“I might have been a little cocky going into this”: My birth story as I remember it

“I might have been a little cocky going into this”: My birth story as I remember it

*Warning: this birth story contains all the gritty details, read at your own risk. 😉

I love giving birth.

The way it forces me to be completely in my body and completely in the moment is incredible. I relish the intensity of the process. Strange, perhaps, but true. It’s my style of thrill-seeking, I guess. And I feel like it’s something I do well. Author and social anthropologist, Sheila Kitzinger said once about her experience giving birth, “Now THIS was a sport I could do!”  (see the video of Sheila Kitzinger telling her story here. It’s short, just 2:15 minutes)  Somehow, whenever I’ve given birth, I’ve had an inherent sense that this was something I knew how to do.

So having the chance to give birth again was one of the reasons I chose to be a surrogate.

Having seen the wide range of birth experiences in my years of work as a doula, though, actually made me less confident about what might happen in labor. Perhaps I was just lucky that my first two labors went smoothly? (FYI- My two children were born at home in a water birth tub. Also, my daughter was born “in the caul” which means that my water never broke, she came out in her sac, and when my son was born, my water only broke as his head was emerging).

Having had smooth, relatively easy labors in the past made me think “I’ve got this in the bag!” But then as soon as I thought that puffed up, self-congratulatory thought, I would immediately talk myself down from that place and remind myself that birth is UNPREDICTABLE and that I had to be prepared for anything (my version of knocking on wood, I suppose). So, I hired a doula who could be there to help me strategize if things were not going smoothly. We talked and made plans for what birth in a hospital would be like for me and how to keep my brain in “birthing mode” rather than “doula mode.”

As I was reaching the end of my pregnancy, I was feeling as if my little surro-boy would come early. But then again, I thought, doesn’t every pregnant woman feel that way? I would sometimes have some fairly steady practice contractions that were not painful, but definitely noticeable. I was offered cervical exams starting around 36 weeks, but I declined them because I knew I would try to draw conclusions from the result even when I know it means nothing.

One of the dads was going to be flying in on April 21, 2014 (when I would be 38 weeks and 2 days) so that he could be here early for whenever the baby decided to come. I figured that was early enough to plan to be here, especially considering that I could go past my May 3rd due date and he could be waiting for a long time! Well, it turns out that it wasn’t quite early enough.

10256800_10202902557917637_3258102181306654959_nHere I am, goofing off with my husband at an Easter Sunday egg hunt and brunch in the last non-labor photo before surro-boy was born.

At 7:15 pm on Easter Sunday, April 20th, my water broke while I was sitting on the couch–a TOTALLY new experience for me. I felt a little pop and then a trickle of fluid. It took a few minutes for me to determine that it really was my water breaking, but as I continued to leak it felt pretty clear that this was really happening. All of a sudden we had 1 million phone calls to make–the hospital, my doula, the dads, finding someone to take care of our children while my husband and I were at the hospital–there was a lot of coordinating to do. The hospital wanted us to come in right away, but we drug our feet for a few hours since I wasn’t having any labor contractions. We found a neighbor who could spend the night and another neighbor who could drive our kids to school in the morning. The dads decided to drive through the night to get to Portland instead of flying and my doula was on standby for when labor actually started to happen.

We got to the hospital at about 11 pm–yes, the fluid I was leaking was amniotic fluid–and once we were thoroughly checked-in my husband and I tried to get some sleep. I had some contractions over night that were mild to moderate, but only 7-9 minutes apart. At some point I stopped timing them and actually fell asleep for a few hours which was a good thing. But at 6 am we started to get moving again. My doula came at about 6 am (actually, my other favorite doula came, since my primary doula got called to another birth that was happening quickly) and a mentee doula was there as well. But nothing was really happening yet, so we talked. I think I got monitored some more and then decided to take a shower with my husband. In the shower we did some nipple stimulation (nothing major, but any touching of the nipples releases some oxytocin which is the main labor hormone) and that seemed to help get things going. But once we were out and in the room again, the contractions decreased again (in frequency and intensity).  No big deal.

