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.

Reflections: Surrogacy Home Birth Story

Reflections: Surrogacy Home Birth Story

Last year 2 years ago, at about this time today, I gave birth for the 4th and last time. How many times have I said it was my last? Well, 3, but this time I think it’s really true. I turned 40 41 this year, I have a teenager and another almost-teenager, and the last two pregnancies were for families other than my own. I’ve done more gestating than most!

I’ve wanted to write this last birth story for a while (as you might have guessed from my edits), almost since the day she was born. But I haven’t quite known what to say. It’s not that I am at a loss for words, more that I have too many thoughts and words all jockeying for the same spot. All wanting to explain why birth is important–why birth matters. 

This is not just the story of this last birth. Because the story of the last birth encompasses all the births and pregnancies before it. It can’t stand alone. 

I want to tell the story of how transformative those births were for me. How elated I was after each one. Stories are powerful and we don’t get to hear enough positive birth stories. But I also fear coming off smug or preachy and that’s the last thing I want. I know how lucky I have been, not only for the genes I was dealt, but also that the path of least resistance for me when pregnant the first time (for financial/insurance and social reasons) was actually to have a homebirth midwife. For most birthing people, the path of least resistance is to use with the OB they saw for their PAP smear, at the hospital their insurance happens to cover. It would be many, many years before I fully realized the impact of choosing a homebirth for my first birth. But perhaps that’s another story…

So, please, come with me on this rambling ride and see what you take away.

Birth #1

My first birth taught me that no one needed to tell me how to birth. I knew what to do from somewhere deep inside. My midwife watched me and my baby carefully, but was very judicious in offering me advice or suggestions. Of course she stepped in when I needed her and offered the kind of subtle guidance that midwives tend to, so I came away feeling that I had figured it out all by myself. I also learned what an amazing afterglow you can get from a really good birth. Despite being weak and depleted in my body, I felt strong beyond belief. It’s not logical, but was a tremendously wonderful way to begin motherhood with my new daughter.

Birth #2

My second birth, with my son, taught me that birth can be sensual and enjoyable. This birth was almost easy. During very early labor, (shh, this is taboo) my husband and I even had intercourse because it felt right and it felt good. It didn’t seem radical at all. Contractions were still far apart (10-15 minutes) and quite mild. It was sweet and deepened our connection. Afterwards, my husband had a sudden inspiration for the middle names (yes names, we picked two) for a boy and it clicked. We had the girl name figured out, but we finally knew what the name would be if we had a boy. A few hours later, labor picked up and progressed, but it never really felt hard until I reached the pushing stage. This part was terribly short (under 5 minutes) and rather shocking, I must say, but it was really the only hard part about the labor. The same day (or the maybe the next day, I can’t remember), I was already sad that I wouldn’t ever birth again, since we had only planned to have two children. 

Besides teaching me that birth could be sensual and enjoyable, the other thing that my second birth taught me was that I had an intuition, and that I could begin to trust it. My contractions started around 2 am. By 7 am, they were stronger, but still very far apart. We decided to call the midwife and let her know what was going on. Towards the end of our conversation she asked me,  “What does your intuition say?” and, somewhat confused, I replied, “About when the baby will be born??” And she said, “Yeah.” And only in that instant, did I realize I had an answer. I said, “Early afternoon?” and she said, “That sounds about right.” My son was born at 12:45 pm.

Birth #3

My third birth was a surrogacy. I had more worries about this birth for many reasons. The first was that I’d had my first ever miscarriage with the first pregnancy for this couple. Losing that baby at about 10 weeks in a missed miscarriage was very challenging. I took medication at home to complete the miscarriage and lost what felt like a scary amount of blood. We went on to do a second embryo transfer, which stuck, but I had early pregnancy bleeding (common with IVF, but scary nonetheless) that made everything feel more uncertain for almost half of the pregnancy. This third birth was my first hospital birth and I was apprehensive about what that would be like. I don’t mind hospitals, and I’m in them all the time for my work as a birth doula, so I felt like I knew the lay of the land, but like all birthing people I was apprehensive about when would be the right time to go into the hospital and what the process would look like for me in this new environment. 

