Tuesday, November 30, 2010

a thought on nurses

I recently attended a birth in the exact same hospital that I delivered my son at.  My experience was far from "natural", and I was extremely frustrated with the nurses.

But when I went back as a doula, I was amazed at the difference.  The nurses were attentive, aware, and always asking my client's opinion.  One of the nurses was in school to be a midwife, and knew about different birthing positions, pushing techniques, and so on.  My client was able to have her baby placed directly on her stomach, and left there for a solid hour before they took her to the nursery.  She was permitted to labor on the toilet, push as she felt appropriate, did not receive an episiotomy, and delayed cord clamping.  All of these were things I had hoped for but did not experience.

What was the difference?

I think it was her doctor.

Nurses do not know you personally; they do not understand your experiences, your preferences, your strengths or your weaknesses ... but you can bet they know your doctor's.  They understand how your doctor works, and they will treat you accordingly.  My client had a midwife who was well respected in this hospital, and I had the king of c-sections (who is actually in jail now ... oops).  It only makes sense that they will tailor their treatment to the doctor's style more than your own.

So, yet another reason to be sure you find a doctor that you absolutely agree with.  You cannot take someone who is good at doing one thing, and ask them to do another.  It will be frustrating for everyone involved.

delayed cord clamping

Delayed cord clamping is exactly that .... delaying the clamping of the cord for around two minutes; or when it stops pulsing.  This is something that is not done too often in hospitals unless the couple requests it.  It allows the last of the nutrients from the placenta to be delivered to the baby, and has some definite benefits; there was a marked improvement in the content of the babys' blood -- particularly their iron levels -- extending throughout their infancy.

I found a great medical article on it here.

The article concludes with:
"Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn, extending into infancy. Although there was an increase in polycythemia among infants in whom cord clamping was delayed, this condition appeared to be benign."

my firstborn son

This is my personal experience with the birth of my son, and greatly influenced my view on birth as a doula.  I wrote this about two weeks after he was born.

"Okay, so labor is intense. Extremely intense. But now that it's over, I'm surprised by how do-able it is! Don't get me wrong though, it was the most physically difficult thing I've ever been through. Of course, I only have a few broken bones and some stitches from Mom's sewing scissors compare it to, and it definitely outdid all of those. But your body just . . . works. It knows what to do, and you find yourself just saying, "Okay, here we go!"
I did find myself having moments where I just wanted to cry and curl up into a ball of anguish, but that's what having a fantastic labor coach is for! Mark was so positive and attentive, I was almost surprised he'd never done this before. He didn't even have the help of the nurses . . . they weren't too involved with much of anything. Looking back I am still undecided as to if I ever want to deliver in a hospital again.  The home birth option is looking more and more awesome to me, but that still is a bit scary.

So I woke up at two o'clock in the morning on Saturday with what felt like a stomachache. After trying to sleep for a while, I began to realize that this stomachache was coming and going . . . with those braxton-hicks contractions. I felt so excited and terrified, there's nothing like that feeling of oh-my-gosh-this-is-really-happening?  You can't wait for that baby to get here, but on the other hand you realize that yes, there will definitely be some pain involved. I knew Mark would need to clean the Olive Garden windows that morning (one of his many odd-jobs) and so I didn't want to wake him up if this wasn't real. So I lied there for a while, just waiting to see if they got stronger. They never did, but I timed them and although they were all over the place, sometimes they were as close as two minutes apart. So I woke him up! Mark was thrilled, and didn't say a thing about his BYU game later that day. :) So I told him when contractions started, and he timed them. We did this for about two hours until we both fell asleep. We woke up at about six thirty . . .. what??? I was so confused, I should not have been able to fall asleep if this was real labor! So despite his worries, I sent Mark off to clean windows and spent all morning counting contractions. And all afternoon (while watching the BYU game). And all evening. We went on several walks, which definitely made them closer together and stronger, but then they would calm down once I lied back down.

Finally I started bleeding. Bloody show? It's supposed to be natural when it's real labor, but all my books said that it's just mucus tinged pink, and there was definitely more blood than just a "tinge". So I worried. Mark wasn't as worried, he was very reassuring and sweet . . . but I kept worrying. Finally we layed down to try to go to sleep at about 11 that night, and I  couldn't sleep ... I was very worried.  (And also sick of waiting around, not knowing what was going on.)  So we decided to go to the hospital just to get checked. I knew I wasn't going to have the baby quite yet, but I wanted to make sure my placenta hadn't detached or anything crazy like that. So we grabbed my suitcase "just in case", and drove over.

