Cool Stamps

I wish I had an excuse to buy American postage stamps.

These stamps created by the American College of Nurse-Midwives are beautiful.

What a fabulous way to increase awareness of the midwifery option for childbirth.

October's Birth story

After taking the summer off for vacationing. I am now again attending births and have stories to share again:

Five day's before her due date, Mom calls to let me know that she has been having cramps every 10 minutes for the last several hours. It is early in the morning so she decides to try to sleep, a great plan I agree. The day passes with minor but consistent cramping. Mom catches up on lost sleep and ensures that she eats as she desires. Around 6 pm Dad calls to report that contractions have been coming every 5 minutes for the last 45 minutes and most of them last a minute in duration. I can hear Mom in the back ground and she doesn't sound like she is coping particularly well at this point. I decide it will be best if I go over to see this couple and spend some time with Mom helping her wrap her head around these "real" contractions. Mom has spontaneously decided that kneeling with her forearms on the floor with her head low is the most comfortable position. I have easy access to Mom's lower back and start rubbing smoothly with a moderate firmness across the place where her hips and sacrum join. I model to Mom how to breath slowly with each surge and soon she is coping exceptionally well. We quickly realize that he contractions become noticeably more intense and close together when she needs to urinate. So we ensure she empties her bladder every 30 -60 minutes which also ensures that she does some moving around periodically too. Around 10:00 pm Mom is becoming tired and finds that she is able to lay on her side both during and between contractions and practically falls asleep during the 4 minute breaks. I continue to rub across Mom's low back with arnica oil during each surge. Around 10:30 pm mom is starting to feel that labour is getting to be too hard. Dad helps her run a bath and I can hear her toying with the idea of going to the hospital for morphine. Contractions are lasting nearly 1.5 minutes and coming every 3 minutes. After the bath I give Mom and Dad some privacy but find it difficult to hear when she is having a contraction. I wonder if maybe they are spacing out a bit. It is not unusual for the body to do this and allow the mom to rest for a bit. Dad soon comes out and expresses his concern that contractions are getting really close and getting very intense. Sure enough I time about 4 contractions which last 1.5 minutes and come every 2.5 minutes. I suggest that now would be a good time to move to the hospital. At 2:30 am Mom is admitted to the hospital essentially fully dilated except for a small lip of cervix at the back of the baby's head. Once Mom is moved to a bed in the Labour and Delivery room she has a powerful surge that releases her membranes and sprays the intern, it's hard not to laugh! Mom soon feels the urge to push. She spends some time on her hands and knees, which is the position she's found most comfortable through the majority of labour. A nice bit of time pushing on the toilet brings the baby past her pubic bone and all that is left is the last few millimeters of vagina to pass. A bit more pushing in a side lying position and at 5am a baby boy enters this world weighing 9 lbs.

This is the way to have a baby in a hospital! Do all your labouring in the comfort of your own home and go to the hospital to give birth. I have adapted a colleagues' suggestion to her clients and now tell my clients that there are 3 reason to go to the hospital:
1) you are ready to give birth to a baby
2) you need a change of environment and the hospital is the place you need to be psychologically
3) you have changed your mind about pain medication and wish to make use of pharmacological pain relief

Funded Midwifery in Alberta

I feel as if I may be dreaming!!! After many long years of lobbying the provincial government to fund midwifery service, it has finally happened.

Today a press release has announced that families who choose midwifery services will have those services covered.

Come April 2009, women in our province will finally have more real choices in maternity care.

I am SOOOOOO happy!

Calm Birth Story

At 4 pm Mom calls me to let me know that they are heading into the hospital with regular contractions. Her house is full of in-laws and young children, she hasn't worried herself with timing these contractions - she knows they're "real". She feels it's a little early for the hospital, but wants the private space to get into labour. I meet the couple at the hospital at 5:30, where they have a long wait to be assessed. Mom puts on her hypnosis CD and relaxes into a calm state of peace as she comfortably sits in a lounging chair. Dad and I pass the time in the hall reading and chatting - we wish to respect Mom's need for privacy. At 6:15, the midwife assesses Mom and finds her to be 4 cm dilated, but the contractions are a bit more spaced out. We decide to take a walk to a near-by restaurant for dinner. Our walk is occasionally slightly slower as Mom walks through each contraction. I doubt out waitress recognizes the imperceivable shift in Mom's attention as she turns inward for each contraction. Even I barely notice the subtle change in her breath as she releases to the work of her body. We return to the hospital where Mom again wishes to escape into the privacy of her room listening to her hypnosis CD. I ensure she has anything she might need ( especially water) and help set the atmosphere of the room a bit by dimming the lights. Around 8:30 pm Mom pops out into the hall and suggests that she'd like the tub if it's OK. We get a nurse's go ahead and start filling the large jacuzzi up. Mom is 7 cm dilated and the nurse and I marvel at the fact that neither one of us can tell that she isn't just taking a rest! WOW. I finally realize, as I sit in silent support of the mom, that I can recognize a contraction by watching the powerful lifting of her uterus. This is my only cue that she is in labour. Every 3 minutes I watch her abdomen tighten, squeeze and rise upwards. But Mom's breath remains slow and regular. She makes no noise; her body doesn't move. No other muscles tighten. After a minute or more you can see the powerful muscle relax again and still mom stays the same. She is floating in her watery cradle just as her baby is still held by the waters of her womb. Dad and I keep the pool temperature comfortable. Dad offers his body in the tub to help support his wife as she completely relaxes. We keep her drinking bottle close by and ensure her hypnosis track is running smoothly. This Mom is without a doubt the calmest women I had ever been honoured to attend in labour.