What this birth taught me was that my labors are “shy” and that the hospital providers didn’t trust my body the same way my midwife had. With this birth my water broke before labor contractions started. We went to the hospital on medical advice, but labor did not get active despite waiting through the night and then trying nipple stimulation in the morning and afternoon. About 18 hours in, with no labor to speak of, the nurse and midwife began to talk about Pitocin augmentation. I knew that Pitocin could be helpful, but I was still skeptical that I needed it. After talking to my doula and my husband, we decided to ask for one hour of uninterrupted time. Everyone left the room except for me and my husband and we hopped into the shower together, where with privacy, warm water, and a few drops of clary sage essential oil on the bottom of the shower, labor began to roll almost instantly. 

About 5 hours after getting out of the shower, surrogate baby #1 was born. 

It was only after this birth that I remembered how in my second birth, my contractions had disappeared for stretches of time, when I was talking to a friend. It didn’t happen in my first birth, but then again no one really tried to talk to me! I realized that even calm, casual chatting was enough to make my body push the pause button on labor. I didn’t need Pitocin, I needed to turn off my brain. 

This 3rd birth was intense. I really thought maybe I couldn’t do it. Maybe I would need the epidural after all. But that turned out to be the transition talking. And just like with my second birth, pushing came on suddenly and was over in under 5 minutes. I felt and sounded like a wild animal, I’m sure. And then it was over and the euphoria kicked in. (For more on this birth, see this blog post)

Birth #4

So finally, when it came to having surrogate baby #2 (birth #4) I knew some things. This time I was carrying for a close friend who was, amazingly, agreeable to having a homebirth, provided the pregnancy stayed healthy and low risk. It had taken a few embryo transfers before we successfully achieved pregnancy, but somehow, even though this was the last embryo and a lot was riding on it, I felt completely calm and reassured that everything would be ok. We hired a homebirth midwife and began to have visits. This was a new midwife, as my midwife for my first two births had moved away and was semi-retired. Unfortunately, despite trusting that she had solid skills, I was not clicking with her. Something felt like it was missing or off. 

As a doula I tell people all the time that it’s okay to change providers, but it still felt uncomfortable to do it. I had talks with the mother-of-the-baby and she was feeling the same thing I was. We interviewed another midwife team and decided to switch care right around the start of the 3rd trimester. 

I knew these new midwives professionally and I also knew a lot about myself as a birthing person, so I felt pretty confident expressing that I didn’t want a lot of hand-holding during the birth, I really just wanted experienced midwives who would recognize if something was not-normal and needed intervention. They took me seriously and when it came to the birth I felt completely in control of my care.

My first baby was 41 weeks when she was born, but the last two babies I had birthed (the boys) came at 39 weeks 1 day and 38 weeks 2 days respectively. I got the impression that I had just gotten more efficient at growing babies! My due date was 12/15 for this girl, so I assumed that I would be giving birth in the first half of December. But 38, 39 and 40 weeks came and went and still we waited. Finally at 40 weeks and 2 days, I woke up to mild contractions about 10 minutes apart and some slight bloody show. YES! I knew we were close. 

Our plan was to have the baby at my friend’s house, the home of the baby I was carrying. Both of my kids wanted to be there to witness it. There was going to be quite a crowd at the birth. It would be me, my husband, my two kids (aged 11 and 15 at the time), my mom (to attend to my kids if needed), both intended parents, the sister of the intended mother (who would take pictures), the two midwives and a midwifery apprentice. It was a Sunday morning and my daughter had a volunteer shift at a Christmas tree lot from 12-3. We debated whether she should try to get someone to cover her shift, or try to arrange for someone to give her a ride if we needed to go to the birth place before she was done with her shift.