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The dads got into town at about 9:30 am and wanted to know if they had time to check into their hotel room and freshen up before coming to the hospital. The answer was a resounding “YES” since I still wasn’t even in labor.

At some point in the mid-morning, a midwife came to see us and mentioned that they could give me pitocin to get labor going, but I said I was thinking more along the lines of nipple stimulation and she said, “Great. I was actually going to suggest that.” And she gave us a nipple stimulation protocol involving a breast pump. It was 3o minutes on and 2 hours off. We agreed to try it. Sure enough, it worked like a charm, but once we stopped… The contractions went away again. Kind of. I kept having these… half contractions? A contraction would start, but then it would plateau instead of reaching a peak before coming down again. I wasn’t sure what to make of them.

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We decided to switch up the scenery a little bit and went out for a walk in the courtyard.  0843

It was lovely outside, a little chilly, but the flowers were in bloom. My husband and I walked the maze. But labor still wasn’t really happening. Sigh.

At some point, I realized the medical professionals were getting a little uneasy and were working up to suggesting Pitocin to get my labor going. I knew that it might be necessary, and I don’t think Pitocin is all bad at all, but I really had the gut feeling that once I could get my labor going it would take off on its own. I had a conversation with my husband and my doulas. (My main doula was back by now, as her other client had given birth early that morning.) We all decided that all the hospital interruptions were probably affecting my ability to go into labor and stay there. Foolishly, I assumed this wouldn’t be a problem for me because I don’t have anxiety about hospitals, but my ability to be chatty in early labor was hindering my ability to transition into active labor.  We had to commit to creating a “laborland” before it was actually there. We asked for 1 hour of uninterrupted time (this was at 4:20 pm). Everyone left the room except for me and my husband. We got into a relaxing shower and almost immediately the contractions started to come back. I went with it. It was intense, but gratifying to know that my body DID know exactly what to do. I just needed the space to do it. A midwife came in while we were still in the shower (before our hour was up!) and through the bathroom door, we put them off for another 20 minutes to equal the hour we had asked for).

When we got out of the shower my husband encouraged me to stay connected with him and shut everything else out. Usually I like sunshine and bright light, but right now I wanted the lights turned down and the window shades lowered to make a cozy cave-like atmosphere. My doulas came back in. I told everyone that I was authorizing them to speak for me so that I could be quiet and focus inward like I usually do in labor. A few times I started to talk, but I stopped myself and asked someone else to explain. I closed my eyes in a slow-dance with my husband and I sang quietly with him. We sang “I Will Follow You into the Dark” by Death Cab for Cutie and a little bit of  “Let Go” by Frou Frou this helped me feel connected and drop into my body.  The nurse was quietly waiting for me to be done before taking my blood pressure, but I just asked her to just sneak in and work around whatever I was doing. I had no intention of popping back out of “laborland” for a blood pressure check.

The midwife, who I’m guessing wanted to have the “Pitocin talk” with us, walked in at this point and said, “Well, this looks different. (pause) I don’t think we need to have the conversation that I was going to have!” And she left. I was relieved and I relaxed a little bit more.

Later, another midwife came on (around 7 pm I think) and she was in the room observing. She asked me a question about whether I felt like I was in labor.  I said, “yes,” but it made me second-guess myself. Maybe this wasn’t active labor yet. Maybe the contractions were still too far apart? The next contraction seemed to take forever to arrive. I didn’t want to let it get to me, so I let go and kept doing what I was doing. I tried to change positions a lot and move my hips. I was afraid that this little boy was posterior (read more about posterior babies here) and I knew that could make it harder to dilate and give birth so I was motivated to try positions that would help him turn if he was posterior (or if his head was in any kind of less-than-optimal position such as asynclitic or with his head flexed instead of tucked).  Here I am in an open-knee-chest position and also sitting on the ball.

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I also remember moving one leg into a lunge position from the all-fours position for one contraction and doing it again with the other leg for the next contraction. I asked my doula if there was anything that I was missing that we should try. She said that I was doing most of it already, but that we could try “the dangle” so we tried that through 3 contractions. It made my arms tired for sure, and didn’t make the contractions any easier, but I was willing to make myself very uncomfortable in the short term, if it could help in the long-run. By this time I definitely felt like I was in labor! It seemed like I was hitting transition, but it seemed like it was taking longer and feeling more intense than in my other labors. I was afraid that even though the contractions were so strong, I might not be close to giving birth after all.

