost her mucus plug and was starting to have regular contractions again. Although I thought I might be woken during the night, the call never came. At 7 am I recieved a text message letting me know that contractions continued but were short and managable. My client was in high spirits and told me she was "feeling groovey". We chcked in throughout the day and while labor continued to progress, it remained slow and managable into the evening.

At 10pm my phone rang and her husband asked if I could come to help them. Ten minutes later I was in a car on my way to their home with insturctions to stop at the nearby corner store for firewood if possible. I had the driver wait while I oicked up to bundles of wood to keep the fireplace filled for as long as she continued to want to labor there. I arrived shortly after, entering the warmth of a beautiful birthing setting.

These clients were not moving to a hospital, but rather had chooses a homebirth with Miriam and had prepared their home as such. Candles made for a soft glow and the fireplace made the house warm and welcoming. Upstairs, a birthing tub had been inflated at the foot of their bed and waited to be filled with warm water when the time came. My client was enjoying sitting in front of the fire, softly gazing into the flames and being held by her husband through the contractions. She was focused and solid, enjoying the sensations and feeling pleasure in the process of birthing. She remarked with curiosity about the feelings of the contractions and was excited to give birth.

Her birth was an intimate and moving experience. Her husband stayed connected to her, their love for each other so apparent as they cuddled and swayed through contractions first near the fireplace and later in bed. As the contractions built in intensity, we filled the tub with warm water. When she began to move increasingly inward and voiced a desire to be in the tub, I went downstairs and called her midwife to let her know it was time to join us. It was just after 1 am and the baby was on her way.

My client got into the tub and immediately remarked that it was amazingly relaxing and that she had no idea how good it would feel for her to be in there. She was relaxed and ready to continue facing her contractons as they grew stronger and longer. Her midwife rang the bell 15 minutes later and I helped her in the door with her equiptment and an update. She was calm and confident, never checking the laboring woman or instructing her but rather just observing the process and joining in the support team and we talked her through and eased any discomforts with cool cloths and drinks.

By 2am the contractions were turing to pushing and Miriam told my client to reach down and check for the baby. She initially said that she could not feel her but then she felt again with instructions and was able to touch her daughters head inside of herself. The contraions continued and quickly moved into forceful "throwing down", which her body pushing her baby out. She moved from a supported position on her back, resting in her husband's arms, to her side and then around onto her knees before pushing her baby out into her arms.

Her daughter emerged from the warm water just after 3am and she guided her up between her legs and into her arms. She and her husband smiled and cried with joy as they held her and examined her for the first time. It was so affirming and powerful to be in the presence of this woman while she birthed her baby and I came home 3 hours later feeling high. Two VBACs in two days, two beautiful little girls welcomed into the world with so much love, two amazingly strong mothers who got the experience of "birth working" after having c-sections with their first babies.

I love my job :) The third birth, another homebirth but this one to a pair of first time parents, will have to wait and I am tired and needing sleep.  To be continued again ...

I had a fabulous week last week. It started with a 3am phone call early on Thursday morning. A client of mine, who was nearly 41 weeks had been laboring on and off for days, was the person I expected to be receiving a call from but I was pleasantly surprised to see another name appear on my phone display that morning. My client told me for to hours she had been laboring with increased intensity and she want to check in with me. I could here the mixture of excitement and intensity in her voice and knew that this would be her birth day. We talked about her eating something and waking her husband to labor together and she told me she would call back when they needed me. As dawn rolled around, I got another call and by 6am I was in a car on my way to South Slope for a birth.

When I arrived, my client's water had just broken onto their living room floor. She was half clothed and feeling stronger contractions that required her to stop and have pressure applied to her hips and lower back. She was breathing into them but the edge of fear was creeping into her sounds as they raised in pitch during the peak of her contractions. We spoke softly in the dim light of her kitchen and fell into a rhythm as she worked through the contractions. She called her doctor to let her know that the water had broken and was instructed to come to the hospital. We knew that this would be the case - my client was having her second baby, a VBAC after the first was born by c-section after an attempted induction at 36.5 weeks. She knew that her doctor would want to monitor her closely and agreed that we would come soon.

Her daughter woke up and came downstairs with sleepy eyes and wild hair. She looked at her laboring mother with curiosity but seemed satisfied with the explanation that the baby was coming and her mom was helping the baby out. She asked her father to read her a story, which he did while getting the bags ready and preparing for the babysitter they had arranged. When the sitter arrived, my client was feeling very ready to go to the hospital, so we walked out into the cold, snowy morning and climbed into the back of their Jeep for the trip into Manhattan.

As we traveled through the Brooklyn-Battery Tunnel, my client on all fours turned with her face looking out the rear of the vehicle, my hands on her hips through each contraction, I reflected that I seem to only ever go through this tunnel with women in active labor. Because it is not the best way to get from my home to or from Manhattan, I rarely take it. As we entered the tunnel, I saw flashes of traveling through the tunnel with so many other women in the last few months who were laboring in the back of cabs or cars just as she was.

After we arrived at the hospital, we made it into triage and she continued to labor beautifully - asserting what she needed from the staff and continuing to remain focused on working through each contraction. We spent a few hours laboring in triage while they worked on freeing a room for her - moving between the bed and the bathroom, standing, squatting, and on the bed on all fours. She moved through her contractions and by 11 am she was nearly 9 cms and finally getting into a labor room for her birth.

Just after 2pm she pushed a beautiful little girl into the world, greeting her with gasps of joy and the teary eyes of a father who watched his first vaginal birth with amazement. It was an incredible moment of triumph - helping this family to get the birth that they wanted in a legal-climate that makes VBACs increasingly difficult in hospital settings. When I hailed a cab a few hours later I was feeling such joy at the victory this birth had been for my client.

