elective induction

I know, I know.

It's so hard to not be able to plan the day you're baby would arrive.  You're a busy gal, you've got plenty on your plate ... dropping it all and bringing a new life into the world feels impossible in our scheduled world.  I understand; I do it on a monthly basis for my clients and it is no small thing.

But there is quite a bit of research out there showing that babies do best inside their mamas.  Your baby is staying inside of you for a reason, and most of the time ... it's best to go with the flow.  Now, of course there are times where this is not at all true; and thank heaven we have technology advanced enough to help your baby!

If the word "induction" starts getting thrown around, ask your caregiver for what they would call a "risk analysis".  It's essentially a big pros and cons list; giving you a much more detailed idea of what would be best for your baby.

Be aware that most hospitals aren't even allowing elective induction any more, according to Medscape.  There is simply too much information out there supporting those last few weeks of development in the womb; enough that professional caregivers can't justify early inductions without a serious cause.

" 'Something we didn't even anticipate as a benefit of this policy, but was a delightful surprise to see, was a decreased admission rate to the neonatal intensive care unit,' Dr. Healy told Medscape Medical News at the meeting."

Read the whole article; it's not too long and quite interesting!
http://www.medscape.com/viewarticle/804700

Educate yourself so you can feel confident in what you chose.  If your baby needs anything, he or she needs confident, loving parents.

pitocin warning

Pitocin is overused.

It is a brand of oxytocin that doctors will use to either start contractions, or keep the ones you've got going.  In the business-world of a hospital, it is an invaluable tool for managing an event that does not work on a dependable time clock.

But you see, it's so important that we don't forget that birth is not on a time clock.  Of course averages have been measured, but who is really average?  Your body is your body, and its uniqueness combined with that of your baby results in a truly singular birth that is far from average.

It is normal for labor to pause.  In fact, it's a coping mechanism.  If you were a cave woman back in the day, laboring to bring your baby into the world and suddenly -- ack! -- a saber-toothed tiger interrupts your focus.  What would you do?  Adrenaline would kick in, oxytocin would all but stop, blood flow would leave your uterus and shoot out to your appendages to get you the crap out of there.

That hasn't changed today.  If you're stressed and that saber-toothed tiger waltzes in the room in the form of your doctor, mother-in-law, or some bizarre point in labor that you've always dreaded, you're more than likely to stall out.  It's instinct.  It's survival.

So if your doctors start throwing out the word pitocin, first ask, "Is this an emergency?"  And if the answer is no, then give yourself some time.  Relax.  Take a deep breath.  Find a way to defeat that tiger and let your body continue doing it's thing.

Not only is pitocin harder on you (inhuman contractions on a very human uterus), there are also studies finally being done on pitocin's effects on your baby.  There are some.  ACOG just released a statement about it:

http://www.acog.org/About_ACOG/News_Room/News_Releases/2013/Study_Finds_Adverse_Effects_of_Pitocin_in_Newborns

Now don't fret, of course there are risks no matter what kind of birth you have.  Do your research, have an intelligent conversation with your partner, doctor, and support people.  You need to feel good about what you experience.  Your ability to care for that baby after he or she arrives will trump any experience your baby had during birth.

a friend's laboring tips

I have a beautiful, wonderful friend.  She lives very far.  But she keeps up on an adorable blog and it has been so nice to stay in touch ... albeit electronically.

She recently had a baby.








































We emailed a few times, and she finally found a moment to give me details on her birth and what worked best for her.  I think they are brilliant, and worth adding to your tool bag as you prepare for you ideal experience.

"Allie!
I just saw your comment on facebook, and I'd been meaning to email you anyway, wanting to thank you for answering all my pregnancy/labor questions and give you a quick update on how everything went (you know, since you were my virtual doula and all :).  I went into labor at midnight on my due date (it started with me passing my mucus plug) and was able to labor naturally for 14 hours and then deliver my baby boy after 2 hours of pushing.  It was wonderful and empowering and went just as I hoped (well, it was more painful then I was expecting...I was laboring in my back... but nothing too terrible.).  I read SO MUCH before hand and really tried to do my part to be educated about this whole labor business, and these are the things that I found worked best for me: 

::  I swam three times a week and went on long daily walks (or waddles towards the end, haha!), and I really think those activities helped me have the strength to keep laboring. 