I asked how far apart my contractions were and my doula told me that they were 4 minutes apart (or 3?) and that if they could get a little closer together it would probably be time to get into the big tub. I was encouraged and discouraged at the same time. I knew the tub might make my contractions feel more manageable, but they were getting so intense it was discouraging to think I might not be giving birth at any moment! I had a string of contractions while sitting on the ball, leaning on the bed that felt so strong that I was having trouble staying on top of the pain. Often I wasn’t managing it, my voice would get higher in pitch and I would lose my rhythm.  I started to feel nauseous and grabbed a barf bag just in case. But I never had time to throw up because my contractions had gotten so close together. I had the classic transition moment where I thought to myself, “I cannot do this.” But I didn’t say it out loud–at least not in those words–because, being a doula, I knew what my doula would say to me.  She would say I was doing it. 😉 But, really, I thought, if we’re not close to giving birth at this moment, this might be the birth where I experience what an epidural is like!  What I said was, “I’m not sure how much longer I can do this.” I guess I wanted them to know that I was starting to hit my limit.

2146Here’s what my labor looked like–moaning (loudly) and sitting on the ball.

Of course they never doubted that I could do it, but I did. I seriously doubted myself. But I also doula’ed myself. I reminded myself to stay in the moment and to stay as relaxed as possible. It wasn’t going to help to get discouraged now. My team finally said that it was time to get into the tub. I finished a contraction and started to turn away from the bed to start the long walk down the hall to the tub room two doors down, but immediately another contraction started. I moaned SOOOO loud, but droning at the top of my lungs worked THE BEST for coping with the intensity of my labor. I have pretty good diaphragm control (my theater voice) so I can get very loud without hurting my voice or getting scream-y. I tried again to turn away from the bed to walk down the hall, but another contraction hit and it hit so hard that as I leaned back over the bed, if just felt as if I couldn’t get low enough. I kept the downward momentum, kneeling onto one knee and then the other until I was on my hands and knees on the floor.

At this point, my husband and my doula asked if there was a wheelchair we could use to get me down to the tub. The nurse asked me if I wanted that and I think I just mumbled, “I don’t know.” So my people answered for me, “Yes, please get a wheelchair.” And she did. Between contractions I placed myself in the wheelchair and our nurse wheeled me rapidly down the hall. I had another contraction in the wheelchair. I pushed on the arms of the chair, lifting myself. I was trying to lift myself out of my body at that point. We arrived in the tub room. I went to the bathroom first. This was the first time that I felt really encouraged–like we were close–because my pad had lots of blood in it. And it was dripping from my body as I stood up from the toilet and I had a worried moment, asking my doula if that was too much blood. She said, “No, it’s great.” As she led me by my elbow quickly over to the labor tub.

I got into the tub. My contractions were still coming so close together–I was making unearthly wild animal noises. My voice would go from a low moan and then into a wild primal shriek. At the end of the first tub contraction I started to feel the unmistakable pressure of a baby entering the birth canal. The pushing stage had begun. And since my second baby had come out in about 3 minutes flat, I knew I needed to say something quickly. I announced to the room that the last contraction felt… pushy. And since this hospital does not allow water birth, they announced that I would need to get out of the tub that I just got into. I wondered how that was going to work, but I figured I would let them handle the details, another contraction was starting. Yep, more pushing. Holy pressure, Batman.

The midwife felt my perineum and she said, “Well, he’s not crowning. We’ll get you out after the next contraction.” My husband heard this and hurriedly explained that if this birth was anything like my last birth, the baby would be coming out on the next contraction. So our midwife just asked that the nurse drain some more water out of the tub. Sure enough, I believe this little boy was crowning on the next contraction. His head was out on the contraction after that. And right after that, his whole body was out. He had the cord wrapped around his neck, around his body and under his arm (a nice long cord, in contrast to the short cords of my own babies), so he required a little bit of untangling, but he was alert and vigorous. At 10:10 pm on April 21st he was born!