There wasn’t a really good option presenting itself, so we decided to wait and see. All morning contractions continued, but stayed very infrequent and very mild. Around midday the contractions slowed waaaaaay down. My daughter went to her shift and I attempted to nap–I’m not a stellar napper, but I did get some rest. I counted one contraction in that time, about an hour from the previous one. It was safe to say I felt comfortable waiting for my daughter to return. Clearly the babe wasn’t in any great hurry. 

But, as I noted, I know my body and I knew that my body has a tendency to wait if all the ducks aren’t in a row. So we made the plan that we would pack up, head to the IPs house around 4 to get settled in, thinking that labor would pick up once everything was ready. 

So when we got there, we said hi and I opted to hop in the shower with my husband. It had worked with the last baby! But… while the shower was nice, and we succeeded in getting more frequent contractions, they were only every 8-10 minutes, hardly active labor. We took a break, ate some pizza and then I went to the room that my IPs had set aside for me. I was a little discouraged, but also determined. I think I tried some nipple stimulation. No dice. 

Not quite ready to give up on making labor happen, I texted my midwives in the impatient way one does when labor isn’t doing what we want it to do. 

6:29 pm 

Me: “Hey, we’re all settled in at [Intended Mother’s House]. I spent some time in the shower with [husband]. We laid down for a little bit. I got out the breast pump for a little bit, but contractions are still pretty spaced out. Active labor hasn’t magically manifested like I had hoped. Still having plenty of mucus and light bleeding. Do you think a membrane sweep would help at this point? Any ideas?”

They responded appropriately, of course.

Midwife 1: Hi Scarlett… that all sounds promising 🙂 Are you worried things aren’t going to pick up or are you just wanting them to pick up now? I’m sure your body knows what it’s doing and is gearing up… I’m kinda thinking this may be a middle of the night birth? Maybe rest is the best idea?????

Midwife 2: I was thinking the same.

Me: I guess I’m wanting them to pick up sooner than later since everyone is here and waiting. You know, all the good reasons…

6:36 pm

Midwife 1: Well… they’re not going anywhere. And we all know what happens to the watched pot!

Me: I have been resting a lot of the day, so that’s good!

Midwife 1: I think the bloody show is a great sign that it’s gonna happen soon!!

6:39 pm

Midwife 1: You could try nipple stimulation or breast pump 15 min on, 5 min off for an hour… that’s a pretty intensive pumping schedule

6:40 pm

Me: That is pretty intense. I’ll think about it!

Midwife 1: K!

6:42 pm

Midwife 2: Ok 🙂 this does all sound pretty normal so far for warm up labor. If there isn’t a baby yet in the morning I could come over first thing and check you and do a membrane sweep.

6:44 pm

Me: That sounds like a good idea. We’re gonna try some posterior baby stuff and see if that changes anything, but if nothing much is happening by bed time we’ll just go to bed. 

Midwife 1: Sounds like a good plan.

Midwife 2: Sounds good.

So we did try some “posterior baby stuff” for good measure. I think I had my husband help me with a sidelying release. And then there was nothing left to do but remember that labor cannot be forced. 

We went upstairs where my mom was watching the first Star Wars movie with my kids and the intended parents (IPs). We watched the rest of the movie and told everyone that we were going to go to bed and they all should too. 

My mom went home (she didn’t live far), we put the kids to bed on the couches upstairs and the grown-ups went downstairs to chat a bit more before turning in. As we were talking, I was on my knees leaning over the ball and the labor contractions were starting to get stronger and more frequent. I went with it and took notice. They were beginning to come 6 minutes apart. I had this exchange with my midwives:

10:52 pm

Me: Contractions are about every 6 minutes for the last 45 minutes and feel like they’re getting more intense.

10:53 pm

Midwife 1: That’s sounding like the right direction! Keep us posted… How long are they lasting?

10:54 pm

Me: Just under a minute. Like 55 seconds-ish.