::  I drank my raspberry leaf tea religiously and towards the end started taking Evening Primrose Oil orally.  I'd like to think those helped me, but I have nothing to compare it to. 

::  I read a hypnobirthing book (there were no classes in my area), and listened to the relaxation exercise cd that came with the book every night before bed for the last 3 months of pregnancy.  

The best thing I learned from hypnobirthing was to keep my face relaxed.  I coached Evan on this, and so he was able to remind me to relax my face whenever he could tell I was tensing up.  It was amazing how much calmer I'd feel! 

I had a 1.5 hour nap right in the middle of labor and then woke up ready to push.  Everyone was kind of scratching their heads wondering how I was able to relax so fully, but I think I was able to be so relaxed because I had practiced every night before bed, and it always put me to sleep.  I needed to rest before the pushing began! 

Thanks again for all your advice and for helping other women through this amazing process, what a wonderful life calling! 

Hope you have a wonderful day!
xo,
Holly"

pain is a perception

Have you seen this video yet?  I love it.

Besides being hilarious, it proves one thing that I try to teach each of my clients:  pain is a perception.  These two men are seriously so far from experiencing childbirth ... sorry guys, there's just no way to really replicate it for you.  It's beautiful and intense and empowering and humbling all at once, and these little machines just can't do that. 

However ...
The guys in this movie are both experiencing pain.  And they handle it very differently.

Ladies, your birth can be whatever you want it to be.  Don't fight it.  Let it happen.  And for heaven's sake, think happy thoughts!

a little bribery goes a long way

I recently had a client who taught me a fabulous lesson. 

Let me back up.  In my doula experience so far, I have worked with a lot of women who want all the "emergency" benefits of a hospital, but still want a natural birth.  Since the set-up of a hospital is more businesslike and often doesn't mold as well to each gal's individual labor pattern, sometimes my job requires handling some awkward head-butting situations.  Nurses have a job to do, and they are doing it by the big boss's standards for several couples at the same time.  I have many nurses in my family, so I can tell you from experience that they are often overworked and emotionally taxed.  It's a tough job!  But of course, couples welcoming a baby into the world are incredibly emotional and -- it is my eternal hope and goal for my clients -- empowered and opinionated on how they want to go about it. 

My job is to stick up for the couple's needs.  At the same time, my individual belief is that creating a confrontational atmosphere is really only damaging to the birth experience, so I have been vigilant in finding ways to keep everyone happy. 

I have read and thought and tried different things to make friends with the nurses, to attend to my clients, and to word everything to everyone just so.

But this recent couple of mine made it all so much simpler for me: 
Just bring chocolate.

Bring me these and my heart is yours.

This couple's labor went through the nurse's shift change (very common), and the new nurse must've just come from something terrible.  She was sullen and short and barely made eye contact.  I began mentally ticking through things I could say to help her seem more human to us, but then my client-bless-her-heart says, "Honey, the chocolate," as soon as the nurse leaves the room.

 

Her husband pulled out a massive bag of Ghiradeli squares and the two of them arranged a lovely little bowl of treats between contractions.  I watched open-mouthed.  Duh.  Why haven't I thought of that?!

 

When the nurse came back in, they handed her their offering to share with the entire nursing staff and thanked her for helping them bring their child into the world.  And by golly, her face lit up and she did a 180.  For the rest of the day she was chatty and obliging and almost doula-ish.

 

So people, here's another thing to pack in your hospital bags:  bribery goodies.  Guaranteed to set up a wonderful atmosphere for your baby to enter the world in.

laboring positions

Finding different positions to labor in is all about two things:  keeping yourself comfortable, and giving your baby the space he needs to make his way into the world.

This great website has a little slideshow with several different positions that work wonders.  I would suggest practicing a little with each of these to see what feels comfortable to you.  Of course, all that may go out the window once the intensity of real labor hits, but there's no doubt it's helpful to have some idea of what you want or don't want.

A friend of mine helped me to show you a couple of my favorites:

In laboring positions I look for two things: movement and opening your hips.  This one does both.

I am a huge fan of the birthing ball.  Or exercise ball, as you probably know it.  Sitting on this allows you to hold onto your significant other (or doula, if that person is absent) and simultaneously get your back worked on. 

