Category: Birth

Your birthing experience.

Seren’s Birth Story

1 Comment

Seren’s Perfect Home Birth

Born May 23, 2010 at 9:46 pm

7 lbs 10 oz, 13.5 inch head circumference , 20 inches long

I think I knew I was going to be going into labor on Saturday night (May 22).  I had just spent Friday and Saturday at the Colorado Midwives Association conference listening to the legendary Ina May Gaskin and when I got home I just felt like I needed to get the house ready.  I was sort of irritable, flying around putting laundry away, etc.  Kyle said, “Just do it tomorrow” but somehow I knew I should do it then.  I had some sporadic contractions all Saturday evening (about 5-10 minutes apart but nothing serious), then had a glass of wine and went to bed.

I continued to be woken by contractions all night long, some of them even working their way into my dreams!  I had a dream we got pulled over by two cop cars for making an illegal U-turn.  I was in the driver’s seat but somehow Kyle was driving.  They asked me to step out of the car and I proceeded to have a contraction (in the dream and in real life) and squatted next to the car.  The cops sort of backed away and said “Umm, never mind!”

I woke up around 7 am with contractions that were about 10 minutes apart and 1.5 minutes long.  They were stronger than they had been and just weren’t going away.  At that point I was thinking that I was maybe 75% sure I was going into labor.  I got up to eat breakfast around 9 and as soon as I was upright they got a lot closer together (3-5 minutes) but still very manageable.  I tried to eat some cereal but was kind of nauseous and gave up.

Laboring in the bathtubKyle took care of the girls while I spent some time in a lavender bath my friend Ashley had gotten me.  They would slow down to about 10 minutes apart when I was laying down so I knew it was still early.  I decided to take advantage of it and get some rest while I still could.  I got out of the tub and laid down for about an hour.  Haven came in to join me and we cuddled with her rubbing my back during my “belly squeezes.”  It helped so much to see her sweet little face looking at me during the contractions!  I just kept thinking that I was about to have a sweet little girl just like the one in front of me.

I got up around 1:30 pm and Heather (one of my best friends) came over to hang out with Haven while Lyric took a nap and Kyle and I walked around the park by our house.  It was a BEAUTIFUL day!  Blue skies, warm but not hot, light breeze, perfect.  We had a leisurely time walking around and swaying during contractions and talking.  We definitely got some looks from neighbors!  The only down side was that there was only one port-a-potty in the park and with Seren’s head so low I had to pee all the time.  Whenever my bladder was full I’d have lots of contractions (about 2 minutes apart) which made walking to the potty really hard!  Not to mention the ones I would have in the port-a-potty…

Haven and I nappingStacie (my midwife) and Miranda (my friend and doula sister) kept telling me that I didn’t have to keep walking if I didn’t feel up to it but it felt so good to be out in the sunshine.  I even got a little bit of a sunburn during my labor which I think is fabulous!  We walked around for about two and a half hours, just making loops and walking with one foot on the curb when I could.  Sometimes we’d sit for a bit in the shade and update our birth team.  Heather was the only one at our house yet so we were letting Stacie, Miranda, Jessica (our other midwife), Diane (one of my best friends), and Ashley (my friend and photographer) know where things were at.  The contractions were (on average) 3 minutes apart while we were walking and sometimes spaced out to 5 minutes apart when we were sitting down, so I knew we were down to business but things were still early.

Back from the park

Back from the park

At about 4:30 pm I started to feel like we should head back to the house.  We got home and ordered some sandwiches from Jimmy John’s (the peppers were great until they weren’t).  I could feel something switching over in my mind and body, and I felt like I wanted to start turning inward and go inside myself.  I sat on the couch, Lyric in my lap, and breathed through some strong contractions.

Stacie came at 5:30 pm and I could feel things starting to move into active labor as I was rocking on the birth ball.  The contractions were getting much more intense, much harder to relax into, and I started feeling sort of shaky.  Stacie wanted to check me just once to try and figure out when to call Jessica, our second midwife.  Seren’s head was so low in my pelvis it was hard for her to feel behind it and all the way around my cervix, but she told me that I was safely 5 cm, if not 6 or 7.  This made me so happy!  I was so worried I’d be 2 cm and be disappointed.  I told myself I’d be satisfied with 4 cm and happy with 5 cm so this was perfect!

