I'm going to dive into this potentially very thorny topic. Birth and the God thing.
Pregnant women have an aura about them. Their sensitivity is all over their beautiful bodies. Their specialness could be called sacred. The moment of birth is unique in its power. It demands honor and respect, and also awe. You might call it a moment of holiness. For many, feeling this truth leads directly to their faith, a specific faith, and for many it does not. The power, the holiness the awe, the sacredness of it all are real whether you are believer (Christian, Jewish, Muslim, Hindu, Wiccan, Zoroastan) or an atheist.
So, when a client asks me about my faith, my beliefs, I answer. But I do not like the question. This is not only because this question for me is very personal, at least as personal as my political opinions, but more because the client usually wants to gauge my sensitivity to the spiritual aspects of birth, and I do not think that religious belief and being in tune with the spiritual are necessarily connected. Does not an atheist woman sense equally the power of the moment of the birth of her child as the woman of strongly held religious belief? Of course.
I respect the power of giving birth and I respect the women giving birth enough to know this.
Thursday, February 18, 2010
Sunday, January 3, 2010
Getting through a transport
If this is a truthful blog about Dinah's Days and Nights, gotta talk about transports. Transports are shit. Transports are really hard. Transports have to happen.
Last week, a first time mother, (and yes, it is usually a first time mother or a VBAC) labored the way first time mothers labor..... A couple of nights of irritating contractions keeping her from resting well, phone conversations and suggestions about ways to get through it and then a meeting at midnight at the birth center. On the phone things sounded good..... she was not exhausted, contractions were consistent, low down in her belly and she sounded like she was coping well. She arrived with her husband, excited and rolling withthe labor..... looking good. I examined her. Cervix completely effaced, 0 station and 3 cms dilated. A nice little bulgey bag of water and baby in a perfect left occiput anterior position....... couldn't be better. 3 cms at midnight, mmmmm. I really wanted her to rest because clearly there would be a lot of work ahead. She lived 40 minutes away. I didn't really want her to drive there and back again in labor, but I've made the mistake too many times before of keeping a 3cm laboring mom at the birth center. Frequent result: exhaustion despite best efforts. C and her hub were happy to head home with a bottle of skullcap and some rest ideas. I went home to rest myself (in theory). Of course with a mom in early labor and menopause plaguing with its nighttime habits, I didn't sleep.
At 4 o'clock, the expected call came. I could hear C in the background loudly moaning and I hopped into the car. She sounded hot and heavy. I ran into the birth center thinking "I knew this was going well" and filled the tub. She was going to arrive almost in transition and would need the water right away....... But you know the end of this story so you know that is not what happened. In she came huffing and hollering........... "Aaaaaah I can't I can't this huuuuuurts" More mmmmmmm. Not good. Birthing a baby requires the "Bring it on" attitude not the "I can't it hurts" attitude.
I checked her: Completely effaced, 0 station and....... still 3 cms with NO bulgey bag of water...... So if you've been to a few births you know what had happened.... yes, water broke on the way home and baby turned posterior....... Oh lordie. This kind of deal requires huge stamina: Mother stamina, spouse stamina, midwife stamina.,.... and it requires motivation: mother motivation, spouse motivation, midwife motivation. So we worked VERY HARD. We worked on motivation. We worked on stamina and we worked on rolling that baby to the front. All of us worked very hard. Knee chest push that baby up and encourage her to turn. Lunge with the left leg. Lunge with the right leg. Dance with the hips rolling. Walk up and down the stairs. Pulsatilla. Aconite. Gelsemium. All these had their parts to play. From 6am to noon C progressed from 4cms to 5 cms and this was not looking good.
When it was time to go, C cried, her huband cried and off we went. At the hospital, wires, tubes and more tears. I stayed at her side in the hospital till at 4pm she got an epidural and it was time to rest. Home discouraged, disappointed, exhausted. That's transports.