It's also perfect for the end of labor, when you are exhausted and not wanting to move at all.  You can roll around and keep your hips moving without breaking a sweat. 

This is another good one.  You can rock back and forth a little, and squat with the contraction if you've got the energy for it.  And once again, you can have people on both sides of you should you wish it.

And there is one final position I didn't quite get a picture of: laboring on the toilet.  This one does not create much movement, but it allows you to relax your pelvic floor in a way that nothing else does.  You'll need to try to use the bathroom every couple of hours during labor, so while you're there, stay a while.  It may be just the push you need to dilate that last centimeter or two.

Try these at home, see how they feel.

Penny Simkin: Using Doulas for Birth Care - Midwifery Today Birth Essent...

All my training materials came from this wonderful woman. Love her.

Scene From Penny Simkin's Comfort Measures - "The 3 Rs" & Slow Breathing

Penny Simkin - Pain Versus Suffering in Labor

I love her.  Prepare yourself for a lot of videos from her.

photos photos photos

One thing that every couple I have doula-ed for has requested is: pictures.  Everybody wants pictures of that life-changing day.  Who wouldn't?

But I do find significant variety in what people want photographed.  Some just want pictures after everyone is decent, coherent, and rested.  Others want pictures of that moment when they first meet each other face-to-face.  Still others want detailed photographs of the entire process.

Whatever you'd like, be sure you assign someone to be on picture-duty before everything happens.  Usually the hubby is not the best choice ... believe it or not, he's going to be quite distracted.  Moms can get distracted too.  Nurses are generally going to be quite busy with you and typically 2-3 other patients and won't have the time. 

Doulas can be extremely useful when it comes to picture-taking.  Some even have a little experience with photography.  I recently purchased this little beauty:

And I am excited to put it to work!

If you haven't been able to find a doula, then get a friend ... someone you trust, but not someone who will be too worried about you to keep at their task.  I found a blog of a gal who photographed her friend's birth, and the results are about the most adorable thing ever: http://www.amelialyon.net/personal/introducing-sweet-lola-dee.html

Once you've got your photographer figured out, you then need to decide what you want pictures of.  Here's some food for thought:

• How do you want to remember this experience?  Would you rather re-live every incredible moment, or focus on the happy ending?
• Do you want pictures of you and your significant other working together to bring your child into the world?
• How do you feel about blood?
• Would you be distracted from the intense work of labor if there was a flash or clicking going on every few minutes?  Could the camera be kept quiet and still do its job?
• Will you be embarrassed later by how some of the photos turn out?
• Would you like to have pictures of everyone there?
• Will the hospital allow pictures of the actual birth?  Most do not.  They don't want clients to have documentation against them should something go wrong.
• Would a simple point-and-shoot camera work?  Or will you need to seek out something more substantial?

Birth is an incredible, life-changing moment that you will never forget.  Photos are the best way to highlight your favorite parts, and beautify the less-than-favorite.  Be sure to work some kind of photography into your birth plan.

tethered

If you're anything like me, being trapped during labor sounds like the worst thing in the world.

Now, if you chose to have your baby at home or in a birthing center, you won't need to worry about that at all.

But if you are in a hospital, be it for personal reasons or insurance reasons (as was our case ... sigh), you will have to face being trapped.  Whether you are asked to stay in bed or not, all hospitals prefer to have quick access to those veins of yours.  Hospitals are always trying to prepare for the worst, and so will want to be able to shoot whatever they need to into your body at a moment's notice.  Having several nurses in my family, I know that opening up a vein is not always the easiest thing, and so is preferably done before any emergency pops up.

So, will you need to be stuck to a pole with tubes running into your arm?

Not necessarily.

Ask for a "heplock".

 They will open up your vein, but they won't attach you to anything.  You'll have to labor with a needle in your hand, but at least you won't be stuck to a pole.  They cap it off so you can move around as you please.
It's another one of those compromises ladies wanting a natural birth in a hospital will likely need to make.

birth plans

Have you considered writing a birth plan?

Think of it as more of a set of preferences.

Births rarely go exactly according to plan.