10:55 pm

Midwife 1: Great!

At around 11 we wrapped up chatting and went to bed… or tried to anyway. About the time I turned off the lamp and tried to settle in I found that I couldn’t quietly breathe through a contraction anymore. I went to my old, familiar low moaning sounds. But the contractions weren’t getting noticeably closer together so I was reluctant to call in the midwives. My husband on the other hand, well, he knows me and he knows how I birth so he began texting the midwives.

12/18/17

12:18 am

Husband: [Husband] here. Contractions are still about 50 seconds long, and coming 5-6 minutes apart, then a few that are 10 or so. BUT they are getting more intense/strong (she is vocalizing more and more). 

12:19 am

Midwife 2: Ok- I’m going to head over.

12:20 am

Midwife 1: Hey [husband]. Sounds like she’s moving in the right direction. Does she want us to come over now?

12:23 am

Husband: She’s indecisive. She’s hoping it’s not a false alarm, but it does seem to be picking up. It may be baby’s position? Maybe one of you could come check in?

12:24 am

Husband: Sorry for the delayed response- rode out a strong contraction in the middle of typing.

Midwife 1: It’s not a false alarm 🙂 Good work! We’ll make our way over. 

12:25 am

Husband: (“ok” emoji symbol)

One of the student midwives arrived first and checked my vitals. Then Midwife 1 arrived. Contractions were very strong, but felt like there was lots of space between them. This made me nervous that everyone was here way too soon, but also it felt an awful lot like my second birth had. 

When Midwife 1 checked in with me, I explained my reservations and asked her if she wanted to check my cervix to find out where I was in the process. She happily obliged. When she checked me, she said I was 6 to 7 cms, further dilated than she would have guessed by looking at me. 

We were filling the tub already and I was happy about the prospect of getting into it. Before the tub was ready, I started to feel my body shaking and I wondered if the birth would be very soon. My mom was on her way back, or maybe she had arrived already. 

Once I got into the tub, everyone was in the downstairs room with me. My kids were on the couch with my mom. Midwives were camped out on the floor. Husband was holding my hand from the sidelines. IPs were sitting quietly. And Auntie was taking photos now and then. 

The tub was hot. I took long drinks out of cans of coconut water that had frozen slightly in the fridge and it was heavenly. 

I used my low, loud moans with every contraction. It was hard, but felt manageable. I would look around at the sleepy faces now and then and crack a wry joke. 

Eventually, I felt like I was SO close to giving birth and right before every contraction I would think, “Is this going to be the contraction where the bottom drops out, and the baby comes out in one big, terrible push?” But then the contraction would happen, I would feel slight pressure, but nothing like the real urge to push. After what seemed like at least an hour of this (time, who knows?), I looked up at one of my midwives and said, “What do you think is happening here? Do you think it’s an anterior lip?” And she told me that she could check to see if I wanted her to. I did.

She checked me while I was still in the tub and she said that there was an anterior lip, but it was soft and moved right out of the way when she touched it, so she didn’t think it was holding the baby back. She did say that there was a bulging bag of water and that this baby might be bigger than my previous babies and just need this water to break so that the head could come down more quickly. She said that she could break my water to help us get the rest of the way.

I thought it over, and I knew that once my water was broken the next contraction was going to be The One which gets the baby out. But I’d been waiting/dreading that moment for quite some time anyway and I didn’t want to wonder and wait anymore. I was ready. She broke my water with a little prick and on the very next contraction there was no mistaking the Fetal Ejection Reflex that kicked in. 

It’s hard to describe what it feels like. What I can tell you is that I yelled my head off, saying things like, “I can’t breathe!” (I could definitely breathe) and “I can’t, I can’t” (I could) and “Oh God, Oh God.” I gripped my husband’s hands and held on for dear life as the baby rocketed out of me. This part of birthing is not pleasant for me and does not feel manageable. But I don’t think it’s pain that makes it unmanageable, I think it’s the speed. In these 3 minute pushing sessions, it’s like someone opened a trap door beneath me and I’m in free fall, clutching and screaming. Thank goodness for hand-holders and the relief when the baby is finally out.

