Friday, June 13, 2014

My Nonspecific Childbirth Advice

I try to not feel guilty about things I did or didn't do during the birth of my children. And I know that there will be things that I wish I had or hadn't done when all is said and done with baby #3. But as I've reflected on my past birth experiences as I look forward to this one, there are a few things I wish I had known or remembered--and that I'm trying to remember for this one.

1) Educate yourself. You can't make a choice if you don't know your choices. And yes, doctors and nurses and midwives have seen more births than you, but they haven't seen the one you're about to have. Many institutions have a way that they normally do things. That doesn't mean that way is right for you.

2) Speak up. This is my #1 regret with baby #1. I ignorantly thought that people had read my birth plan or cared. Some things happened in the hospital both during and after labor that I did not agree to. And I wish I'd spoken up. I wish I'd told that night nurse to leave my room and get someone else. I'm  not great at speaking up for myself. And I don't think either my husband or I realized that we could and should speak up. This is where a doula could really help.

3) Rest and enjoy the moments between contractions. With baby #1 I was so anxious to go into labor that I didn't sleep in very early labor, which was a Thursday night. Then I spent all of Friday and Friday night in labor and didn't deliver until Saturday morning. Exhaustion did not help the challenges I faced in labor or the recovery period at all. With both births, I spent the moments between contractions in fear of the next one. And that got me nowhere. Labor is not nonstop pain. One of the main things I want to do differently this time is to try to remember to use the moments in between to relax, to renew, and to enjoy not having a contraction.

4) Remember the baby. I know this sounds weird, and hopefully I won't be judged too harshly for it, but at many points during both my previous labors, I was so wrapped up in the work and the pain and the exhaustion that I didn't think about the coming baby much. I'm not saying I didn't care, but I didn't take advantage of the coping technique of imagining the baby in my arms--the whole point of what I was going through. This is my favorite picture from the birth of baby #2. I have it framed and I recently got it down to look at to remind myself that this is what it's all for:

I've also gathered some quotes from my readings that I review and want to remember. Here are just a few:

“Don’t let your over-busy mind interfere with the ancient wisdom of your body.” – Ina May Gaskin

“To diminish the suffering of pain, we need to make a crucial distinction between the pain of pain and the pain we create by our thoughts about the pain. Fear, anger, guilt, loneliness, and helplessness are all mental and emotional responses that can intensify pain.” – The Dalai Lama

“Knowing unshakably that everything is in constant transformation can be extremely helpful in childbirth. No matter how long your labor takes—hours or days—or how challenging or easy the experience is, it will end. Each labor lasts only a certain number of breaths. Then it’s over. We don’t know how many breaths we will take in and release during labor or many intense physical sensations we call contraction-expansions will arise and pass, but however it goes, it goes. That much we do know.” - Nancy Bardacke

Sunday, June 8, 2014

What Do Homebirth Midwives Do?

As homebirth is becoming more common, I'm finding that more people are enthusiastic (or at least not panicking) when I tell them I'm doing a homebirth. Even if "there's no way I ever would/could do a homebirth," many people of my generation have at least heard of someone else who did it.

There are still a few people who ask if I'm going to have a midwife come. Umm, yes. I may be a bit outside of normal, but not that much. I appreciate having the expertise of a licensed midwife combined with the comforts and freedoms of home. There are extremists out there who choose an unattended birth or want to give birth in the ocean with dolphins (I seriously remember a news story about that from a few years ago, I'm not making it up). But even back when homebirth was the norm, women usually had midwives and other women attend them.

Since we moved, I'm experiencing my second homebirth midwife. Though their personalities are wildly different, as Licensed Midwives their education, training, and abilities are the same. My current midwife's practice is called Sweet Baby Midwifery. I was going to write my own explanation of what a homebirth midwife does, but she writes it so well on her website that I'm going to borrow some of her words (and you can check out her site if you want more detailed information).

Prenatal Care

I offer complete prenatal care during your pregnancy. Visits are scheduled at standard intervals: Once a  month until 28 weeks, every two weeks until 36 weeks and once a week until the baby is born. All visits are done in the comfort of your own home.

All prenatal care covers the exact same care you would get from an OB or a hospital based midwife. They check the same things and do the same lab tests at the same times.

Labor and Birth

When your body goes into labor, my birth assistant and I will come to your home. I bring with me everything needed for the labor, birth and immediate postpartum. This includes my birth kit of instruments, bulb syringe, oxygen, IV supplies, emergency equipment and medications to stop postpartum bleeding. I am fully prepared and trained should the birth or postpartum move outside of normal.  

While in labor, you have complete freedom of movement. You are encouraged to eat and drink. I have the ability to give you an IV, but it is not standard and only given if needed. I will monitor your blood pressure, pulse and temperature. I will listen to the baby's heart beat with my handheld Doppler in increasing intervals as labor progresses. 

Baby comes right to your chest after birth. Anything that I need to do for baby, I can do right on your chest.

Once you and baby are medically stable, comfortable breastfeeding and ready to sleep, my birth assistant and I will leave you to enjoy your new family addition.

Should a situation arise that requires transferring to the hospital, I will accompany you. I will call ahead to the hospital to let them know what is happening and what is needed. We will go either via ambulance or personal vehicle depending on the situation. Although, I don't have hospital privileges, I will be able to communicate with the hospital staff to insure a smooth transition.

Homebirth midwives come with all the equipment and medication (and training to use them!) that would be needed in an emergency. Without interventions, birth usually goes just fine. But a homebirth midwife is trained to face any emergency and to know when it's wise to transfer to a hospital.

Postpartum Care

I will return to your home 24-48 hrs after the birth. I will check on you and the baby. I provide breastfeeding help. Overall, I make sure you and baby are happy and healthy. I will then return at 2 weeks and 6 weeks postpartum.