However, I still think it's a great idea to think happy thoughts and repeatedly visualize that perfect experience.  Here is the birth plan I wrote up for the birth of my little girl:

Birth Preferences for Allison and Mark Gunn

Patient of Dr. Gregory Chan

Due Date November 30

Attending the birth: Mark Gunn, husband; Elizabeth Wolgast, doula

Hello one and all!  We are the Gunns and are so very excited to welcome our newest little one into the world.  We searched a few different hospitals and birth centers to find the right fit for our little family.  We decided on your hospital, and have made a list of things we would love to have happen, although we are completely aware that no birth ever goes according to plan!  Thank you for all your efforts to make our baby’s birth day the best it could be.  We are excited to be working with you.

Right off the bat, there are a few things you should be aware of with me:

•  I am allergic to penicillin.  Should I need something of the sort, please use something else.
•  This will be our second child.  The birth of our first was wonderful and uncomplicated, but not exactly the best experience.  We are looking forward to this one being much better.
• We want a very natural, un-medicated labor.  Please do not suggest drugs to get me through.  If there is any positioning or relaxation techniques you know of, I would love the support! 
• I am worried about being trapped in bed.  Please help me to find ways to keep moving.  I do not want to be on the fetal monitor the entire time.

First Stage of Labor Preferences

•  I will be attempting to do most of my laboring in the comfort of my own home.
• Once at the hospital, I would like to continue on with a quiet, relaxing atmosphere as much as possible.
•  I do not want drugs suggested unless my child or I are in danger. 
•  I am hoping to maybe use the shower, the birthing ball, and movement to get through labor pains.  I will be bringing along a doula for support, and would love any wisdom your staff has to offer!
• I would prefer intermittent fetal monitoring if at all possible. 
•  I would prefer a heplock instead of being tethered to a pole.

Second Stage Preferences:

•  Once I feel the urge to push, I would like to push in a few different positions (squatting, side-lying) until the baby is about to be born, in which case I’ll do what the doctor needs me to do.
•   I would like to attempt mother-directed pushing, unless I’m very out-of-it and need the guidance.
• I would love any assistance you can give to keep me from tearing.  Compresses, massage, oil … whatever works.
•  Should tearing happen, please do not perform an episiotomy unless you feel that I might tear into the urethra or clitoris.  That would be a bummer.  As I was cut with my first birth, I assume that area would be the place to tear anyway.
• Please place the baby directly on my skin after birth.
•  Please allow my husband to cut the cord, and please give it a bit of time to stop pulsing.

 Care of Our Newborn

• Please do not bathe the baby.  We would like to give her the first bath.
• Please leave her with us as much as possible.
• We do not want any immunizations at all and will sign whatever we need to.
• Please wait a couple of hours before giving her Vitamin K and eye cream.

 Afterward

• Please allow my two year old and mother to visit as much as they can.
• Should any other visitors show up, bring them in!  (As long as it has been a couple of hours since the birth.) 
•  Please leave our baby with us.
• We are anticipating wanting to leave the hospital within about 24 hours, but who knows … maybe I’ll be so comfortable and relaxed that I’ll want to stay the full two days. 

Thank you again for taking the time to skim through this.  We understand that you are busy and see all sorts of births.  Thank you for helping to make ours special to us. 

make sure your birth partner knows ...

One of my favorite parts of being a doula is helping your significant other to help you.  I promise every single one of them really truly wants to ... its just that most of them have no idea what to do.  Of course they know you better than anyone and love you to pieces, but that love often generates all sorts of worry and frustration as they witness what you are going through. 

(Which, might I add, is a great reason to have a doula:  bring someone to the party who has only your interests in mind -- not the hospital's -- without stressing over every little discomfort you may feel.  Doulas make a fantastic team with your birth partner!)

The basic things I tell these loved ones to do while you are laboring alone include the following:

• Distract, distract, distract.  While you still can.  I promise labor will get to a point where you can't ignore it any more.  Until then, relax.  Have some fun.  Go for walk.
• Move her!  At least every hour.  If you're trying to catch up on some rest, then just rotate from side to side.  It'll help that little one find the easiest way out.
• Keep her hydrated.  Don't forget to drink.  Juice will add some energy and calories to get her through it.  Let her eat what she wants as well.
• Use the bathroom.  Every couple of hours.  That baby is sitting on top of her bladder, and if it is full, it will keep the head off of the cervix and slow down dilation.

And of course, make sure this person knows how much you love them, and not to take anything you say in the next few hours too harshly.

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a tip on breaking your water ...