It was so so so busy there. Apparently the next closest hospital decided not to admit Medi-Cal patients, and so this one was over-crowded. I told them I only wanted to be checked, and they warned me that if I left and tried to come back that they probably wouldn't have any space for me. That was a chance I was willing to take; I had done all sorts of reading and studying and knew what I wanted my birthing experience to be like, and it definitely included being at home as long as I possibly could!

So they took me into the last available laboring room and there told me I was dialated to a three and that they were a little concerned about the baby's heart rate, and wanted to keep me strapped to these machines for about another hour so they could monitor him. I was a little frustrated, being strapped to a bed was absolutely the LAST thing I wanted to do while laboring. But I kept telling myself it would only be for an hour and then I could go back to the comforts of my own home! I wasn't concerned about the heart rate, everyone had told me it was very normal for a baby's heart rate to drop a bit with contractions.  (And of course those opinions were more valid than the nurse's.  ??  But having worked in a facility with patients -- my anorexic girls -- I know that nurses have to be ultra-aware of every bad scenario for liability reasons too.  That was what I kept thinking about at this point, and it was bothering me.)

The nurse who was helping us was very sweet, but I felt like she was kind of confused. They were obviously very busy;we heard two babies being born while waiting. But she finally came in and said that they really felt like it would be best if I just stayed. I understood that the hospital was now liable for us, and that it was ridiculously busy and we might not be able to ever get back in, but I wanted to cry. This was not going according to my plan. She told me I could shift positions a bit, but that I couldn't leave the bed and needed to keep the monitors strapped to me. I kept telling myself it was for the good of the baby, but I also didn't trust the old equipment they had me hooked up to. So the following hours consisted of Mark and I laying there watching t.v., left alone unless I moved, which of course made the monitors not work, so a nurse would come rushing in and adjust it. Mark fell asleep at one point, and my contractions were reeeeeaally starting to hurt. I remembered reading that sitting on a backwards chair and leaning forward really took some pressure off, and though I couldn't get to a chair, I thought I might try it on the bed. Well that attempt ended in four nurses running in, turning on all the lights, startling poor Mark half to death, and a stern chastisement informing me that they thought the baby had gone into cardiac arrest. They adjusted everything and left, and I started to cry. Not what I had planned on.

So Mark suddenly became super-dad and rubbed my head and my feet and my back. We decided to play cards, and since I didn't feel like I could focus enough for Slap Jack, we settled on War. So we played for a good half hour with random breaks as the contractions came. They still weren't regular, but they definitely were beginning to hurt. Then of course a nurse came running in saying she couldn't read me very well in this position, and so I layed back down. And the contractions got worse. Mark tickled my back and got the life squeezed out of his hand as I rocked my knee back and forth, breathing as deeply as I possibly could, which seemed to help. The breathing almost made it feel like I was pushing the contractions downward, so they didn't feel like they were choking me so much.

Finally at five thirty the nurse came in to check me. I was exhausted. I hadn't slept in almost two days, and I was already getting shaky. I was thinking this kid better come soon, because I was worried I would be too tired to push him out! The nurse informed me I was at about a six, and still had a good six or seven hours to go. She asked me if I wanted anything, and I told her about my fear of being too tired to push. She told me she could give me a little bit of something to take the edge off, that it would wear off soon and that she could keep it small so what little bit did get to the baby would be through his system and out of there by the time I had to push. That sounded good to me. She gave me half of a dose of nubane, and it knocked me out. I think I forgot to mention that I am really sensitive to medications.

I slept for two hours, and started to come out of it as the morning shift came on and Mark started to tickle my back again. But I felt like I had been run over by a truck. Like I had taken nyquil or something, and just couldn't focus on anything. The contractions started to bring me back, but between them I would drift off to sleep. The new nurse told me I was at an eight and to move from side to side as the contractions came on, because the baby's heart rate was still an issue. She turned up the monitor really loud, and so the next couple hours were spent listening to that heart rate slow down as my pain went up, and Mark helped me rock from side to side until we found a position that the baby "liked". Gads, I that part feels like a hazy nightmare. I hated feeling so groggy, and really depended on Mark to tell me what to do. Plus there is nothing so horrible as hearing that heart rate get slower and slower . . . . and then miraculously pick back up as I moved. The nurse gave me an oxygen mask to help the baby, which at first I hated and it make my mouth taste horrid, but the couple times it fell off I found myself gasping for air, so I suppose it was worth it.
Eventually the pain of the contractions brought me out of it, and boy could I feel them! Contractions have such a distinct feeling . . . it's really hard to describe. My sister-in-law calls it a menstral cramp on steroids, which is fairly accurate. But that still doesn't quite do it. Anyway, despite how much it hurt, it was still doable.  It just happens, whether or not you think you can do it.

