Is Labor a Marathon?

Is Labor a Marathon?

Labor is often compared to a marathon.

And it’s a comparison that goes a long way (see what I did there?)… but it doesn’t go all the way. I’ll tell you what I mean.

The analogy works when we think about the fact that labor is quite a journey and often takes a long time too. Coping with labor can be like coping during a marathon when we think about “staying in the moment”, “putting one foot in front of the other” or relying on breath and rhythm to keep us going.

But when we think of sporting events we also often think of “toughing it out” or “powering through” or “gritting your teeth” to get to the end. These are phrases might work if you’ve hit a wall while doing a marathon but they just aren’t helpful in labor. 

Because labor isn’t something you tough out, it’s something you soften into. 

Coping with labor–it’s bigness, it’s intensity, it’s unpredictability–works better when we can let go, get soft, and actually take away our tough layers until we’re loose, mushy, and vulnerable. 

When we can stop tightening up to brace for the next labor wave, the labor actually becomes easier. For some it might actually feel enjoyable to ride those waves in the process of bringing new life into the world. 

As a birth doula, I can help prepare you for a birth that you can relax into. I can sprinkle calm dust all over your room and help you to breathe out any worries and breathe in the steady, soft strength you will need.

Why do partners feel so helpless during birth?

Why do partners feel so helpless during birth?

When I teach childbirth classes and meet with my doula clients, the number one thing that most partners want to know is how they can help. 

The good news: You can help. 

The bad news: Help in labor doesn’t always look how you think it looks. 

For labor support, it’s less about what you do and more about how you are.

What does that even mean, “how you are?” 

Well, are you tense, stressed, and/or worried? Or are you calm, loving, present, and supportive? If you were in labor, which energy would you rather have in the room?

That’s a rhetorical question. We all know the answer. 

But calm, loving, present, and supportive can be done masterfully without, like, dooooing much of anything, maybe just resting your hand on the birthing persons back or leg. In fact, someone recently did a study about how the touch of a loving partner actually reduced pain

If you’re the kind of person that thinks helping equals a lot of doing (hint: this is a pretty common belief among cisgender men) then you’re more likely to feel helpless during the process. But if you can adjust your perception to include “holding space” as something that you are “doing” you will not feel helpless even if your body is largely holding still. 

If you don’t know much about the concept of “holding space”, this article will demonstrate how a midwife or doula can “hold space” simply by knitting in the corner. This article explains “holding space” in the context of a relationship, but it totally works for labor (and can be great to learn for the postpartum period, and really, for the rest of your relationship and your life). 

If you had someone who held space for you during your labor, tell me your story! Let me know what that support looked like and how it felt for you?

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!

—–

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!

You’ve entered the judgement-free zone

Everybody has opinions. Everybody has biases. I’m no different. Lets just get that out of the way right here.

Something else to get out of the way: I am a birth junkie. It’s what I geek out on. When I had my two babies, I had not one second of doubt about whether I would be able to give birth at home without drugs. Don’t ask me why. I just…knew. But I’m not on some high horse. It’s just a little insight into what was important to me.

And the key word here is “me.”  I did what was important to me. And my choices, unique to me, don’t belong in anyone else’s birth.

Duh.

Most women have huge doubts about whether they can achieve a drug-free birth and, more importantly, whether they want to.  This is a perfectly valid question to have: “Do I want to have a pain-medication-free birth?”

While I never waffled about what I wanted for my own births, and always respected the decisions of others, I was really able to understand this on a personal level through an activity that I’m far less confident in. Bicycling.

My husband loves bicycling. I, on the other hand, rode a bike when I was, like, 8 and then never again until I was in my 20s. Riding in traffic scared the pants off of me and I was so out of shape that I thought I would collapse after just short trips. I’ve come a looooooong way, but I still wouldn’t identify myself as a cyclist. So when my husband and a friend hatched a plan to ride 40 miles (with children) to camp in cabins, I was leery. Very leery. The saving grace was that other friends would be driving a car that could carry the cargo and they could ‘rescue’ anyone who needed to quit. So I committed. And we did training rides. And I felt pretty confident. But I knew that if push came to shove I could opt for the ride. And if I did I wouldn’t feel disappointed or like I’d failed. My identity just wasn’t all that tied up in whether I made it all the way on my own power.*

People, this is more than fine.

Maybe I don’t need to be an accomplished bicyclist in order to feel like my life is complete. Many women out there feel the same way about birth. Like, it’d be kinda cool to have a drug-free birth, but they’re not willing to be pushed to the limits of what they can endure for the sake of a drug-free birth. I get it.

I work with lots of women that want to try for a drug-free labor, but they have a threshold after which they would want medication. Some women know they want an epidural, but they want a doula for emotional support, information and lots physical support during labor prior to an epidural (and the massages don’t have to stop when the epidural arrives, for sure!). Some women really, really do not want an epidural, but end up getting one because they desperately need rest after several days of labor. And let me tell you, it can be incredibly empowering to stand up and say, “This is what I need right now, even though it doesn’t fit the plan I had for my labor.” Some women know that they don’t want drugs in labor and they do it–sometimes with ease and sometimes with a lot of effort and resolve.

When I’m with a woman/couple in labor, I stay flexible and responsive, checking-in as things morph and change. There are no absolutes when it comes to labor. And there is just no room for judgment. When my clients come to me, they are safe (emotionally speaking). There are no “right” answers. They’ve entered the “Judgment Free Zone” where making choices isn’t easy, but it’s free.

*For those that are curious, we made it almost the whole way, but the last 3/4 of a mile was a steep uphill, so I took my kids (sparing my exhausted husband from hauling their dead weight up the hill) in the car.