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He stayed on my chest until it was time to cut the cord. One of his daddies cut the cord and then held him, skin-to-skin. I got out to deliver the placenta, which turned out to be more complicated than it usually is. (I’ll spare you the pictures of that) My placenta was having trouble detaching and I needed to push hard to help it come out. It eventually did, but I had some more bleeding than they like to see so I ended up with a lot of medications to control the bleeding. I think it may have been overkill, but I understand why they get concerned. I hadn’t gotten an IV port in labor, so they put it in postpartum to give me IV pitocin (for the bleeding) and had to try three times to get the IV in properly. I just didn’t mind at all, though, because I was still so in love with everyone who had helped me through labor. I couldn’t believe how crazy and intense it had been. Also, it felt like labor had taken a long time, but when I did the math it turned out that it was only about 5 hours from when I entered actual labor to when he was born.

Dads, Scarlett, AJ (b&w)

These dads are amazing human beings, who are adorable and loving parents and also–I’m eternally grateful for this–they completely had my back when it came to labor which was important to me in two ways: 1) I got to have a labor with no drugs, the way I prefer, and even more importantly, 2) It meant that they completely trusted me with their baby. We all had the same goal, after all, but they trusted that I knew how to get there.

Laboring is like trying to find your way through a maze without a map or a light. It’s done by feel.

I might have been a little cocky going into this, but thank goodness I realized early that that sort of ego wasn’t going to help in labor. I let myself be stripped down, to get quiet and let the internal compass guide me as I was supported by my incredible birth team whom I know would have supported me through anything. Thank you birth team!

Aren’t Doulas Just for Natural Birth?

Aren’t Doulas Just for Natural Birth?

Every doula I know smacks her palm to her forehead whenever she hears or reads some version of the headline above.

But guess what?  We hear it a lot… so our foreheads are pretty sore.

And we must be somewhat to blame. It would seem that our efforts to educate are falling very short. Of course, this perception doesn’t come from nowhere. Definitely, doulas tend to relish birth in all of its raw, primal intensity. Witnessing a birth like that or experiencing it firsthand might be what brought a doula to her work in the first place. I, myself, never fail to enjoy supporting an unmedicated birth, but then again, I’ve never failed to enjoy supporting a medicated birth either. Supporting natural (unmedicated) birth is NOT the crux of what I do.

A am awed and impressed by the birthing mother*. Always. I don’t care what the birth looks like. The person giving birth is a complex human, with a complex past and complex feelings and motivations. Her partner or other support people are multi-faceted and her relationship with this person or these people is unique. Her pregnancy is one-of-a-kind. Trying to bring a healthy human in the world is hard and vulnerable work. It takes thought, guts, control, surrender, strength, vulnerability and so much more. And that is true for anyone giving birth. Whether a person gives birth with Pitocin (a drug that causes contractions), without Pitocin, with pain medication, without pain medication, by planned cesarean, unplanned cesarean or crash, emergency cesarean, none of it is easy.

The crux of what I do is support the pregnant person and the father/partner when present.

That support starts in pregnancy. Are you planning to have an epidural? Great! Is that alone enough to make you feel secure and confident about giving birth? Probably not…  Wouldn’t it be nice to have someone who is well-versed in birth (in all its forms) to whom you can ask your questions, who can send you information, and can listen to your worries and your partner’s worries and help you work through them without judging what you’re feeling? That’s just some of what I do as a doula.

As your doula, I  can help you learn what to expect from an epidural, talk to you about when you might want to get the epidural, how to cope with contractions until the epidural arrives, keep you massaged and hydrated once the epidural is in place, help you change positions, reassure you when you feel nauseous or shaky, apply cool washcloths to your forehead, and translate “medicalese” to you and your partner. I can talk to you in advance about how to isolate the muscles used to push, so that it’s easier to push when the time comes.

As your doula, I am your constant. When you plan to give birth at a hospital you won’t know the nurse that will attend to you–the nurses change with the shift–and it’s not uncommon to see your OB or midwife only at the very end, when it’s time to deliver your baby. With all of those variables,  wouldn’t it be wonderful to have your own, dedicated birth consultant at your side?