At that point some nurses came in and told us they couldn't find some of my paperwork.  I had been routinely tested for an infection that often comes on at the end of pregancy, and they couldn't find the test results.  Well, I knew very well that I had had no infection of any kind, and told them so.  They said sorry, they needed the paperwork.  So they would just go ahead and give me a whole bunch of antibiotics.  I was quite annoyed that they couldn't find a stupid piece of paper, and already feeling guilty that I had used some narcotic that probably had my little infant feeling quite loopy even still -- and maybe causing allergies, who knew??  The drama in my brain was having a hay-day.  But the intense contractions quite impaired my ability to argue, and even though Mark attempted a bit, they hooked me up to a bunch of antibiotics anyway, and off they went.

The nurse had also told us to call her when I felt the urge to push, which kind of made me nervous because I had no idea what that felt like and worried I wouldn't call her in enough time. But those fears were unfounded, because there is no mistaking that feeling. It's like you have to take the biggest dump of your life! And then you find that pushing actually helps the contractions to not hurt so much, maybe because you're actually doing something, working with it, instead of just trying to take it. 

So we called her, and she didn't come. Two contractions went by with no sign of the nurse, and I did not know what to do! Mark ran out into the hall and found someone, and still another contraction went by until she came. Busy busy hospital. So then the pushing began! Mark helped me grab my knees and the nurse kept shoving around down below, which HURT. I was getting very upset with her. I don't know if she could tell or what, she didn't say much and ended up just standing by the machine for a while. Pushing entailed Mark counting to ten while I acted like I was basically trying to poo, taking a deep breath and doing it again and again until the contraction ended. After about forty-five minutes, the nurse told me to stop. STOP??? She had to be joking . . . I could not fight that urge to push! She said the baby's head was crowning and the doctor wasn't there yet. GAAAAH!!! And so I had a minor freak-out as they told me to just breath, and Mark jumped right in with the "hee-hee-hee" breathing to help guide me. I attempted to do that but I think I was crying too . . . finally, after two contractions like that Dr. Vouis ran in, threw on some scrubs and numbed the perineal area. They told me to push again, and Mark started getting so excited and saying "Allie Allie I see him! He has black curly hair, he's coming he's coming!" And then they told me to push again, push push as hard as you can Mamita!! I feel my face turn purple and in the back of my mind wonder if eyes can explode, and then all of a sudden . . . WHOOSH! It feels like all my guts have fallen out of me, Mark is thrilled and the doctor looks startled, and then suddenly there he is, this bloody, lanky little man lying on my stomach . . . suddenly there are three or four nurses in the room -- where did they come from? -- and everyone is hovering, sucking my guts out of the baby's nose and mouth, Mark is kissing me and shaking -- or is it me? -- and whispering, "Oh he's perfect, Allie you did so good, so good. . ." and then the nurses are saying, "Daddy come cut the cord!" And I think, oh my word this is real . . . that is my son.

Then Mark heads with the nurse into another corner of the room and I watch as they clean him up and check him out. Then another nurse starts kneading my stomach and there are a couple more contractions, but they are nothing compared to anything before, and I hardly noticed them. Turns out the doctor had been in the process of an episiotomy when Mac came flying out, he informed me he had not been expecting him to come all in one push, and therefore I tore like crazy. The repairs took a little longer than I wanted them to, but nothing really matters much at that point, because MacAlister was here, he was healthy, and we are a family!"

Sunday, November 21, 2010

eating and drinking

During labor, nearly all hospitals restrict eating and drinking.  It stems from a procedure that is rarely used today, and is quite unnecessary.  Eating and drinking (juice, particularly) will boost your energy and aid you physically, and oftentimes emotionally as well.  Talk to your doctor to see if this will be a possibility.