I decided I really wanted to get in the birth tub and I wanted Jessica and Miranda to come.  I wanted to give Jessica a lot of time since she was driving up from Colorado Springs just for us!  I think everyone got here exactly when they were meant to, even Ashley who flew in from Oklahoma at 6 pm and still made the birth!

Haven laboring with meI got into the tub and have seriously never felt anything so wonderful!!  The warm water washed over me relaxing all the muscles that I could relax and I felt like I could sink into the contractions so much easier!  I labored in the tub while Jessica, Diane, and Miranda made their way here.  Heather, Diane, and the kids played together outside and it was fun to hear their voices in the backyard.  I think it was a good distraction for Haven and Lyric to have some friends to play with them.  They came up periodically.  Haven was particularly interested and wanted to hold me through some “belly squeezes.”  Lyric came up and saw me have a contraction on the toilet and looked a little concerned, but when she saw everyone’s smiling faces (including mine) she seemed reassured.

Birth teamI stayed in the tub most of the time, leaning on Kyle and moaning through contractions.  Miranda was rubbing my back, and Stacie and Jessica would wipe my forehead and hold my hand if I needed them to.  Everyone was perfectly in sync and were exactly what I needed!  If one of them had to leave the room for something it felt like there was a definite void.  The contractions were getting more intense and taking on a different quality.  The contraction itself felt mostly muscular, but during the peak they started to take on a skeletal quality as well.  I just felt like my whole pelvis felt sort of achy.  This was different than my births with Haven and Lyric.

Kyle and IIt turns out that this was because Seren was facing sunny side up.  For those of you who don’t know, most babies come out OA (occiput anterior, or facing mom’s back).  If a baby is OP (occiput posterior, or facing mom’s front) there is usually a greater surface area to the head and the back of the head pushes into mom’s sacrum causing what’s called “back labor.”  Because I was carrying Seren totally different than Haven and Lyric (Seren’s back was always on the right, the girls were always on the left) this was my number one fear!  I’ve been at births with women experiencing back labor that described it like an axe embedded in their back, even in between contractions. It can also cause a lot of false starts to labor, long labors, long pushing stages, etc.

I didn’t want this to happen to me!  The completely ironic thing was that I never had back labor.  Besides the sort of aching in my pelvis it was completely normal!  Not only that but it was by far my fastest birth!  Apparently I have one of those pelvises that can accommodate an OP baby.

Around 8 pm things started to get really intense.  The contractions were coming about every 3 minutes and it was getting more and more difficult to relax through them.  In between, however, I was really able to relax and be present and happy about my baby being born that day.  I asked to have some music played (Heart Sutra: Bliss and Serenity) and it just made me cry!  It was the music that was playing at our wedding and at Lyric’s birth, and it made me think of when my last sweet baby was born.

Getting more difficultI was starting to think that this intensity was going to last forever.  I had only been checked once (I had GBS, group B strep, in my urine and everyone agreed on keeping vaginal exams to a minimum) and I had no idea how close I was to giving birth.  I also had never lost any of my mucous plug or had any bloody show, the usual signs that you’re getting closer.  I was starting to think I couldn’t do it.  Jessica said, “Don’t worry, she’s just packing up her womb” which made me laugh.

And then everything happened at once, LITERALLY!  I felt a huge gush as my water broke like a torrent.  I immediately started projectile vomiting (on Kyle, sorry babe!), and as soon as that subsided I felt her stretching my perineum.  I shouted, “She’s coming NOW, go get Haven!” and that was all I could muster before my body took over and started to bear down.  It was the most amazing, crazy, beautiful, frightening thing I’ve ever felt!  Haven’s pushing and birth had been very coached (first baby, epidural) and even though I waited for a while with Lyric I never had that urge to push.  This was completely different.  My body took over and it was like I was hanging on by my fingernails!  Jessica told me later, “It’s like throwing up except it’s throwing down,” which is exactly how it felt!  I’d never realized how strong the fetal ejection reflex is.