If in your pregnancy you begin to be faced with the possibility of induction or planned cesarean for medical reasons, you may need to change your “plan” drastically from what you imagined. What if you had a person who could help you process your emotions and talk out your options? There is such a person. You guessed it! It’s a doula.

I have attended planned cesarean births, in which I was allowed into the operating room with the mother and the father and I took pictures of the birth, held the mother’s hand or stroked her head when she needed it. I let the parents know what kinds of requests they could make of the birth team (for instance asking for delayed cord clamping or skin-to-skin contact soon after delivery). These mothers and fathers have told me how precious it was to have photographs of their baby’s first moments and their first meeting of their baby.

Perhaps I could try to list every different situation in which a birth doula could be a helpful addition to the birth team, but that could go on forever. Mostly, what I want to say is that giving birth is a profoundly physical and a profoundly emotional process. No matter how your baby comes out, that statement is true.  The medical members of the birth team can get caught up in the purely physical aspects of the labor (and this can make sense, since they are tasked with the job of keeping you and your baby safe), but it’s not the only aspect that needs tending to. You and your partner need considerable emotional support also. A professional doula’s focus is on support and comfort for you, both physically and emotionally.  This is something that all birthing families need.  For this reason I am not, nor will I ever be, just for “natural” birth.

*Mostly I serve mothers, but a birthing father, non-binary birthing person, or person who was not planning to parent the child is equally awe-inspiring.

Surrogacy: The Most Hands-On Professional Development I May Ever Get

Surrogacy: The Most Hands-On Professional Development I May Ever Get

For those of you that haven’t heard, I have some big news: Once again, I’m carrying a life. This life is a kicking, somersaulting little boy who, when born, will be handed back to his parents, two Dads who live in Utah.  He is due on May 3rd or thereabouts.

I might be crazy, I’m not sure. But this has been an amazing journey so far and one that is still teaching me.

One thing that everyone wants to know is what made me choose to be a surrogate. It’s a fair question, but one with an understandingly complicated answer.  There are a few parts to it.

A) I’m one of those women who liked being pregnant (and if I could skip the first trimester, I would like it even more) and I loved giving birth. I know that’s weird, but I absolutely loved the birth process. Author and anthropologist, Sheila Kitzinger, once said about birth, “Now this is a sport I can do!” and I completely relate to that. Besides that, I had my children at 23 and 28 respectively, so at 35 I’m totally done with my family, but have still felt the itch to go through the process again.

See! Here is how giant my children are now. There’s no trace of baby left in them.

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B) As a doula and childbirth educator I work with women that are pregnant and giving birth, and while some of these women had an easy time getting and staying pregnant, many of them had a long road of miscarriages or infertility before they got to the point of carrying a full-term pregnancy. Many women in my personal sphere have also had their hearts broken over and over in their attempts to have a child. Many times I have wanted to hand over some of my own fertility to these families.

C) Putting A & B together made me realize that I would be a perfect candidate for helping someone have their own biological child. I had no trouble getting pregnant or staying pregnant and had had uncomplicated pregnancies and births. In the end I was matched with a wonderful gay couple (rather than a heterosexual couple, with a mother unable to carry a child) and I wouldn’t change a thing. I feel lucky to be matched with these great guys and they say they feel the same about me.

D) Professional development- It’s no secret that I live and breathe fertility, pregnancy, childbirth and breastfeeding. Being a surrogate would allow me to experience IVF (crazy!), ultrasounds and hospital birth– all things I did not experience in my own pregnancies and births. What I got was even more than I bargained for. I went through the IVF process once, got pregnant, had the easiest first trimester I’ve EVER had and at almost 10 weeks found that the baby had no heart beat and had stopped growing at about 8 weeks 5 days. It’s hard to explain the shock of finding that out (I was supposed to be taking care of this baby!), but even after I had accepted that the baby was gone, I still wasn’t done because I had to deal with the reality of “birthing” this baby that was no longer with us. Too many of you have experienced this. For me it was the first time and I will never forget it or take for granted the difficulty of that piece of the process. Luckily, the second embryo transfer also resulted in pregnancy  and this one has stuck despite a rocky beginning with some scary bleeding (and this time the first trimester was much more like what I remember with my own children, namely, nauseous).