I just read a really great article about it, and here is the first paragraph to tantalize your tastebuds ...
"The traditional practice of restricting food and fluids during labour does not provide any benefits, finds a new review co-authored by a Queen's University Associate Professor."
Read the rest of the article here.

some definitions

pain·ful  [peyn-fuhl] 

1. affected with, causing, or characterized by pain: a painful wound; a painful night; a painful memory.
2. laborious; exacting; difficult: a painful life.
3. Archaic . painstaking; careful.


in·tense  [in-tens] 

1. existing or occurring in a high or extreme degree: intense heat.
2. acute, strong, or vehement, as sensations, feelings, or emotions: intense anger.
3. of an extreme kind; very great, as in strength, keenness, severity, or the like: an intense gale.
4. having a characteristic quality in a high degree: The intense sunlight was blinding.
5. strenuous or earnest, as activity, exertion, diligence, or thought: an intense life.
6. exhibiting a high degree of some quality or action.
7. having or showing great strength, strong feeling, or tension, as a person, the face, or language.
8. susceptible to strong emotion; emotional: an intense person.
9. (of color) very deep: intense red.

We've all heard that "Pain is mandatory.  Suffering is optional."  Lately, I heard a new one.  A gal was telling me how she had been so worried that the pain would worsen to the point that she would just loose it; but she said that ended up not being the case at all for her.  She told me it didn't become more painful, just more intense.  There is a difference, and as labor is as much, if not more mental than physical, I think it's important to understand the difference. I highlighted my favorite parts.  Hope it helps you. 
(Used this online dictionary) 


the love hormone

Ever heard of oxytocin?
"Oxytocin is a hormone that has effects on brain function. Although it is best known for its role in facilitating labor, delivery, and breast-feeding, it is also important in promoting trust, love, and social recognition." (Quote from this article)
 It is an absolutely enormous part of labor, and being nick-named the love hormone, it is also produced with human touch, intimacy, empathy, and breastfeeding to name a few.  Naturally occurring oxytocin enhances the immediate mother-infant bond, and as the icing on the cake ... it dulls pain!

Therefore, if you are able to start labor spontaneously (without medical induction), you will have a natural pain killer going and you will be greatly helped.  If you are induced, you will be much more likely to require pain medication as you will not have the oxytocin flowing yet and the contractions will likely be extremely intense.

So, if you are contemplating a natural birth, here is one more neat little fact for you to gain a little more confidence in your body's abilities.

Sunday, November 14, 2010

mother directed pushing in hospital

There are many different ways to push, though most hospitals automatically do directed pushing.  Some women prefer directed pushing, which works very quickly.  But there are options you should know about.  I was unaware that mother-directed pushing even existed, and relied on my husband and nurses counting it out for me.  I pushed as hard as I possibly could -- appreciating the chance to work with my contractions instead of merely coping -- and tried to get him out quickly.  I did.  I pushed for forty five minutes (which is quite fast for a first-time mom), broke blood vessels in my face, chest, and eyes, (they were all red ... it looked scary) and burst Mac out in one push.  No head and then shoulders; he came out all at once.

 And I tore like crazy.

Next time around, I am going to try to take it slowly, do whatever feels right, and tell my doctor to most definitely NOT numb the perineum; otherwise you can't tell when you've stretched to your limit and need to take a break while your skin catches up.

Watch this great video.

why go natural? part 2

Did you read this post?

Well, I remembered something else; it's quite important.

I was worried about my baby.  I understand that many many children are born by c-section or pain killers and seem to be just fine, but I also knew that most c-section babies are a little slower on developing through the first year of life.  There doesn't seem to be as many long term effects, but I couldn't help but wonder about how many things we do not understand about all of this.  It is definitely not a perfect science; in my mind there isn't much that could actually be labeled as "perfect science".  Most "healthy" trends seem to later be practically condemned; an extreme example of that being tobacco. 

Cesarean sections save the lives of countless mothers and babies, but if we are both fine, why ruin a good thing?  I had the idea in my mind of a chick in an egg.  Most of us have helped to hatch eggs in preschool, and have all learned the importance of letting the chick come out itself.  If we attempt to pull the baby out, the chick will later die as it did not have the opportunity to break through on its own and thereby gain the necessary muscles to live.  Now, babies are not chicks.  And we have enough medical knowledge to be able to help that baby, whatever disadvantages it comes to the world with.