She's born!Kyle jumped in the tub to catch Seren like we planned (in his clothes, there was no time to put on a swimsuit) and Haven did as well.  A few minutes later Seren’s head was born, it whipped around like a corkscrew, then shoulders, and then she was out.  I couldn’t believe how aware I was of every sensation.  I could feel every contour of her body as she came out and there was such a relief once she was out.  I had really wanted not to tear with this one like I did with the others and had told everyone prenatally that I wanted reminders to go slowly, stretch, breathe her out, etc.  Now everything was happening so fast that I felt like my my mind was telling my body “Slowly, breathe!” and my body was saying, “Nope, here we go, out she comes!”  Even so, Stacie told me later that my body eased her out beautifully, that it took breaks when it should have to let her rotate, that I stretched wonderfully, etc.  In fact I didn’t need stitches after all!  I only had a “skid mark” that would heal if I rested enough postpartum.

FamilyFrom my water breaking to Seren coming out was just 6 MINUTES!  At this point Lyric was upstairs as well.  We had tried to get her up here for the birth but everything happened so fast there just wasn’t a good opportunity.  She jumped in the tub with us and started blowing bubbles in the birth water (oh well)!  The girls took turns smooching Seren’s head and Lyric kept pointing to her saying “Baby, nursing!” though quizzically looking at my empty belly.

Beautiful girlWe all looked our new baby over.  No one could get over the fact that she was such a pretty baby!  So perfect and chubby with a button nose and sweet little rosebud lips and a little round head.  She reminded me a lot of Haven, especially the nose.

Since she came out so fast Seren was a little stunned.  Her APGARs were 8-8 (off for color and tone) but her respirations and heart rate were as perfect as it had been during labor.  A little postural drainage from Jessica helped her get some of the gunk out and then she pinked up quite nicely (no bulb syringes at this birth thank you very much!).  Kyle felt that the cord was still pulsing so we knew that she was still getting lots of oxygen from the placenta.  About 25 minutes later Seren latched on (and I got a dose of Angelica herb), and I felt cramping and pressure, as well as a little separation gush of blood.  Then I pushed out the placenta.  All in all I only lost 250 cc’s of blood, which is really great!

In bedWe decided to go and get cozy on the bed as a new family.  Seren kept nursing like a champ.  After a long while of that I got up to try and pee and Kyle took Seren for a while.  He was such a sweet daddy, smooching and loving on her.  He had waited for a long time to hold an itty bitty baby.

Haven cutting Seren's cord

Haven cutting Seren's cord

I came back and we did the newborn exam and of course she was perfect, term, and healthy!  Stacie helped Haven to cut the cord like she had been telling her preschool teachers for months.  Then Haven got to hold her (Kyle had to put Lyric to bed, she was so tired) and Miranda made placenta prints which turned out beautiful.  I was feeling great and Seren was nursing and pink and beautiful when everyone went home.  In fact, Seren nursed until 2:30 am when I finally cut her off and gave her my pinkie finger so I could get some sleep.  She’s still a champion nurser.

It was by far the most perfect, lovely, empowering, beautiful birth I could have ever hoped for!  I absolutely loved giving birth in my own home because I could settle into my space and my body and it made everything really peaceful and manageable.  I wouldn’t do it any other way!

Daddy smooches

Our midwife Stacie Meredith

Our midwife Stacie Meredith

Haven holding her sister

Haven holding her sister

Seren's first morning

Seren's first morning

The Safety of Home Birth – New Study of 530,000 Women

A recent study in the Netherlands, a country known for it’s fantastic maternal and infant outcomes, has proven that home birth is safe.  It is the largest study of it’s kind and found that low-risk women planning to give birth at home had as good outcomes as low-risk women birthing in the hospital.

Check it out!

Home births ‘as safe as hospital’

Newborn baby

There have been few comprehensive studies into home births

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

FROM THE TODAY PROGRAMME

More from Today programme

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

The NHS is simply not set up to meet the potential demand for home births
Louise Silverton
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital
RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

Mary Newburn, of the National Childbirth Trust, said: “This makes a significant contribution to the growing body of reassuring evidence that suggests offering women a choice of place of birth is entirely appropriate.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”

STUDY – Vitamin D deficiency linked to primary C-section rate

image-3931619-35797336-2-websmall_0_dd0f5a04af6e73346ed777299ec88556_1A small study found that twice as many women (28%) who were vitamin D deficient at the time of giving birth had a Caesarean delivery compared with those with normal levels (14%).