If by chance you get to the hospital and your water hasn't broken yet, many women are asked at one point or another if they'd like to have it broken. 

You'll probably shrug and have them do whatever they'd like unless you know why.

If you labor without that sack of water surrounding your little one, things will go much more quickly.  You baby's head is able to sit more thoroughly upon your cervix; that pressure is what gets it to open up.

But it will also be significantly more painful.  Your body will need to stretch out much more quickly to accomadate that little person, and it will do so without that super soft cushion of amniotic fluid.

So if you get asked, "Would you like us to break your water?"  You have to decide if you'd rather ease your way through that last leg of the marathon, or if you'd like body-busting sprint to the finish.  How ready are you to be done with it all?

a beautiful natural birth

I feel like the labor part of my daughter's birth started the day I went in for my 36 week check up. Up until that point, the midwives had declined checking my cervix and I had agreed, but at 36 weeks, with the amount of contractions, pressure, and changes I'd been feeling I was dying to know if I was progressing at all. I'd lost my mucus plug at a very early 29 weeks, so I thought surely something was happening; I just wanted to know how much.
The midwife checked me. I was at 5 1/2 cm. My midwife told me that surely I'd be back either later that day or maybe that weekend.

I went home, shocked and excited, and prepped everything for a rush to the hospital sometime in the next day or so.

And then I waited.
Three whole weeks.

Those three weeks felt like three years. I will never again ask an overdue woman any question relating to "no baby yet?" "still here?" "what does the doctor say?" or even the seemingly innocent "how are you feeling?" Those questions drove me bonkers and I just wanted everyone to leave me alone. If I wanted them to know how I was feeling, I would tell them, otherwise, don't ask me!

I started to get pretty stressed about it, actually, because back at 36 weeks when we felt delivery was imminent, Kent scheduled a trip to San Francisco with his new job. He would be leaving on November 6, the day after my due date. We figured Ellie would be 2 or 3 weeks old by then.
But she didn't come. And each day that passed, I got more and more discouraged. Some days I felt lots of contractions, but some days I actually felt better. Those were the worst days because I started to feel like maybe Ellie was never going to be born.

My midwives took pity on me, and the Saturday I turned 39 weeks (they weren't legally allowed to do it any earlier than that) they agreed to let me come in and have this baby.
That morning we woke Nicholas up early and took him to our friends the Jensens' house. He was super excited to go to their house, and he didn't seem phased at all that we were leaving him, which really helped ease my mother-guilt.

We were a bit early still for our 8:00 am induction appointment, so we stopped at a donut place on the way. I only nibbled on my donuts; I was too excited and nervous to eat much.

When we got to the hospital, it seemed pretty quiet. The nurses at the desk in L&D were just sitting there chatting, and I was assigned to the biggest suite. It was a beautiful room, with hardwood floors, lots of space, and an entire wall of windows. The nurses were slow to get things started. It was an entire hour before I was even handed a gown to change into, but looking back on it, I think the slow pace helped calm me down even more and it helped me get into the mindset I would need to get me through what was to come.

I had two nurses; one was in training, and they pretty much let me do my own thing. Once they saw that I was with the midwives, they automatically assumed that I was planning on doing this without pain meds, and although that was merely my hope going in (I had a "we'll see what happens" attitude about it), having everyone in the mindset that I was going to do it naturally really gave me the support that allowed me to do it in the end.

My midwife Pam started me on Pitocin at 10 am. Over the next 5 hours they continued to increase the pitocin, I rotated between the birthing ball and the rocking chair, and Kent and I watched extreme home makeover on TV. I was contracting every two minutes or so. I was uncomfortable, but not in much pain. And the pitocin wasn't really progressing me. I was still at a stubborn 5 1/2 cm.

So at 3 pm, my midwife and I decided that she should break my water. The very next contraction was a bit stronger, and the one after that left me breathless.
Yep, things were definitely moving along now. Pam and the nurses left me and Kent and said they'd be back in 20 minutes to check on me again.

With each contraction I felt my resolve weakening. This was pain. This was tough. And I didn't think I had it in me. I started to tell Kent that I couldn't do it, that I wanted the epidural.

He was SO good, helping me in the way I needed it most--just being by me and telling me to calm down and slow down my breathing. I really struggled with that; I kept nearly hyperventilating. But everytime Kent told me to breathe slower, I was able to refocus and make it just a little bit longer. I really needed him there by my side--I remember feeling like there had to be some way he could just make it all go away, and even though he couldn't do that, somehow just having him next to me was very comforting.