After a transport it is easy to self blame, to feel that you are the only midwife who gets transports; that another midwife could have done differently, better; to feel guilty.I know that it is right to think through what happens after every birth whatever the outcome, but especially the transports: How did that happen? What can I learn from this? But at the end of the day, a midwife can't go on if she blames herself. In fact there is something egotistical about self-blame, like the midwife is the center of everything that happens. I must remember that I have a part in the birth story but I am not the cause of most things that happen at a birth.
Being a midwife involves learning to live with transports.
By the way, by 3am, C was still at 8 cms and ended up with a C-section. She, her husband, and her baby, are doing OK.
Last week, a first time mother, (and yes, it is usually a first time mother or a VBAC) labored the way first time mothers labor..... A couple of nights of irritating contractions keeping her from resting well, phone conversations and suggestions about ways to get through it and then a meeting at midnight at the birth center. On the phone things sounded good..... she was not exhausted, contractions were consistent, low down in her belly and she sounded like she was coping well. She arrived with her husband, excited and rolling withthe labor..... looking good. I examined her. Cervix completely effaced, 0 station and 3 cms dilated. A nice little bulgey bag of water and baby in a perfect left occiput anterior position....... couldn't be better. 3 cms at midnight, mmmmm. I really wanted her to rest because clearly there would be a lot of work ahead. She lived 40 minutes away. I didn't really want her to drive there and back again in labor, but I've made the mistake too many times before of keeping a 3cm laboring mom at the birth center. Frequent result: exhaustion despite best efforts. C and her hub were happy to head home with a bottle of skullcap and some rest ideas. I went home to rest myself (in theory). Of course with a mom in early labor and menopause plaguing with its nighttime habits, I didn't sleep.
At 4 o'clock, the expected call came. I could hear C in the background loudly moaning and I hopped into the car. She sounded hot and heavy. I ran into the birth center thinking "I knew this was going well" and filled the tub. She was going to arrive almost in transition and would need the water right away....... But you know the end of this story so you know that is not what happened. In she came huffing and hollering........... "Aaaaaah I can't I can't this huuuuuurts" More mmmmmmm. Not good. Birthing a baby requires the "Bring it on" attitude not the "I can't it hurts" attitude.
I checked her: Completely effaced, 0 station and....... still 3 cms with NO bulgey bag of water...... So if you've been to a few births you know what had happened.... yes, water broke on the way home and baby turned posterior....... Oh lordie. This kind of deal requires huge stamina: Mother stamina, spouse stamina, midwife stamina.,.... and it requires motivation: mother motivation, spouse motivation, midwife motivation. So we worked VERY HARD. We worked on motivation. We worked on stamina and we worked on rolling that baby to the front. All of us worked very hard. Knee chest push that baby up and encourage her to turn. Lunge with the left leg. Lunge with the right leg. Dance with the hips rolling. Walk up and down the stairs. Pulsatilla. Aconite. Gelsemium. All these had their parts to play. From 6am to noon C progressed from 4cms to 5 cms and this was not looking good.
When it was time to go, C cried, her huband cried and off we went. At the hospital, wires, tubes and more tears. I stayed at her side in the hospital till at 4pm she got an epidural and it was time to rest. Home discouraged, disappointed, exhausted. That's transports.
After a transport it is easy to self blame, to feel that you are the only midwife who gets transports; that another midwife could have done differently, better; to feel guilty.I know that it is right to think through what happens after every birth whatever the outcome, but especially the transports: How did that happen? What can I learn from this? But at the end of the day, a midwife can't go on if she blames herself. In fact there is something egotistical about self-blame, like the midwife is the center of everything that happens. I must remember that I have a part in the birth story but I am not the cause of most things that happen at a birth.
Being a midwife involves learning to live with transports.
By the way, by 3am, C was still at 8 cms and ended up with a C-section. She, her husband, and her baby, are doing OK.