Read the article from Medscape

Karen Robinson, a local Certified Professional Midwife, said the following about the benefits of vitamin D during pregnancy:

Vitamin D is getting a lot of scrutiny lately and is being found to be a superstar vitamin that we haven’t paid enough attention to.

Vitamin D supplementation can help increase immunity and decrease the impact and frequency of colds and common viruses.

Its role is also being looked at closely in the implantation of the placenta, how well the placenta functions, and therefore prevention of pre-eclampsia.

In our world of indoor jobs and layers of sunscreen when we do go outside, it’s easy to see how the majority of us may be deficient in Vitamin D.

The best places to get Vitamin D include a bit of sun exposure every week (so that the body can manufacture its own Vitamin D), fatty fish (salmon, mackerel, tuna, etc), fish oil (especially cod liver oil) and beef liver.

So, one thing doulas can do for their clients is to encourage good diet (lots of fresh fruits and vegetables, clean meats and plenty of fats) and suggest they consider supplementation of Calcium/Magnesium, Folic Acid, and Vitamin D.

Haven’s Birth Story

1 Comment

image-3931619-36010647-2-websmall_0_973cdad2124a93d7966fe00319df7663_1I started having contractions every 8 minutes apart from 3pm on Saturday.  I was at the Rigpa Center in Boulder so I had my husband come and pick me up while I took a walk to see if the contractions would go away.  They continued a bit into the evening, then eased up before I went to bed.  The next day when I woke up they were 5 minutes apart for close to two hours.  I also expelled my mucous plug which was exciting and a little scary!

I debated whether to call the doctor and decided against it.  Instead Kyle and I went to Chipotle for lunch and had my car cleaned.  We were planning to go back to Boulder and go for a hike then bring Kyle’s car back, but decided against it when the contractions didn’t ease up.  So we went home and I took a nap and rested on the couch.

About 1 am we tried to lay down to sleep but ended up talking about the baby for a few hours.  It’s so hard to rest when you think you might be in labor and might have a baby soon!  I was getting annoyed that everything was starting and stopping and starting and started jumping up and down to get things going again.  Still restless I tried to wind down and take a bath for an hour.  Towards then end my contractions shot up to 5 minutes apart again for a few hours.

image-3931619-35797336-2-websmall_0_dd0f5a04af6e73346ed777299ec88556_1At 4:30 am we called the doctor and he told us to come down to the hospital.  We called our doula, Karen Voss, and told her we were on our way and she came to meet us at the hospital.  It was such a warm beautiful night for February!  Everything was so still and peaceful as we drove to the hospital.  It was hard dealing with the contractions in the car though.

We arrived at the hospital at about 5:30 am and already I was pretty exhausted.  We waited around with our doula until our doctor came and examined me around 9 am.  He told me I was 80% effaced and 2-3 cm dilated at about -1/0 station (so I was already carrying her a little low).  Then he said, “I think you’re probably in labor.”  In hindsight I think we went to the hospital way too early.  We had never been through this before and didn’t know that I was still in early labor and not very active yet.  But we thought we had come to the hospital when they had told us to (5 minutes apart, 1 minute long, for 1 hour)

That’s when we started calling friends and family to tell them baby was on her way!  My mom came over as soon as she heard and waited in the waiting room (per my request).  Meanwhile, Kyle and I were making laps around the maternity floor.  I would always stop at the nursery to keep things in perspective!

Whenever I had a contraction I would lean over a rail and groan while Kyle rubbed my back and Karen put warm compresses on my lower back.  Periodically we would go back to the room to get checked but it seemed like I was dilating slowly.  I think the move to the hospital had disrupted the flow of my labor a bit.  It took a while (like 12 hours) to get back into a good rhythm.

image-3931619-35797175-2-websmall_0_475a1dedcbeb022089418d1a3ad9391f_1When contractions got stronger I got into the jacuzzi and was able to rest for a while (what I wouldn’t have done for a nice long nap!).  Karen fed me some (illegal) trail mix and juice to help me keep up my energy.  (Sidenote:  Decades of research have found that it is better for a laboring woman to eat and drink on her own during labor as she feels comfortable, than to fast or be given a routine IV)  When I wasn’t in the tub I was sitting on the birth ball rolling around and looking out the window.  I really wanted to go outside and walk, it was such a nice day, but they wouldn’t allow it.

