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.

Might the Government actualy fund Midwifery in Alberta?

For years and years ASAC has lobbied the government for publicly funded midwifery services. There have definitely been times in the past when people have become excited that the government is going to finally follow through on a many decade's old promise. But it does seem promising that our current health minister seems to be suggesting that midwifery services will be funded in the near future. Will funded midwifery be part of a Primary Care Network system? Such that only some consumers,in limited regions of the province, are able to access funded midwifery care. Will families still be able to choose their birth location? Will there be further restrictions to midwives' scope of practice following funding? Would funding be followed by a government commitment to ensuring a midwifery education program is established in Alberta?
I have so many hopes and so many questions about this tantalizing news. Curious to see how things play out over the months to come.

Birth Story of the Month

Mom called to let me know that her waters had released. I crossed my fingers and hoped that the mild contractions she was experiencing would pick-up their intensity before we saw the sun rise on the next day. At about 11:15 pm that evening I received a phone call from dad. Mom was in the shower with 45 second long contractions coming every 6 minutes or so. They'd been this way for about an hour and we decided that it would be appropriate for me to come join them at home. I had no doubt now, that baby was on the way!
At home mom had found herself a comfortable position lying on the living room floor. Calmly relaxing as she watched TV. She was coping perfectly with every contraction, breathing slowly and deeply, rocking her hips. Around 1 am mom decided that she wanted to move to the hospital to avoid the cold bumpy ride at a later and more challenging point of labour.
By 2:25 am the couple is being admitted to Labour and Delivery. She was about 3 cm dilated and baby's heart rate was strong and healthy. As soon as the nurse was willing to remove the monitors,mom moved into the shower. For close to the next 2 hours she followed the lead of her body and moved into various positions in the shower. Dad never left her side and together we made sure she had warm blankets, towels to kneel and rest on, cool water to drink and satisfied any other needs we could to help mom stay on top of the powerful contractions.
Just before 5 am, mom decided to come out of the shower. Missing a night of sleep combined with the efforts of labour were making her pretty tired. As mom lay on her side in the bed dad put on some music for her. I marveled at how smart mom's body was to allow her contractions to slow and spread out just a little bit, as if to help her rest and regain some energy. We used some hot packs under her belly and on her back to ease the ache of these intense contractions. As I used a bit of counter pressure on mom's back, I over-heard her whisper to dad; “I don't think I can do this”. I don't know what words of encouragement dad was whispering back to her, but through the next hour he kept his arms around her and told her exactly what she needed to hear.
By 6:30 am mom had gotten up to use the wash room and started sounding a bit “grunty” . What a delight to hear the nurse announce that mom was fully dilated! Mom expertly followed her body's pushing efforts and began the hard work of bringing baby through the birth canal into this world. The OB impressed me by encouraging mom to spend some time pushing on the toilet. But when she tired of that, she pushed kneeling on the bed while leaning over the back. Dad and I worked to keep her cool with wash cloths on her neck and back.
The OB was starting to feel discouraged that nearly 3 hours of pushing had not yet delivered a baby. She felt that mom need some pitocin to augment her labour. But as the nurses changed shifts, I laughed in delight as our new nurse insisted (and proved) that some nipple stimulation and acupressure to strengthen the contractions, along with some good pushes in a squatting position would bring down this baby. Sure enough at 9:25 am a baby boy came lustfully crying into this world. He weighed 8 lbs. 5 oz at 20 inches long.
BEAUTIFUL!

British Breastfeeding Ads

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Birth Story of the Month

I think one of the things which is lacking in our collective birth culture is the sharing of real and positive birth stories. I get a feeling, as a doula, that many pregnant women crave this sort of knowledge about birth. So many watch TLC's birth stories. But, as is common with reality TV, drama and NOT reality tends to drive a producer's editing and airing decisions!
Once upon a time, I am sure that women would have heard many more "normal" birth stories in talking with mothers, aunts, cousins and neighbors. But in this age of the nuclear family, many first time mothers are heading into their own births with few, if any, ideas of what birth is REALLY like. Not Hollywood's movie version.
And so; I hope to print a "normal" birth story for you every month. Here's your first sampling:

Around 6:30 am mom called to let me know that her waters had release earlier that morning. Since she wasn't aware of having any contractions, yet, she decided that she wanted to wait at home to see if labour would begin on its own.

After talking with the nurses in labour and delivery the parents decided to go into the hospital around 4:00 pm so the nurses could monitor for contractions and baby's heart rate. I joined the parents at their house, where I shared a meal with dad as mom calmly continued her regular activities. Soon we headed off in the cold dark of a winter evening to the hospital.

In the assessment room I played games with an older sibling as the parents and I discussed the risks and benefits of the options that lay ahead of them. I did a little bit of acupressure on mom to see if we could encourage contractions to pick-up. The monitors recorded that she was having mild contractions, but she found no discomfort in them at all. The doctor did an internal exam and found the mom was 2 cm dilated and baby's heart rate was a healthy 135 bpm. It was clear that labour was not active yet and together we decided that the best option was to head home to eat and sleep in the comfort of our own homes. At 8:30 pm Dr. X agreed to the family's wishes to head home for the night to await labour. If nothing happened by 8 am the next day they would likely be called back to start an induction of labour. At home, I gave dad a quick lesson in applying acupressure to encourage contractions. I wished them a good nights rest, as I suspected they'd be calling me before the sun rose the next day.