6 minutes after my midwife broke my water, at 5:54 am, all 9 lbs 1 oz of my belly buddy was out, caught by her very own mother who had gotten into the tub with me for just that reason. Sadly, the first words that little one heard from me were profane as I yelled “HOLY S&*%T!” right after I caught my breath. It was a second before I could turn around and take in the beauty of my friend, her husband and her baby, united at last.

What this last birth taught me was that as much as I really wanted one of those controlled, blissful, calm pushing phases I will not get it (not that I’m ever having another one, because I am not). I tried really hard to mind-over-matter my way into a calm and collected pushing phase, but I was spectacularly unsuccessful. The birth reminded me how wonderful it feels to have my autonomy so respected and to have complete trust from my family and my providers. 

Birth matters because we are so vulnerable during our birthing times. We need tenderness, respect, and choices that are not an illusion. When we have these things, we can come through birth feeling more powerful than before even if the birth looked nothing like we wished or expected it would. 

My births taught me about compassion and love. And this world needs more of both.

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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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!

Finding Your Voice

I was at a networking meeting for birth professionals recently and in small group discussions we asked a question: “What do you wish more people knew about pregnancy, birth, postpartum or breastfeeding?”

There are a lot of answers to that question, but immediately one doula said (and I paraphrase), “I wish more women knew… that they had options.”  Options*. Yes. You have tons of them. But often people don’t know about them–well, you can’t ask questions about something you don’t know exists–so they get swept along with the status quo.

Here’s how it so often goes: You already have an OB/GYN that you see for your annual Pap test and any other “feminine issues”. When you get pregnant you’re a jumble of emotions and new physical sensations.  The birth is, like, forever away.  You call your OB/GYN to see what to do next and you’re told that they don’t see you until you’re about 12 weeks along. And so you wait. And hopefully you’re not too nauseous as you’re waiting.

When you do go in for your first visit, you’ll spend short visit being weighed, measured and listening to the heartbeat (♥). You may do some tests to screen for Down Syndrome and Spina Bifida. (Do you have to do these tests? No. But then again, you probably don’t know that’s option. And you don’t know that the screening test is only about 60% accurate. The other 40% of the time, it gives you a false positive or a false negative, yielding either a lot of anxiety and more tests or a false sense of security).  And then… you make an appointment for the next visit in another month. Maybe you had some questions, but your doctor seemed pretty busy. Besides you’ve got tons of time before you have to talk about all this stuff (remember, the birth is forever away). You can cover it in the next visit. Or can you? (For an illuminating view on the differing amounts of time you spend with an OB vs. a Midwife, watch this 2 1/2 minute video)

Maybe you have a vague concept that there are other childbirth choices, but they all seem kind of out there, odd, or um, crunchy. You can’t really relate.

I can relate.

You might be the ‘respect authority’ type, or the laid back ‘I-don’t-want-to-trouble-anyone’ type. I know I was. Only because my interest in birth goes back pretty far, did I go for the “crunchy” option right away.  But I don’t like to inconvenience people, especially not doctors. They’re important and they’re busy. I’m not a diva. I don’t feel like my needs have the be the highest priority. No big deal, right?

Wrong-o.

There are all kinds of choices that need to be made in your pregnancy and birth (in your life for that matter) and if you are not making those choices, it doesn’t mean that there wasn’t a choice, it just means that someone else is making it for you.  Sometimes that’s nice. I hate making decisions. If it’s of little consequence, I’m only too happy to hand that responsibility off to someone else! (Thai food? Burgers and fries? I don’t care! Pick for me.) But the key word here is “consequence.” Who has to live with them?  You do.