I got back in the tub around 2 pm on my hands and knees during contractions.  Then I felt a gush and said “Um, I think my water just broke…..but it might have been a jet???”  I stood up and was still leaking so yes, it had broken.  It was a pretty high tear because the fluid would trickle out intermittently.  After that, much to my dismay, my doctor wouldn’t let me get back into the tub because of an antiquated view of infection. (Sidenote:  Some babies, if the bag is left alone, will be born in the sac or “in the caul.” Water birth, when used appropriately, has no increased risk for infection or aspiration of water by the baby)

I also had a bit of bloody show and was dilated to 4 cm.  Afterwards the contractions really started spiking and coming frequently, mostly when I was getting checked which was horrible or when I had to go to the bathroom.  It was so hard to maintain any sense of normal body functions.

I had a few visitors off and on but mostly it was Kyle and I and Karen.  Kyle was absolutely wonderful, so intuitive, relaxed, calming, nurturing, supportive, and encouraging.  Everyone was so impressed with him!  I never could have done it without him!

image-3931619-35797411-2-websmall_0_84d799ea46ebfcd93e06f09e717ab013_1Despite that, the contractions were getting incredibly strong and it was harder and harder to keep focus.  We hadn’t had any sleep for more than two days and spotty sleep before that with days of early labor.  We started talking about other options and I decided to have a little fentonyl to take the edge off and try and regain my composure.  But after it wore off my body had stopped making natural endorphines (they were replaced by the narcotic) and I was right back where I was before.

I had been stuck at 6 cms for such a long time and was completely exhausted.  Slower dilation is pretty common for first time moms, but after Haven was born we would discover what was taking so long.  I really needed to rest so I decided to get an epidural.  Afterwards I felt better and was able to relax a bit.  I had some visitors and snuggled with Kyle.  The two of us took a much-needed hour long nap.  As far as epidurals go, I didn’t have a bad one.  I could still feel the contractions but they were more round, less jagged, and I could still feel the pressure.

As the baby moved down I could feel more pain and pressure so they upped my dose of medication with the epidural and started me on pitocin to boost my contractions.  When we woke up from our nap I was almost completely dilated with a little lip of cervix.  (In hindsight that just might be what my cervix does since it was the same with Lyric’s birth)  They pushed the lip over baby’s head and called for the doctor.  I started pushing around 10 pm.

I don’t remember much about the pushing stage, just that everyone wanted to move and jostle and change the bed around.  I was so annoyed, I just wanted them to go away so I could have my baby (“Lift your butt, we’ve got to push this up, put this under you…etc”).

I got a little overzealous with the pushing and was pushing for too long.  I got really light-headed and nauseous so they gave me some oxygen and told me to push for lesser amounds of time.  With the mirror I could see the top of Haven’s dark hairy head!

At 10:44 pm, after 40 minutes of pushing, Haven was born!  As her head came out, so did her hand.  So THAT’S what took so long!  Compound presentations like that can be hard since there’s an irregular pressure to the cervix and a bigger diameter to the baby’s head.  They had to pull Haven’s arm out with her head and her elbow caused me to tear in four places.  It was pretty intense.  Haven came out, thrust her arms out, gave a short cry and then was placed on my belly (after our doctor said, “Hmm, might be a little short…” because of a short cord that just barely let her reach me).

When she opened her big, dark eyes I swear I have never seen a more breathtakingly beautiful human being in my entire life.  She calmly surveyed her surroundings and looked from me to Kyle with a gaze more intense than most newborns.  I got her to nurse and just held her, mesmerized, while our doctor stitched me up.  I couldn’t take my eyes off her!  It’s incredible to think that that tiny little baby was what I felt moving around in my belly for months!

They left us alone with her for over an hour, then took she and Kyle went to the other side of the room to have eye drops, vitamin K shots, PKU heel stick, and bath (Sidenote:  Eyedrops are primarily necessary only if you have chlamydia or gonorrhea, which I didn’t have, and you can do vitamin K orally if you wish to be less invasive.  You can also refuse a bath since it can dry a baby’s skin out).