Sunday, December 13, 2009
A good night's work
J's first baby was a typical first birth in many ways: It was long and tiring and hard work. But after 30 hours (about 10 hours of active labor) Her baby son slid happily into the hands of his mother, father and midwife. Beautiful, rewarding, just the way it was meant to be.
After he was snuggled up and nursing well, we awaited the placenta. After thirty minutes no placenta. No worry. No bleeding. We tried a little pitocin then a little "Placenta Out" herbal tincture. No placenta. After an hour no bleeding and no placenta, we tried a little caulophyllum homeopathic remedy. No bleeding and no placenta. More breastfeeding, more patience, and when there was no placenta after 2 hours we went to the hospital.
The Doctor was very excited and called in the Maternal Fetal Medicine specialists for a consult. They warned J that she may bleed profusely as they attempted to extract the placenta, and that she may need a hysterectomy. Everybody cried a lot and was very anxious. The Doctor did his work and went in to manually extract the placenta. .... And it came out just fine! ("Very hard to extract", he said. Whatever,... it came out no bleeding, just fine) "You should not have another baby outside the hospital he said. This could repeat. You may be less lucky next time"
J and I heard and we were not sure what to think.
2 years later, she was in my office pregnant again. "What do you think?" 2 years had passed. I was feeling mellow that day. "Let's go for it" I said.
On Wednesday evening J called me at 9:45 in the evening "I've had half an hour of contractions, not too strong, every 10 to 15 minutes.... I think it's going to happen". I suggested we both try and get some rest. At 1:15am my phone rang. It was J's mom "Her contractions are 4 minutes apart and her water just broke. Water breaking in a multip..... often a sign that there's no time to lose. I jump in the car and off to Irving. I was so sure that things were moving fast that when J's mom opened the door to me at 1:50am I said "Is the baby out?" "No!" she said "If it were I'd be lying on the floor" (I'm not sure what she meant by that) but anyway I went into the bathroom where J was sitting on the toilet having a GINORMOUS contraction... "Ooooh" I thought, "The baby's going to come out right here in the bathroom VERY soon" So I lugged my stuff along the hallway so I'd be ready for the birth. Meanwhile J stood up and went "Uuuuuugh..... I'm pushing" As she said this she walked through to the living room and stood in the middle of the carpet in front of the big screen TV. Her mom, ever resourceful, grabbed a large tarp and threw it on the floor. J's husband (J2) was lying in bed with J3 trying to keep him asleep. J's mom ran in to get him up "She's pushing" He rubbed his eyes, walked in saying "What can I do?" "Look, can you see the head?"I said. J stood powerfully in the center of the living room and baby O slipped out. She sat down and J and J2 welcomed her into the world. 10 minutes later the placenta let go and slid out followed by a drop of blood the size of a half dollar.
A good night's work J
After he was snuggled up and nursing well, we awaited the placenta. After thirty minutes no placenta. No worry. No bleeding. We tried a little pitocin then a little "Placenta Out" herbal tincture. No placenta. After an hour no bleeding and no placenta, we tried a little caulophyllum homeopathic remedy. No bleeding and no placenta. More breastfeeding, more patience, and when there was no placenta after 2 hours we went to the hospital.
The Doctor was very excited and called in the Maternal Fetal Medicine specialists for a consult. They warned J that she may bleed profusely as they attempted to extract the placenta, and that she may need a hysterectomy. Everybody cried a lot and was very anxious. The Doctor did his work and went in to manually extract the placenta. .... And it came out just fine! ("Very hard to extract", he said. Whatever,... it came out no bleeding, just fine) "You should not have another baby outside the hospital he said. This could repeat. You may be less lucky next time"
J and I heard and we were not sure what to think.
2 years later, she was in my office pregnant again. "What do you think?" 2 years had passed. I was feeling mellow that day. "Let's go for it" I said.