While traveling back down the West Side Highway towards Brooklyn, I called the client who I had initially though would have been the one waking me early that morning. She said she continued to feel some contractions on and off and her spirits were good. She sounded bubbly and light, laughing and joking with me about errands she had been on that day. I told her about the VBAC I had just come from - news she welcomed as she was also planning for a VBAC and felt bolstered by that afternoons sucess story. She warned me to go home and get some sleep because she would be calling me soon!

(To Be Continued ..)

I woke up Saturday morning with a phone call from a client who thought she might be in labor. She suggested she had been feeling off all night but could not really say she was having regular contractions of clear signs of labor. Within an hour things started to become more clear and by 10:30 I was headed to their house. This mother was laboring so sweetly and making really funny jokes between and even during contractions. After less than an hour of being with her through contractions we left for the hospital. It turned out to be a slightly longer than expected drive with traffic and this was miserable for the mother. She was laboring amazingly and handling her contractions so solidly. But being stuck on the West Side Highway is an awful fate for any laboring woman and I offer silent prayers to the traffic gods to clear the roads for us quickly.

After getting by some construction 15 blocks north of us we sailed the rest of the way to SLR. They called her 7cm at arrival but she was clearly in transition and within 30 minutes she was feeling the urge to push. With no OB there yet the staff was a bit overwhelmed and asked if she could just hold off on pushing (yeah right). By 1:15 a new little girl was in the breathing world, born to two incredibly sweet parents who clearly adore each other and their new baby. I went and saw them yesterday and felt really lucky to have known them and helped them in this special time of their lives. 

A couple of days ago my client went into the hospital for a test at 41 weeks and they found low fluid. She was rehydrated but an induction was on the table at this point with the low fluids and favorable cervical conditions. Our first conversation ever had included her telling me that an induction was her nightmare, something she never wanted to have happen. I was so concerned for her during the day, worrying that she would not get the birth she had wanted. But, she fought for it and won. They let her leave the hospital and we talked from her home that night. I told her I hoped she would call in the middle of the night in labor after really enjoying her evening and then she did! 

Early this morning I attended the birth of a little girl who comes into the world with two big brothers. Her parents were thrilled to meet her, so muich so that dad began looking weak and needed to have a seat. it reminded me of my own birth experience. With my first son, a friend had come to the birth along with my mother. When August's head (but not his body) had come out, she passed out onto the floor. With everyone looking at the emerging baby, I was the only one who noticed her going down and so I waving at everyone to get their attention to help her. My husband always said that the spirit had entered her when August came into the world. And so, early this morning, I was reminded of that moment and of the power of seeing a baby enter the breathing world, as this father of three became weak at the sight of his beautiful baby girl. His wife had labored quickly and beautifully, and she pushed the baby out in about 8 minutes. 

Yesterday I attended the birth of a beautiful almost 9 pound baby boy who entered the breathing world at 7:24 pm. He has an amazingly cute little round face and bright attentive eyes. His mom called me after midnight in early labor and at 3:30 am I headed over the her house. She was laboring really beautifully and we went into her beadroom with the lights low to try for some restful laboring to conserve her energy for later. By 5 am the contractions were really picking up and the cab ride into the city was very hard for her. When we arrived she was 5 cm and requested an epidural for the pain. She went from 5 cm up to 9 cm within the first few hours of being at this hospital but then things calmed down. Repeated vaginal exams showed a 9-91/2 cm resting place for nearly 8 hours and they administered Pit, which initially did nothing to change her dialation. But then, as the OB was beginning to suggest a c-section might be needed for failure to progress, her body began responding with stronger and stronger contractions and we got her up right for some dancing to shift the baby around and bring him down the birth canal. This quickly brought on that uncomfortable pressure and the feeling of needing to use the bathroom and within minutes she was ready to push. 

When I was more heavily involved in my academic pursuits, I wrote a paper about reproduction and procreation that argued that the facts of life needed to be more thoroughly investigated as our understandings of procreation and reproduction are saturated with cultural meanings including gendered politics and ideologies about sex difference and sexualities. In that paper I stated that procreation and reproduction hold a unique place in Western constructions of kinship, gender, and sexuality: central to bio-gentic notions of kinship, embedded in and naturalizing a binary of sexed bodies (and therefore gender), and marking off 'natural sex' (coitus) and (hetero)sexuality from 'unnatural' and deviant forms. Given this power, I agrued that anthropologists engaged in denaturalizing projects were repeatedly identifying cultural conceptualizations of procreation and reproduction as productive of the naturalized beliefs that they were seeking to challenege. This repeated stumbling upon our understandings of the 'facts of liffe' was circumscribing their analytical efforts and as such, limiting the scope of their theorectical interventions. Calling into question the stability and naturalness of these processes and constructing alternative visions of each was the goal of my analysis in that essay. 

My last birth was an epic one with days of labor and slow progression but an amazingly strong mama who birthed a big healthy baby! Early this morning I attended a quick birth. I had thought that last night would be a perfect night for my client to give birth (avoiding a non-stress test and such). I layed out all my things assuming she would call and then at 1 am when she did, I was so happy to hear from her! Water had broken and she was starting to feel contractions. I went over within an hour and things were going quickly. Within 45 minutes we decided to head into the hospital since she was planning to birth about 25 minutes by car away (in good traffic, which thankfully we had!). By the end of the car ride her contractions were shifting towards pushing contractions and I was hearing the small grunting sounds that often accompany this shift.