Nevertheless, I wanted to try to give my baby the best chance possible.  A cesarean felt like it should be the absolute last option.  Pain killers I was somewhat mixed on, though it worried me that there have been no studies done on how babies are effected by epidurals.  There is a window of time in which narcotics are considered "safe" during labor, outside of which many side effects have been found.  However, I came to the conclusion that I would do all that I could, and if I felt myself losing it, I would resort to drugs.  Otherwise, I would let the process happen that was meant to happen.

(I wish I had known about doulas.  I would have greatly liked an experienced person to give me a few more options before I made the choice to use a drug.  If you have not yet experienced it, let me tell you: birth is by far the most intense thing you will ever experience in your life.)

Tuesday, November 9, 2010

why go natural?

I have a good friend who is all about medical delivery.  And a lot of relatives.  This friend and I have had many discussions about birth; as she used to work in labor and delivery, she has a lot of stories to tell.  I really enjoy hearing them, there are just so many different things that happen, and I like to know about as many as I can.  The other day she was telling me about her epidural, and then asked me: "Why wouldn't you get one?"  It's a very good question.  Why would you put yourself through it, if you don't have to?  I'm pretty sure I blundered through something or other, but now that I've had more time to think about it, here is a more thorough attempt to convey the multi-layered thought process that brought me to the desire to experience a more natural birth.

First of all, I must preface by saying that my husband is about finished with chiropractic school.  As a chiropractor, your entire philosophy is that the body takes care of itself.  All you do is get it in line, increase movement and bloodflow, and let the body do its thing.  If that is your mantra, then you must treat the body well.  Since we have come out here, we have done a number of things to improve our health, and I have to say that I am feeling and therefore looking better than I ever have.  I have learned a lot about the body and have really increased my faith in its abilities.

Also, I was terrified of a c-section.  I wanted to have control over how many children I would have, and not have to worry about how many scars I could handle.  I wanted to be able to sit up and walk around with my newborn.  And mostly, I just didn't want to get cut up.  So in my reading, I learned that each intervention given makes you about 50% more likely to receive another intervention, which becomes a spiral ending in a c-section.  On the other hand, I also knew very well that my mom had four children with epidurals as cleanly as easily as could be, and that my aunt had been induced with all six of her children and loved every experience.

However, I really liked the idea of giving myself a shot.  I heard on "The Business of Being Born" a statement that absolutely struck a chord with me: "I didn't feel like it was something to be numbed, it was something to be experienced."  I did not want to miss out on any part of my baby's birth, and while most women respond to the drugs in such a way that perhaps even enhance their experience, I really wanted to do it on my own.  I wanted to see what I could do, and I wanted to do what my body was built to do.  I didn't want to have to stare at a machine to know a contraction was coming.  I didn't want to depend on a clock to tell me when to roll over.  I wanted to bring my baby into the world.

Also, I wanted a quick recovery.  A normal birth -- without tears, or cuts, or swelling, or numbness -- will always be easier to recover from. 

All that aside, I did not check into that hospital one hundred percent sure that I would go without an epidural.  I could not rid myself of the idea that I couldn't take the pain.  I just wanted to see what I was capable of.  I did end up getting some sort of narcotic at about six centimeters, and it took me a while to come out of it.  I hated feeling so out of control.  Eventually the contractions pulled me back to the real world, and I was able to feel it all as my son was born. 

Looking back, I would do it all again.  There would be a few things I would change, but believe it or not, they actually all involve making things more natural.  Good thing I want a few more kids, maybe by the end I'll get it down.

Monday, November 8, 2010

when your water breaks

If by chance you are full term and experience a "gush of water" (verses a slow leak, which would mean your bag of waters is still intact) and contractions have not yet started, you will likely feel excited and terrified and rush off to the hospital as quickly as possible.  Most women have been deeply rooted to the fear of infection. 

But before you head to the hosptial, you need to consider a few things.  Were you wanting a more natural birth, or medial?  What kinds of interventions were you hoping for, or wishing to avoid?  Most hospitals will require an induced labor if you come to them with a ruptured bag of waters.  Most hospital policies require the birth of the baby within 24 hours after the waters have ruptured.  Unless you have discussed this with your doctor beforehand, that is more than likely what you can expect.