On Wednesday evening J called me at 9:45 in the evening "I've had half an hour of contractions, not too strong, every 10 to 15 minutes.... I think it's going to happen". I suggested we both try and get some rest. At 1:15am my phone rang. It was J's mom "Her contractions are 4 minutes apart and her water just broke. Water breaking in a multip..... often a sign that there's no time to lose. I jump in the car and off to Irving. I was so sure that things were moving fast that when J's mom opened the door to me at 1:50am I said "Is the baby out?" "No!" she said "If it were I'd be lying on the floor" (I'm not sure what she meant by that) but anyway I went into the bathroom where J was sitting on the toilet having a GINORMOUS contraction... "Ooooh" I thought, "The baby's going to come out right here in the bathroom VERY soon" So I lugged my stuff along the hallway so I'd be ready for the birth. Meanwhile J stood up and went "Uuuuuugh..... I'm pushing" As she said this she walked through to the living room and stood in the middle of the carpet in front of the big screen TV. Her mom, ever resourceful, grabbed a large tarp and threw it on the floor. J's husband (J2) was lying in bed with J3 trying to keep him asleep. J's mom ran in to get him up "She's pushing" He rubbed his eyes, walked in saying "What can I do?" "Look, can you see the head?"I said. J stood powerfully in the center of the living room and baby O slipped out. She sat down and J and J2 welcomed her into the world. 10 minutes later the placenta let go and slid out followed by a drop of blood the size of a half dollar.
A good night's work J
Wednesday, September 16, 2009
miraculous birthing bodies
Women who let their bodies do what they need to do have amazing and sometimes surprising birth experiences. A big tall mamma birthing a few days ago: She moved around the birth room eventually getting herself into what seemed like a counter-intuitive leaning backwards squat. After watching her for about 15 minutes, I said"That looks uncomfortable. Try your hands and knees." She did. The water broke and her baby was out in a few minutes. Imagine my surprise when a beautiful, flexible birthing goddess type mamma a couple of nights later got into that same backwards leaning pose, not once, but repeatedly. She even did a few yoga crab moves (she really was a bit of a birth yogi), pushing upwards and backwards onto her hands from a seated posture with her belly in the air.... Then she squatted and the baby came out....fabulous.... Love it
Saturday, September 12, 2009
A sandwich is an opportunity
Pregnancy is about opportunity. A client tells me about her lunch sandwich: A piece of processed turkey with some mayonnaise on some ...er... bread..... A missed opportunity! Then I hear of a sort of salad with some lettuce, olives, croutons, grated cheese and ranch dressing. A missed opportunity! What about that weird dream she had last night? "My brothers are teasing me and I wake up really scared and in tears. That was strange. I don't think about my brothers too much", and she gets up and goes to work without thinking any more about it. And here we have another wonderful missed opportunity.
A pregnant woman cares intensely about her unborn child. It gets all her nourishing juices flowing. If, up until this pregnancy, she hasn't taken the opportunities that life offers to nourish herself, being pregnant is a powerful opportunity. In her journey of self-discovery that is pregnancy she can add interesting new ingredients to her sandwich: What about avocado, sprouts, radish, humus, even a scrambled egg in there between those pieces of crusty, grainy stuff....? What a pleasure. And what could she put in that salad bowl? Cabbage might be good, why not? And jicama, she could give that a try. And how about celery and sweet red pepper, tiny juicy tomatoes, pine nuts, green and red onion, and a little basil, all dressed with olive oil, a squeeze of lemon and some balsamic vinegar? Doesn't that inspire you to go into the kitchen right now and create something tasty?
And what about that dream? Let's not dismiss it. Maybe she can tease out for herself her subconscious message. You don't need a degree in psychology or a year on the couch to ask some simple questions of yourself. Go past the immediate facts of the dream to its meaning in the feelings that it evokes. What is it the feeling of the place in which this is happening? What does that intense feeling when you are being teased remind you of? Does it remind you of another time and place? What would make you think of those feelings now? How does that help you to use this opportunity in your pregnancy for greater self-knowledge and ultimately to be the best mother that you can be? How will talking about these feelings and understanding them help you to deepen your relationship with your spouse and thus work better as a team to parent your child?