At 5:42 am dad phoned me to report that mom's contractions had begun and were coming every 5 minutes. We agreed to meet at the hospital. I arrived around 6:30 am to find the parents being settle into their labour and delivery room. Mom was already 7 cm dilated and well on her way to bringing a new baby into this world.

This final stage of dilation is powerful and often overwhelming. Mom was trying to lie in the narrow hospital bed. With every contraction, however, I could see her body tense and start writhing in resistance to the power of the contractions which gripped her every couple of minutes. Dad and I gave mom our gentle and calm energy. We touched her thighs and stroked her hair and face. As dad held her, we verbally reminded her to relax into each contraction, not to fight or resist the work of her own body. I modeled to this mom how I wanted her to breath; slowly and deeply in through her nose and out through her mouth. Together we were able to help mom ride the stormy waves of the powerful contractions. For a short period mom used laughing gas to help calm and slow her breathing, but very quickly she was ready to push.

In no time at all, at 7:36 am a sweet little 6lbs. 12 oz. baby girl emerged slippery wet, yet so calm! She was placed next to the warmth of her mother's chest and we all soaked in the magic of this moment as a new live enters our presence.

Having experience a highly medicalized and managed first birth, it was so nice to hear the parents comment afterwards that this was the way to have a baby, "nice and normal".

Author takes a stand

I have boycotted Nestle since before I knew what boycott meant - my mother just told us that we didn't buy their products. I later discovered what boycotting meant, and why Nestle was a good candidate to remain on my list of boycotted companies. They are the world's largest multinational corporation which continues to violate the WHO's (World Health Organization) International Code of Marketing of Breast-milk Substitutes
I was delighted to receive this news flash in Midwifery Today's E-news

Author Sean Taylor refused to accept his half of 32,500 pound prize money after winning the 2007 Nestle Children's Book Prize. Taylor's picture book, When a Monster Is Born, illustrated by Nick Sharratt, took the Gold Award in the under-fives category. Taylor cited "questions surrounding Nestle's marketing of breast-milk substitutes" in his refusal to accept the money. He said: "When a Monster is Born is a book that has something to do with choices. Some of these choices seem to be life-giving and some of them seem to take life away. I hope that I have made a life-giving choice. I have decided to refuse this check and ask that it goes back where it came from." www.thebookseller.com/news/49893-author-refuses-nestl-prize-cheque.html, 14 Dec 2007

Nice to see someone putting their money where their mouth is.

Danger of formula additives

According to the INFACT Canada mailing list

Common ingredient in infant formula linked to diarrhea, severe dehydration, and seizures in babies, according to complaints submitted to the FDA

A shocking report has been released on the adverse health effects of fatty acids found in infant formulas. On Friday the Cornucopia Institute, a U.S.-based corporate watchdog group, presented their findings on the fatty acids DHA and ARA, which are now commonly added to formula.

The report is based on a Freedom of Information Act request that the Cornucopia Institute filed with the Food and Drug Administration, the result of which was the uncovering of 98 reports filed by parents and physicians detailing incidences when babies had reacted adversly to formula containing DHA/ARA. The reported incidences range from cases of vomitting and diarrhea that stopped when babies switched to non-DHA/ARA formula to babies being treated in intensive care units for severe dehydration and seizures.

The FDA has never been convinced of the safety of DHA/ARA additives, according to the report. In its initial analysis of the additives, the FDA stated it had reached no determination on their safety status. The administration also noted that some studies had reported unexpected deaths among infants who had been fed with DHA/ARA formula. Despite its reservations, inexplicably the FDA did not withhold approval for the additives.

INFACT Canada has long questioned the use of DHA and ARA (also marketed as omega-3 and omega-6 fatty acids) in infant formula. All major formula companies have added the fatty acids to their products in recent years, claiming that they aid in brain and eye development. However most test results have found the additives have negligable effects on infant development. But because DHA and ARA are found naturally in breastmilk, formula companies market DHA/ARA formula as “closer to breastmilk.”

Martek Biosciences Corporation, the company which supplies almost all formula companies with DHA/ARA, has admitted that the purpose of the additives is not to encourage healthy development, but to be used as a marketing tool. In its promotional material to encourage investment, Martek has stated:

“Infant formula is currently a commodity market, with all products being almost identical and marketers competing intensely to differentiate their product. Even if [DHA/ARA] has no benefit, we think it would be widely incorporated into formulas, as a marketing tool and to allow companies to promote their formula as “closest to human milk.”

While DHA and ARA are found naturally in breastmilk, the idea that Martek’s manufactured acids make formula closer to breastmilk is ridiculous. Martek produces DHA and ARA from fermented algae and fungus, and uses hexane (a neurotoxin) in the manufacturing process. Simply adding these synthetic substances to formula cannot make artificial baby milk behave like breastmilk, which is a complex, living substance that provides babies with the best possible nutrition and immunological protection.

Regular infant formula puts babies’ health at risk, but now infants are being harmed for the sake of a marketing tool. This is an egregious case of formula companies putting profit margins above infant health. In light of this report, it is imperative that all parents be made aware of the potential risks of feeding their babies formula with DHA/ARA. The products should be pulled from the market until their safety can be properly assessed by independent investigations.

Babies should not have to get sick just because companies want to raise their sales figures.

For the more information on the Cornucopia report, please see: http://foodconsumer.org/7777/8888/C_hildren_amp_W_omen_33/012510002008_Lab-made_imitation_breast_milk_puts_infants_at_risk_study_shows.shtml

For the full report, see: http://cornucopia.org/DHA/DHA_FullReport.pdf