As midnight rolls around you can sense Moms slight edge of concern. Not worry, more curious wondering, “Why hasn't this baby come yet?” Have we slowed things down by getting in the pool? Mom decides that she wants out of the tub, and that a shower may be a nice alternative.

Dad sits on a stool across from Mom as she sits and leans against his body. She's slightly more vocal now and we sense that her urge to bear down has begun. The hard floor of a shower is not the place she wishes to deliver her baby and she is anxious that he will fall. No amount of blankets beneath her and reassurance can sway that maternal instinct to protect. The midwife finds a small anterior lip of cervix which she tries to push past baby's head. Accidentally, she ruptures the membranes, releasing clear amniotic fluid. The mom decides to move and has one powerful surge as she walks towards the bed. For the first time she cries out with the contraction. The next surge brings her to her knees at the foot of the bed and she roars like a lioness, like a goddess of creation! Her baby is crowning. The next moment at 12:32 in the morning, he is born pink and beautiful, peaceful, calm. Is it any surprise he is so calm? I have never seen a babe nurse like such a champ. I left an hour after he was born and he hadn't moved from his mothers breast, nor had he cried. This birth was perfection.

The birth of a baby is always a joy. Regardless of the specific circumstances of the labour; every mother is utterly delighted to hold her child in her arms for the first time. I always feel honored to be welcomed by a family to share in this wondrous and sacred moment. This particular birth however, like no others before it, awed me. I can not stress enough how important the qualities of calm, acceptance, relaxation, surrender and absence of fear can be in creating an ideal birth.

Bravery

When I decided to give birth to our children at home, and thus with out pain medication, I often heard the comment: "Wow, you're brave". I, however, never felt brave in making the choice to have a natural childbirth. In my mind birth was just something a women was designed to do, no big deal. I didn't quite understand the comment about being brave.


Now years have passed and a great children's story has made it's way onto my boys' book shelf. This story has reminded me about the idea of bravery in childbirth.


In "Commander Toad in Space" by Jane Yolen, a team of space exploring frogs encounters a monster which they must outsmart to escape becoming its dinner. Upon safely returning to their space ship Lieutenant Lily questions their bravery, since all they did was run away. Their wise commander points out that "You cannot be brave unless you are first very much afraid". The three frogs concur that since they were most certainly afraid, they were thus very, very brave.


So now I finally understand the suggestion that I was brave having homebirths. Most people in our culture fear childbirth. Other people would have assumed that I carried this cultural fear of birth also. In their eyes I obviously should have been very much afraid and then brave to face up to that fear during my births.


I realize now that I didn't feel brave in my births, because I never felt the prerequisite fear!
I wasn't afraid that I would experience discomfort that I might interpret as suffering. I wasn't scared that I or my baby would encounter any sort of mishap that would endanger our lives. I wasn't in the least bit concerned that childbirth was going to be lonely, isolating or disempowering.


I wish that all women were able to dispel any childbirth fears they carry as they approach their birth experiences. I wish women didn't feel they had to be brave in childbirth.


Have No Fear!

Stroke and Cesarean

Cesareans birth is a major surgery, and as with all surgeries it caries risks. But this is one risk of having a surgical birth I wasn't aware of.

The cesarean rate in our city is hovering close to 30%, while the World Health Organization advises that cesarean rates should not exceed 10-15% of all births. So about half of all moms who have a cesarean delivery have been unnecessarily put at risk of suffering a post partum stroke.

The International Cesarean Awareness Network is an invaluable resource in learning what you can do to avoid a cesarean.

Birth story of the month :)

After on and off contractions for nearly 2 days, I got a call around lunchtime from mom saying they'd decided to head into the hospital. She'd been up since the early hours of the morning with very early labour. Contractions now, however, were anywhere from 5- 10 minutes apart and lasting a minute or more. If they were in the city I might have suggested they wait a bit longer. But, they had a long drive in from the country and no one wanted to tempt fate. I too got ready to leave to meet then at the hospital around 1:45pm.

I entered the Labour/Delivery/Recovery room to find mom deeply engrossed in hard labour kneeling upon the bed. There was a small flurry of activity as the nurses tried to start her IV line. She had tested Group B Step Positive and chose to accept antibiotic treatment during her labour. Dad and I sorted out our various supporting roles to help mom through each powerful surge. We were all so excited that mom was already 4-5 cm dilated, 75 % effaced and baby's head was at 0 station already. Things were certainly moving along quickly.
For a while mom laid on her left side with her right leg propped up. Dad offered her all his love, supportive words, soothing touches, cool water and cool cloths.

The nurse brought in the laughing gas. We encouraged mom to try using the etonox to slow down her breathing and hopefully take the edge of the intensity of this rapid labour. But she wasn't very interested in it. As 3pm approached we suggested that mom move back to kneeling as she had seemed better able to cope with the surges in this position. The midwife found mom to be 9 cm dilated and then a short 10 minutes later fully dilated and ready to push!

The amniotic sack had not yet ruptured, so as pushing began the midwife released the waters baby had been floating in. Dad expertly rubbed mom's hips and helped keep a steady supply of cool clothes covering mom's neck, back and forehead. I did my best to encourage mom's deep vocalizations as we all reminded her to direct her energy and breath down through her body to guide baby into this world.

The midwife requested that mom lay back down on her right side and I held a mirror up for her to see the baby's head playing peek-a-boo with the world as she eased baby down the birth canal. A few more pushes brought baby to crowing and mom reached down to feel baby's downy little head. A pause at the peak of intensity and then, finally release at 3:45 pm a beautiful little boy was passed into his mother's loving arms.

The snow was melting away as I drove home later that evening; it was as if the love that warmed everyone's hearts in the birth room had spilled out into the world. I found that my trust in birthing women,and the universe over all, was renewed by being permitted to share in this birth.