Hospitals do this because the ruptured bag of waters has been associated with a prolapsed cord (where the umbilical cord comes out before the head, can get pinched, and block oxygen from the baby), and infection.  A recent medical article states, however, that while fewer infants were admitted to the NICU when labor was induced -- verses starting spontaneously -- there was no significant difference in whether or not the infant developed an infection.  It does not give any details as to why the infants were being admitted to the NICU, but later on it does say that babies born with a premature rupture of the membranes and spontaneous labor will be classified by most hospital policies as "high risk" and therefore go straight to the NICU, with or without any obvious emergency. 

In all cases, whether labor was induced or started on its own, an infection occured in 2-3% of the babies born.  So then, if your waters break and you are not wishing to be induced, it would be a good idea to stay home for a while.  Typically contractions will start withing 24 hours after your water has broken, but sometimes it can take up to a week.

Personally, I wouldn't wait around for an entire week.  The longer you wait, the greater the chance that your baby or you will develop some sort of infection and need to be pumped with antibiotics.  However I would give myself about a day to see where it went.  Of course you should be cautious; no sex, no baths -- unless the tub has been thoroughly scrubbed -- and generally keeping yourself clean. 

Nothing happens immediately; not infections, contractions, or especially the birth of your baby -- so if you are looking to avoid being induced, give yourself some time at home and see what your body does.  If, however, you have been begging your doctor to induce you, you are in luck.  A ruptured bag of waters will undoubtedly get the doctor moving.

There is a fantastic article with more information here:

Friday, November 5, 2010

a perfect home birth

My sister-in-law is a huge advocate for home birth, and as she has had such wonderful experiences, I asked her to write a favorite down for me.  This is the email she sent:

"I have had four kids.  The first one in the hospital without any pain medication (six hours of labor), and the next three at home (all of them 30 minutes of labor).  I LOVE the miracle of birth.  Everytime I have a baby my heart is on fire and bursting with joy and wonder at the sight of the beautiful little being.  It is the best feeling!  I love every birth story whether it's hospital or home, epidural or natural.  Whatever the story is, it is a miracle and a new little person meets their family for the first time. 

Allie asked me to share one of my stories and I am happy to do so.  My second child was an unexpected homebirth.  It happened so fast that she was delivered in our bathroom with only my husband to help me.  Everything was okay until the paramedics came in and made a big fiasco.  (Long story for another day). So for our third child we thought about a planned homebirth.  I had all kinds of doubts about it.  However, the more I researched, interviewed, and learned from others the more confident I was that homebirth would be safe and healthy choice for us. 

I chose Chris Miller to be my midwife.  She had been a midwife for 30 years and had helped bring over 2,000 babies into the world safely.  She never lost a baby or a mother.  There wasn't a single symptom, question, or concern that she didn't have the answer to.  She never preassured us and always informed us on our options.  She was more personal and professsional then any other doctor I had had.  Luckily for me, she only lived 7 minutes away. 

One morning I had contractions and she came over just in case things went as fast as my last birth (30 minutes). We set up a birth pool and filled it with really warm water and covered it to make sure it stayed warm.  The contractions weren't hard and they were irregular and far between and faded completely away.  She checked me and I was at a three.  While we were saying she could probably  go home, my water broke.  Immediately my contractions started up and were very intense.  She looked at and felt my belly and told me the baby was posterior (the baby's head was down but facing the wrong direction) so when I got in the birthing pool she had me get on my knees and my upper body on the side of the pool.  This allowed my belly to hang down freely and encourage the baby to turn.  It worked right away.  I love being in the water to labor.  Moving is so much easier while you're semi-floating.  Plus it helps me relax so much more.  (I have used Hypnobirthing with every birth.) 

Soon I felt pressure and I turned to a sitting posotion, layed back a little, and delivered a 9lb 13 oz beautiful baby girl.  The pain was intense, but every time a contraction started I just gave into my body.  Rather than tensing up and fighting the contraction, I just relaxed even more.  My body knew what to do and I tried to let it go ahead and do its thing.  The midwife did her part by making sure the baby's heart rate was good and safe.  So thirty minutes after my water broke, I had a baby in my arms and a fire bursting through my heart. 

While I was loving my baby, Chris Miller was checking things so quietly and smoothly that we were hardly interupted by any of it.  Not all homebirths go so smoothly.  Sometimes Chris has to tell the mother that the labor has come to a risk too great to stay at home and the time has come to go to a hospital.  So she goes with the mother to the hospital and stays with her through it all.  Everyone's goal is a healthy baby and mama.  Most of the time though, hospitals are not needed."