Wrenching as it sometimes is to make big decisions (or little ones, even) there’s something immensely satisfying about being in the drivers seat when it comes to your care.

Women should be making decisions together with their doctors or midwives. Your doctor or midwife should know enough about you to understand your hopes, fears and peculiarities. He or she should listen, answer your questions fully and should have a genuine interest in you and your well being.

If you have a nagging feeling about whether your choice of provider or birth place is really right, my advice is not to push it away. Take that nagging feeling and look it in the eye. Are you confident that you will get all the support you might need? If not, it’s time to start researching your options. There’s that word again! Options. Research them. Ask questions. Read books. Read blogs!  It doesn’t mean you have to change your mind or your plans. In fact all your research might show you that, in fact, your first choice was the right one for you. But whatever you choose, it will feel better–more purposeful–now. And, really, one less nagging worry is always a good thing!

Congratulations. You’ve found your voice.

*Obviously, this post isn’t about specific options (too much to cover in one blog entry!), but about the value of exercising your freedom of choice. 🙂

What to read when you’re expecting

I’m kind of picky about my birth literature.

Weeell… I’m maybe I’m not that picky about what I read, but I’m super, über nit-picky about what I’ll recommend.  I’m a Virgo. I’m critical. What can I say?

The list of ‘can’ts’ is long. It can’t be too preachy, too fluffy, too scary, too bland, too rigid, too slanted or too, uh, new-agey, let’s say. I know, I know, what’s left?  Not much, unfortunately.

Certainly not the most ubiquitous pregnancy book on the market. I don’t know whether I’m proud or embarrassed to admitted that I’ve never cracked a copy of  What to Expect When You’re Expecting. It seems unthinkable but, well, I’m not really sorry about it. Everyone I know who has read it said that it gave them anxiety attacks. And does anyone really think that what pregnant women really need is another dose of anxiety?

And then there are the books that I actually like, like The Thinking Woman’s Guide to a Better Birth by Henci Goer. It is an incredible book with research-backed information, but… it comes down pretty hard on hospitals. It’s just not that approachable if you think hospitals are pretty okay–and most people do. And then there’s the fact that it doesn’t do much to bolster your confidence about giving birth. Instead it gives you something else to worry about, not Big Bad Listeria that’s lurking in delicious soft cheeses, but the care providers themselves and the often routine hospital procedures. More anxiety! Not helpful.

Also I devoured The Baby Catcher, written by midwife Peggy Vincent about her many years of catching babies, but I’m not going to hand it to a pregnant lady. Vincent chose all the most memorably dramatic births (translation: fast and scary) to write about, which is great for the purposes of the book, but too skewed of a picture to be considered solidly educational.

Nope. I’m not going to pile those books into your arms when you come over just to borrow a cup of sugar for your zucchini bread.

Instead I’m going to meaningfully press a copy of Ina May’s Guide to Childbirth into your palms. I want all pregnant women to read this book. It’s an engaging read. You can read it cover to cover without getting bored.  It uses birth stories to illustrate the wide range of ‘normal’ in a labor and birth. It describes how each woman passed her own hurdles of labor (or whether labor was easy and enjoyable) to powerfully deliver her baby. Ina May Gaskin boils down her 30+ years of witnessing normal labor and gives her insights into how birth works (you have to read it to get all the little gems, like one of my favorites, a chapter called “Sphincter Law”).  All in all, it’s pretty radical stuff, but she doesn’t jam it down your throat. She’s not out to judge anyone or tell you there’s a right or wrong way to give birth. But she knows that birth works and she wants to make sure that you know it too.  If we let mainstream media tell the story, birth is very dangerous and usually needs lots and lots of intervention. Ina May’s Guide tells us another story–one that doesn’t get much press.  After reading all those birth stories, its hard not to think “Well, if they could do it, so can I!”

Sold!

Labor and birth are filled with unknowns. Without being scary, this book helps you feel prepared to expect the unexpected. Forget What to Expect; be prepared to be surprised.