Kyle stayed with her the whole time and took his shirt off so he could carry her skin-to-skin.  Then she pooped meconium all over him, super fun.  After they were finished stitching me up they gave me a few minutes to try and urinate before I could me moved to the recovery room.  When I couldn’t and they were impatient to get me into the next room so they put a catheter in which was the most excruciating thing I’ve ever experienced.  Then we were moved.

image-3931619-35797181-2-websmall_0_67b6f7f5c320ecf3ddc3a8f44fb8c256_1Even though I was beyond exhaustion, I couldn’t sleep!  I just wanted to look at her.  I couldn’t get enough!  Kyle on the other hand was completely comatose.  The next day we just spent time getting to know her.  We had some visitors and decided to name her Haven Aria Dae.  Haven becasue she was so peaceful and calm.  Aria because she was “singing” with this breathy sigh all day.  And Dae is “greatness” in Korean to honor her heritage.

At 10:30 pm we left the hospital after two days and she felt the outside air for the first time.  It was a beautiful warm night.  She fussed a little bit when we put her in the car seat.  Then we took her home.  I introduced her to her new home and it struck me, I have a brand new immediate family!

To be honest, for a while after her birth I would still feel phantom “kicks” in my belly, like she was still inside.  I loved being pregnant and feeling her move inside me and sometimes I wish I could just tuck her in, warm and safe, like a mama kangaroo.  A part of me misses us being the same flesh, sharing the same warmth and fluids and air.  She will always be a part of me in the deepest and most profound way.  When I hold her in my arms I have to resist the urge to squeeze her so hard I absorb her.  I never imagined it was possible to love someone so much!

My children are the greatest thing I have ever done in my life, and I can’t wait to see what they will do with theirs!

View Lyric’s Birth

image-3931619-35797337-2-websmall_0_de81a801162c5ec2066f5210d18a59cb_1

Scheduled Inductions/C-sections – Why Every Week Counts

I recently read a great article in the Wall Street Journal about some new trends to induce or schedule c-sections prior to an estimated due date.  Past 34 weeks the baby’s lungs are done “cooking” and the chance that Baby will survive is pretty good, but scientists are finding more and more evidence that those precious few weeks mean more to fetal development than we previously thought.

A word on starting labor:

  • Labor is usually started by the BABY when Baby’s lungs are ready and Baby has reached good maturity in the womb
  • It is well within normal limits for babies to be born healthy anywhere between 37 and 42 weeks (and sometimes beyond!)
  • The average length of pregnancy for a first time mom is 41 weeks, 3 days (or 10 dates past estimated due date)
  • Methods of induction can seriously mess up natural body chemistry and function and cause other serious measures (failed induction, infection, c-section, etc.)
  • If your body isn’t ready to go into labor, it won’t.  Oftentimes inducing labor (either natural remedies or with drugs) will fail if your body and your baby aren’t ready

Here is that great article from the Wall Street Journal:

This time of year, some hospitals see a small uptick in baby deliveries thanks to families eager to fit the blessed event in around holiday plans or in time to claim a tax deduction. Conventional wisdom has long held that inducing labor or having a Caesarean section a bit early posed little risk, since after 34 weeks gestation, all the baby has to do was grow.

But new research shows that those last weeks of pregnancy are more important than once thought for brain, lung and liver development. And there may be lasting consequences for babies born at 34 to 36 weeks, now called “late preterm.”

[Why Every Week of Pregnancy Counts] New research shows that the last weeks of pregnancy are more important than once thought for brain, lung and liver development.

A study in the American Journal of Obstetrics and Gynecology in October calculated that for each week a baby stayed in the womb between 32 and 39 weeks, there is a 23% decrease in problems such as respiratory distress, jaundice, seizures, temperature instability and brain hemorrhages.

A study of nearly 15,000 children in the Journal of Pediatrics in July found that those born between 32 and 36 weeks had lower reading and math scores in first grade than babies who went to full term. New research also suggests that late preterm infants are at higher risk for mild cognitive and behavioral problems and may have lower I.Q.s than those who go full term.

What’s more, experts warn that a fetus’s estimated age may be off by as much as two weeks either way, meaning that a baby thought to be 36 weeks along might be only 34.

The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the March of Dimes are now urging obstetricians not to deliver babies before 39 weeks unless there is a medical reason to do so.