Here’s me just after the last embryo transfer in August.

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Here’s me after I’m pretty sure I’m pregnant, but before I’ve gotten a blood test to confirm it.

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E) Compensation- I really should mention that I’m being monetarily compensated for this pregnancy. For me that was important, though not at all the sole motivation. This “job” is a 24/7 endeavor and one I’ve been working on for more than a year. It has affected my work and my family, so it feels important that I’m not making those sacrifices for nothing. It’s giving our family a little boost, but really, if I just wanted to make some extra cash there are far less laborious ways of doing that.

I knitted some booties while on bed rest after the embryo transfer for good luck with this baby sticking:

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It’s exciting to be pregnant again. It’s also a little strange too to figure out how to be excited about a baby that doesn’t belong to our family. We’re figuring it out.

In the mean time, I’m totally back in the world of maternity jeans, round-ligament pain, slow digestion, you name it! And it’s reminding me of all sorts of pregnancy tidbits that I had long since forgotten. This is good news for my clients–it’s a refresher for me!  So while I’ll be off work for most of April, May and a little bit of June, I can already tell that I’ll be excited to take on more clients for the second half of the year.

I’m wishing you all health and wellness this winter and through the year!

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These are some ultrasound pictures from the anatomy scan at 19 weeks. I never did this with my own children!

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And here’s a recent picture of my growing belly. Babycenter.com informs me that my uterus is the size of a soccer ball now, which seems huge to me! But it’s only going to get bigger…

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Take Nothing for Granted: What it Feels Like to Come Home from a Birth

What do you feel like when you come home from a day of work? Tired? Energized? Cranky? Cuddly?

When I come home from a day (or more) of being with a laboring mom I feel like I’ve been in another world. A world where life and death hang in the balance. A world where lives are changed dramatically and forever. A world where women and their partners exhibit amazing feats of endurance and remain exquisitely beautiful as they negotiate decisions in the throes of great physical and emotional strain. I bond with these people as if we’ve been in a war zone together, hanging on to each other for dear life.

That may sound awfully dramatic, but in those moments it sometimes feels that real.

And given all of that drama, it’s impossible to just reintegrate to normal life.  I know that birth happens every day–it’s mundane in that sense–but when you have just witnessed The Miracle of Life it doesn’t shake off easily.

I was talking to a doula friend who said that she’s uncomfortable with this transition period. She wants to be able to flip a switch and go back to her normal routine. But she can’t. She’s working on how to reconcile this emotional dilemma of how she thinks she should feel versus how she actually feels. In the mean time, she just lives with that uncomfortable feeling until it fades away and things start to feel normal again.

For me, after 4 years of doing this work, the post-birth “syndrome” is predictable and recognizable. It has two sides. On one side I am in love with the world and everyone in it and truly grateful for the most important things in my life–my family. I live in the moment and take joy in things like baking a big batch of granola for the family or cleaning the kitchen. But on the other side I am incredibly vulnerable. I have a hard time tolerating grouchiness or bickering, especially if it is directed at me. Sometimes little things will make me break into tears. And I look around at people honking at a bad driver or venting about a co-worker and I think, “Why? Why spend your energy on this when there is so much to be happy for?” I appreciate this feeling. Sure, it makes me a little moodier (this is where I apologize to my husband), but it routinely humbles me, reminding me to take nothing for granted.

Death has the same effect on people that are close to it. Two bombs exploded yesterday near the finish line of the Boston marathon. Three are dead and many others are wounded. My heart goes out to the victims, their families, and those who just narrowly missed being in the path of the blast. I often feel powerless after events such as these. What can you do? But where I find my power is knowing that in the face of great pain we often find great strength. Those who survive will be reminded not to take their lives and their loved ones for granted. Those who have lost loved ones will hopefully find healing by finding ways every day to love, honor and remember the one they lost. Boston, pull your loved ones in close, give kindness, compassion and casseroles. Take nothing for granted.