This care is significantly better than what I received from the hospital. If I have problems with breastfeeding, I have someone's personal cell I can call to get that help as soon as I need it.


When I was pregnant with baby #2, I was in a car accident. I called my midwife and she came to check on me and the baby at home right away. It was a Sunday and I didn't have to decide between waiting to make an appointment the next day or going to the ER to make sure my baby was safe.

Homebirth is definitely not for everyone or even for every birth. But true choice in childbirth includes knowing your choices. And I can attest that anyone making a different choice than what you're accustomed to will appreciate you learning a little bit about their choice before passing judgment.

Friday, June 6, 2014

Birth Books

Going on baby #3, I've read lots of pregnancy and birth books. The list tends to be heavy on natural birthing because that it is what I have chosen when possible, but I've read a variety. Though I certainly advocate natural birth, I also know that it's not the right choice for everyone or a possibility for every pregnancy. But I firmly believe that you can't truly make a choice unless you actually know what your choices are. And just as it's important for someone like me planning a home birth to know about and be prepared for any possibility, including a c-section if it is truly needed, I believe it's important for someone planning a hospital birth with pain medications to have some knowledge of how to get through an unmedicated birth. I know plenty of women who planned a hospital birth with medications who had a baby too quickly to take anything--even one who gave birth in her car on the way to the hospital.

Since I keep a list of books I've read (yes, I'm a nerd like that), I can look back and know exactly what books I've read before each child.

Before Baby #1 (who I wanted to have naturally but being in a hospital setting contributed to me needing an epidural--one that didn't work like they're supposed to):

1) Having a Baby, Naturally by Peggy O'Mara
Written by the editor of Mothering Magazine, it's a good overview of natural childbirth.
2) Birthing from Within by Pam England
I don't remember a lot of details from this book, but I remember that it covers lots of methods for coping with the pain of childbirth, not just one like most books do.
3) Birth: The Surprising History of How We are Born by Tina Cassidy
Talks about the history of childbirth through the years. Interesting to see how much things change and how certain beliefs came to be.
4) Belly Laughs by Jenny McCarthy
Not an education book, but she does give some funny insight into a first time mom's experience. She can be a little crude, and I didn't like the follow up Baby Laughs nearly as much.
5) The Girlfriend's Guide to Pregnancy by Vicki Iovine
Written by a normal woman. It talks about some of the weird, embarrassing things that women in experience during pregnancy and childbirth that we don't talk about with everyone.
6) Hypnobirthing by Marie F. Mongan
I've known this method to work great for many people. It simply didn't for me. I don't think I'm the right personality for it. But if you are planning a natural birth, it's a good one to look into.
7) What to Expect When You're Expecting
This is the only book I wish I hadn't read. It should only be used as a reference book (but you can easily search the same information on childbirth websites like Read from cover to cover it brings up too many scary what ifs that are rarely an issue.

Before Baby #2 (who I gave birth to in a tub at home):

1) Better Birth by Denise Spatafora
My take on it after reading it was: "Pretty good, a little too touchy feely, repetitive and there are lots of others like it."
2) Your Best Birth by Ricki Lake and Abby Epstein
This is a good one with lots of information and fairly unbiased. They also have two documentaries: The Business of Being Born and More Business of Being Born which are usually available n Netflix Streaming. The first one set out to explore natural birth, but in an unexpected turn of events also follows a birth that ends up taking place in a hospital. Which reinforces my feelings that it's important to know all aspects of birth.
3) Birth Matters: A Midwife's Manifesta by Ina May Gaskin
Ina May is the most well-known midwife in America, and is also known throughout the world. She definitely advocates natural birth. But if you want to learn about it, she is the one to read.
4) Gentle Birth Choices by Barbara Harper, RN
This one was long, but had a good coverage of lots of issues surrounding childbirth.
5) The Official Lamaze Guide by Lothian and DeVries
Another method of childbirth pain management. I've never stuck to one method, but was glad that I read a variety so I had different methods to call on at the time.
6) Ina May's Guide to Childbirth by Ina May Gaskin
The book to read on natural childbirth.
7) Ina May's Guide to Breastfeeding by Ina May Gaskin
A good guide to breastfeeding no matter what your childbirth choices or realities are.

Before Baby #3 (who is due in a couple of weeks and I'm planning a home waterbirth, though I have back up plans for if something goes wrong):

1) A Good Birth by Anne Drapkin Lyerly
I highly recommend this book to anyone who has given birth, especially if things didn't go as hoped. It helped me process both of my previous births and come to terms with some regrets I had.
2) The Homebirth Guide by some doctors
This one was okay. As someone who had already given birth at home, it was mostly reminders.
3) Ina May's Guide to Childbirth by Ina May Gaskin
A good reread and reminder.
4) Ina May's Guide to Breastfeeding by Ina May Gaskin
Another good reread. I'm really hoping to avoid the same early breastfeeding issues I encountered with my first two (who had different issues). What I've probably learned the most is to get professional intervention right away if I'm having any difficulties.
5) Mindful Birthing by Nancy Bardacke
The method in this one is mostly meditation, but I've found good information in it even without doing the meditation practices. Even with all the other childbirth books I've read, I'm glad that I picked up this one.

So there you have it. I believe that knowledge is power--but too much knowledge can stress you out. What I really wish I'd known the first time around (both in reading about birthing and parenting) was to gather knowledge but to trust in myself, to not become too attached to any one method or idea, and to speak up for myself.

For Baby #3, I have plans for how I want things to go, contingency plans for if something goes wrong, and trying to have more trust in my body's ability to birth, and since I'm religious, a little more faith in God and a little less need to try and control things out of my control.