Every occasion from the sandwich and the salad to your dream last night, is an opportunity. In pregnancy this is especially true because it is a time of change, and therefore a time when women are open to all kinds of new experiences. Don't miss the opportunity!
A pregnant woman cares intensely about her unborn child. It gets all her nourishing juices flowing. If, up until this pregnancy, she hasn't taken the opportunities that life offers to nourish herself, being pregnant is a powerful opportunity. In her journey of self-discovery that is pregnancy she can add interesting new ingredients to her sandwich: What about avocado, sprouts, radish, humus, even a scrambled egg in there between those pieces of crusty, grainy stuff....? What a pleasure. And what could she put in that salad bowl? Cabbage might be good, why not? And jicama, she could give that a try. And how about celery and sweet red pepper, tiny juicy tomatoes, pine nuts, green and red onion, and a little basil, all dressed with olive oil, a squeeze of lemon and some balsamic vinegar? Doesn't that inspire you to go into the kitchen right now and create something tasty?
And what about that dream? Let's not dismiss it. Maybe she can tease out for herself her subconscious message. You don't need a degree in psychology or a year on the couch to ask some simple questions of yourself. Go past the immediate facts of the dream to its meaning in the feelings that it evokes. What is it the feeling of the place in which this is happening? What does that intense feeling when you are being teased remind you of? Does it remind you of another time and place? What would make you think of those feelings now? How does that help you to use this opportunity in your pregnancy for greater self-knowledge and ultimately to be the best mother that you can be? How will talking about these feelings and understanding them help you to deepen your relationship with your spouse and thus work better as a team to parent your child?
Every occasion from the sandwich and the salad to your dream last night, is an opportunity. In pregnancy this is especially true because it is a time of change, and therefore a time when women are open to all kinds of new experiences. Don't miss the opportunity!
Saturday, September 5, 2009
the midwifery sisterhood
To be a midwife is to be part of a different world. The life is intense. Pregnancy and birth are so powerful. As a midwife I experience that power often. I go home and shop and cook and talk about school, kids, money, daily ups and downs; but all the time, I have another life, a life of pregnancy and birth in which there is no mundane, it is all significant and powerful. The only people who share that contrast of daily grind interspersed with the immense pressure, responsibility and pleasure of attending births, are my midwife sisters. So, to go out with another midwife for lunch, as I did the other day, is special and wonderful. We ate Thai food. We talked about mundane things. We laughed about menopause, and we hoped that we are aging with wisdom and pleasure.
Wednesday, September 2, 2009
same old depressing story
At her first appointment E told me about the day that she went into her OB's office at 38 weeks along in her last pregnancy. "I'm uncomfortable", she complained, as women who are in their last few weeks typically complain. But E didn't know the way an obstetrician's mind works..... Complaining is his opportunity to act on your body at his convenience.... BEWARE. Her obstetrician smiled sweetly: "Another sucker", he thought. "I can fit her in on Tuesday afternoon and then I'll able to make the gala dinner that the pharmaceutical company is throwing in the evening". So he said, "Your baby is big enough" (whatever that means), "Why don't we induce labor on Tuesday morning?" "OK" said E, clueless and trusting. So he started with cytotec and went on with pitocin and within a short time there was an alarming dip in the baby's heart rate: "Let's put you on your right side....er....maybe not, let's try your left.....er.....ooops, I guess we'd better cut you RIGHT NOW" and so he did. Thank goodness he acted quickly and saved the baby's life. I suppose she'll have to be cut for all her babies now, "You don't mind that do you?"
The baby was fed bottles in the nursery and never got the breastfeeding thing.
Sometimes I'm angry. Today I was just sad.
The baby was fed bottles in the nursery and never got the breastfeeding thing.
Sometimes I'm angry. Today I was just sad.
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