And to all my doula clients past, present and yet to come, I thank you. I thank you for the chance to support you, for the chance to be a part of your life at such a critical time, and most of all, for the consistent reminder that life is amazing, fragile and beautiful.

Ripe for the Picking

Ripe for the Picking

It’s late summer now. Middays are hot, but the mornings are chilly. And the blackberries–my favorite berries of all– so ripe a few weeks ago, are starting to shrivel and go dormant until next year. Sure I have some guilt for loving this invasive plant, but somehow I can’t help myself. Ahhh… blackberries.

And the picking of berries makes me think of–what else?–pregnancy and birth, of course. Why, you ask? Because I’m an impossible birth nerd and I nearly always have labor on the brain. And also because they are both about nature, about the mystery of why one berry on the vine is ripe for the picking and releases easily with a gentle tug and others on the same branch resist the traction you place on them. The unripe berry might have good size, it might be nice and black (although if you turn it, you may find it’s still pale on the underside), but still it tells you, “Not yet. Give me another day.”

But while most people seem to understand and accept that not all berries ripen at the same time, they do not always feel the same about pregnant women and labor. Sometimes I think they view it more like baking a cake. When the timer goes “ding” the cake needs to come out soon or it will end up dry, or worse, burnt. Though any good baker knows to check the cake for doneness, in the baking world it’s always better to pull the cake out early (and put it back if underdone) than to wait too long. Often, this thinking pervades in the labor and delivery world even though you can’t check a baby for doneness without getting him/her out and you certainly can’t put the baby back in to “cook” for longer if s/he was born too early.

We just like to know when the baby is supposed to be done and in this day and age it seems impossible that we still cannot pinpoint a normal healthy delivery date to any smaller range than 4 weeks. But such is life. As annoying as it is, there are some good reasons to learn to live with it.

Consider:

a) When women are induced or scheduled for cesarean births prior to 39 or 40 weeks, providers sometimes discover that the due date was wrong and that the baby hadn’t yet reached “term” resulting in an accidental premature birth with all the resulting health risks (known as “accidental iatrogenic prematurity”).

b) Though we consider 40 weeks the average end-point to a normal pregnancy, a 1990 study by the Harvard School of Public Health showed that the average (median) length of gestation for uncomplicated first pregnancies (in which the mother goes into labor spontaneously) is actually 41 weeks + 1 day. For subsequent pregnancies the average length of gestation was 40 weeks + 3 days. (Note: This study applies to white women only. Weird, huh? There’s a lot to explain about this which I can’t get into here, but for those who are curious, here’s a short explanation: For reasons that aren’t completely understood [but may be related to the stress of institutional racism, not just in the woman’s lifetime but in the lifetime of her mother and grandmother] black women have a much higher rate of premature delivery even when they are highly educated, get good prenatal care and have higher incomes).

c) By studying other mammals, such as the mice in this study, we know that the presence of lung surfactant protein (which is key in making the lungs work after birth) acts to trigger the hormones which lead to labor. Though this has not been studied in humans, it has been studied in other mammals so it’s reasonable to guess that something similar occurs in humans. If this hypothesis is correct, it means that babies signal their mother’s bodies to go into labor when when they are ready to survive outside of the womb.

Everything seems to flow more easily when babies are ripe and ready to be born–while it might look early or late based on the calendar, often when labor happens on its own, it is right on time for the baby.

In my own experience, I’ve seen babies born at 38 weeks at 7.5 lbs and babes born at 42 weeks at 8 lbs and everything in between.  My own two little monkeys had quite different gestational times. My first child was born at 41 weeks exactly and my second was born at 39 weeks +1 day, weighing just a few ounces less than my first (they were 8 lbs 2 oz and 7 lbs 14 oz, respectively). For whatever reason, my younger child needed nearly 2 weeks less gestational time than my older child did.

Of course, nature does make mistakes sometimes. I would be a fool not to recognize that. Women do go into labor prematurely and some women do get to a point at which it is safer to induce labor. But this ought to be the exception, not the rule. Having a great care practitioner that you trust is key–one that recommends induction only if it is truly needed, not just because the clock is ticking.

Good things are worth the wait. Here’s to babies born ripe, healthy, plump and delicious!