“It’s very important for people to realize that every week counts,” says Lucky E. Jain, a professor of pediatrics at Emory University School of Medicine.

It’s unclear how many deliveries are performed early for nonmedical reasons. Preterm births (before 37 weeks) have risen 31% in the U.S. since 1981 — to one in every eight births. The most serious problems are seen in the tiniest babies. But nearly 75% of preterm babies are born between 34 and 36 weeks, and much of the increase has come in C-sections, which now account for a third of all U.S. births. An additional one-fifth of all births are via induced labor, up 125% since 1989.

Many of those elective deliveries are done for medical reasons such as fetal distress or pre-eclampsia, a sudden spike in the mother’s blood pressure. Those that aren’t can be hard to distinguish. “Obstetricians know the rules and they are very creative about some of their indications — like ‘impending pre-eclampsia,'” says Alan Fleischman, medical director for the March of Dimes.

Why do doctors agree to deliver a baby early when there’s no medical reason? Some cite pressure from parents. “‘I’m tired of being pregnant. My fingers are swollen. My mother-in-law is coming’ — we hear that all the time,” says Laura E. Riley, medical director of labor and delivery at Massachusetts General Hospital. “But there are 25 other patients waiting, and saying ‘no’ can take 45 minutes, so sometimes we cave.”

There’s also a perception that delivering early by c-section is safer for the baby, even though it means major surgery for the mom. “The idea is that somehow, if you’re in complete control of the delivery, then only good things will happen. But that’s categorically wrong. The baby and the uterus know best,” says F. Sessions Cole, director of newborn medicine at St. Louis Children’s Hospital.

He explains that a complex series of events occurs in late pregnancy to prepare the baby to survive outside the womb: The fetus acquires fat needed to maintain body temperature; the liver matures enough to eliminate a toxin called bilirubin from the body; and the lungs get ready to exchange oxygen as soon as the umbilical cord is clamped. Disrupting any of those steps can result in brain damage and other problems. In addition, the squeezing of the uterus during labor stimulates the baby and the placenta to make steroid hormones that help this last phase of lung maturation — and that’s missed if the mother never goes into labor.

[Why Every Week of Pregnancy Counts] Gail Zuniga/WSJ

“We don’t have a magic ball to predict which babies might have problems,” says Dr. Cole. “But we can say that the more before 39 weeks a baby is delivered, the more likely that one or more complications will occur.”

In cases where there are medical reasons to deliver a baby early, lung maturation can be determined with amniocentesis — using a long needle to withdraw fluid from inside the uterus. But that can cause infection, bleeding or a leak or fetal distress, which could require an emergency c-section.

Trying to determine maturity by the size of the fetus can also be problematic. Babies of mothers with gestational diabetes are often very large for their age, but even less developed for their age than normal-size babies.

Growing beyond 42 weeks can also pose problems, since the placenta deteriorates and can’t sustain the growing baby.

Making families aware of the risks of delivering early makes a big difference. In Utah, where 27% of elective deliveries in 1999 took place before the 39th week, a major awareness campaign has reduced that to less than 5%. At two St. Louis hospitals that send premature babies to Dr. Cole’s neonatal intensive-care unit, obstetricians now ask couples who want to schedule a delivery before 39 weeks to sign a consent form acknowledging the risks. At that point, many wait for nature to take its course, says Dr. Cole.

Join a Discussion

Are parents too eager to induce labor or schedule an early C-section for sheer convenience? Are doctors too willing to go along? Share your views.

Mother Blessing Beads – Bead for Life

index_08I just did henna (mehndi) at a party for Bead for Life.  This fantastic organization teaches African women in Uganda to make beautiful beads from recycled paper.  They in turn sell them over here to provide income, food, medicine, and pay school fees.

I thought this non-profit would be perfect if people are looking for that special bead for a Mother Blessing or Blessingway.  Not only are they beautiful, but give back by empowering the women who make them and creating opportunities for their communities in Uganda.

I strongly encourage you to visit their store or host a bead party!

Great Midwifery Article in the LA Times

Here’s a wonderful pro-midwifery article in the LA Times!

I also have the text here:

Midwives deliver

America needs better birth care, and midwives can deliver it.

By Jennifer Block
December 24, 2008
» Discuss Article (23 Comments)

Some healthcare trivia: In the United States, what is the No. 1 reason people are admitted to the hospital? Not diabetes, not heart attack, not stroke. The answer is something that isn’t even a disease: childbirth.

Not only is childbirth the most common reason for a hospital stay — more than 4 million American women give birth each year — it costs the country far more than any other health condition. Six of the 15 most frequent hospital procedures billed to private insurers and Medicaid are maternity-related. The nation’s maternity bill totaled $86 billion in 2006, nearly half of which was picked up by taxpayers.

But cost hasn’t translated into quality. We spend more than double per capita on childbirth than other industrialized countries, yet our rates of pre-term birth, newborn death and maternal death rank us dismally in comparison. Last month, the March of Dimes gave the country a “D” on its prematurity report card; California got a “C,” but 18 other states and the District of Columbia, where 15.9% of babies are born too early, failed entirely.

The U.S. ranks 41st among industrialized nations in maternal mortality. And there are unconscionable racial disparities: African American mothers are three times more likely to die in childbirth than white mothers.

In short, we are overspending and under-serving women and families. If the United States is serious about health reform, we need to begin, well, at the beginning.

The problem is not access to care; it is the care itself. As a new joint report by the Milbank Memorial Fund, the Reforming States Group and Childbirth Connection makes clear, American maternity wards are not following evidence-based best practices. They are inducing and speeding up far too many labors and reaching too quickly for the scalpel: Nearly one-third of births are now by caesarean section, more than twice what the World Health Organization has documented is a safe rate. In fact, the report found that the most common billable maternity procedures — continuous electronic fetal monitoring, for instance — have no clear benefit when used routinely.

The most cost-effective, health-promoting maternity care for normal, healthy women is midwife led and out of hospital. Hospitals charge from $7,000 to $16,000, depending on the type and complexity of the birth. The average birth-center fee is only $1,600 because high-tech medical intervention is rarely applied and stays are shorter. This model of care is not just cheaper; decades of medical research show that it’s better. Mother and baby are more likely to have a normal, vaginal birth; less likely to experience trauma, such as a bad vaginal tear or a surgical delivery; and more likely to breast feed. In other words, less is actually more.

The Obama administration could save the country billions by overhauling the American way of birth.

Consider Washington, where a state review of licensed midwives (just 100 in practice) found that they saved the state an estimated $2.7 million over two years. One reason for the savings is that midwives prevent costly caesarean surgeries: 11.9% of midwifery patients in Wash- ington ended up with C-sections, compared with 24% of low-risk women in traditional obstetric care.

Currently, just 1% of women nationwide get midwife-led care outside a hospital setting. Imagine the savings if that number jumped to 10% or even 30%. Imagine if hospitals started promoting best practices: giving women one-on-one, continuous support, promoting movement and water immersion for pain relief, and reducing the use of labor stimulants and labor induction. The C-section rate would plummet, as would related infections, hemorrhages, neonatal intensive care admissions and deaths. And the country could save some serious cash. The joint Milbank report conservatively estimates savings of $2.5 billion a year if the caesarean rate were brought down to 15%.

To be frank, the U.S. maternity care system needs to be turned upside down. Midwives should be caring for the majority of pregnant women, and physicians should continue to handle high-risk cases, complications and emergencies. This is the division of labor, so to speak, that you find in the countries that spend less but get more.

In those countries, a persistent public health concern is a midwife shortage. In the U.S., we don’t have similar regard for midwives or their model of care. Hospitals frequently shut down nurse-midwifery practices because they don’t bring in enough revenue. And although certified nurse midwives are eligible providers under federal Medicaid law and mandated for reimbursement, certified professional midwives — who are trained in out-of-hospital birth care — are not. In several state legislatures, they are fighting simply to be licensed, legal healthcare providers. (Californians are lucky — certified professional midwives are licensed, and Medi-Cal covers out-of-hospital birth.)

Barack Obama could be, among so many other firsts, the first birth-friendly president. How about a Midwife Corps to recruit and train the thousands of new midwives we’ll need? How about federal funding to create hundreds of new birth centers? How about an ad campaign to educate women about optimal birth?

America needs better birth care, and midwives can deliver it.

Jennifer Block is the author of “Pushed: The Painful Truth About Childbirth and Modern Maternity Care.”