Before we'd gone in that morning, I had explained to Kent that I really really wanted to try and have this baby without the epidural. I told him that I needed him to encourage me, to push me to keep going.

It wasn't until afterwards that I realized what it was that I'd asked him to do.

There I was, in a very lonely, helpless, powerless place, pleading for relief, and he had to stand there and tell me to keep going.

I am so so grateful that he did.

He told me to just wait and see what they said when they checked me again. When the nurses came back I told them I probably wanted the epidural, but they also encouraged me to wait until Pam came back and checked me.

But Pam never got another chance to check me. Before she arrived I decided that I wanted to try and go to the bathroom, because I knew that an empty bladder would help things along. Getting to the bathroom took probably a full 10 minutes, because I had to stop and breathe through every contraction. The nurses showed Kent how to put counterpressure on my lower back, and that felt SO good. He continued to massage my back as I sat on the toilet and because we were already in there, I asked the nurses if I could get in the shower. With each contraction part of me would go numb, either my arms or my legs, and I was shaking.

But as they prepped the shower, I suddenly felt that urge to push. It was small at first, and I kind of doubted it, I mean, it had only been about 40 minutes since Pam broke my water and I had been at 5 or 6 cm. But then it came again, and the nurses turned off the water and sent me back over to the bed.

Once I got to the bed, I felt restless. I wanted to be on my side. I wanted to kneel. I wanted to do anything and everything except lay on my back. I wanted this to be over with already.
But then the urge to push came again, and much stronger, and I found myself on my back and the nurses were breaking down the bed.

Within moments, I was pushing. I don't remember anyone really telling me much--the nurses weren't counting or telling me when to push. It was all very instinctual. In fact, it would have been hard for me to follow directions anyway. I couldn't do anything but exactly what my body was telling me to do.

And it was hard. I screamed. A lot. But I couldn't stop myself--it was almost a surreal experience; I kind of felt like I was just sitting back and letting my body take over. I pushed three or four times, and then Kent told me he could see the baby's head, that she was right there. I remember telling him that I couldn't do it, that I was done, and he just told me that I was doing it, that it was almost over, that I was doing great.

I pushed again, and in my head I decided that I was done. She wasn't coming. I wasn't going to give birth after all. I didn't want to do it anymore.

But when the next contraction hit, I pushed with all my soul. I was getting that baby out right then and there. And she was here. The relief was instantaneous. It was done!

I laughed, I caught my breath, and my daughter's warm little body was placed on my bare stomach. She was beautiful, she was quiet, and she was BIG. 8 1/2 lbs. She wasn't turning pink as fast as they wanted, so the nurses took her over to the warming bed to rub her down with towels. She didn't like that, so she started to really cry, which "pinked" her up very quick, so they brought her back to me once Pam was done repairing my tearing. Besides being a big baby, as Ellie was born she punched her fist up next to her head, so the tearing was pretty bad.

As soon as Ellie was in my arms again I brought her up to nurse. She latched immediately, and she nursed for an entire 45 minutes! After the struggle we had starting breastfeeding with my son, this was amazing!

One of the nurses came in and told me that she had some bad news. I was worried she meant something was wrong with me or the baby, but she just said, "I have to prick your finger to draw some blood." I laughed. After what I'd just done, a finger prick was nothing. So I told her, "go ahead, prick all my fingers if you need to."

As the room quieted down and the nurses cleaned up, I felt this overwhelming sense of "did I really just do that?" I kept telling Kent "I did it. I just had this baby. I did it!"

That hour from my water breaking to Ellie being born was the most intense, difficult, painful hour of my life. But I am planning on doing it again when I have my next baby, because the recovery was incredible. I was walking within an hour after Ellie was born. I was able to sit up, eat my dinner, walk myself to the bathroom, hold Ellie--it was great! I remember after my son was born it took a few days before I was able to get out of bed on my own; the epidural was so hard to recover from. But with this birth, by the next morning I was up and out of bed, ready to leave the hospital and go home. I felt like myself again, even better because I wasn't pregnant anymore. And the recovery once we got home, instead of taking a week or so, seemed to only take a day or two. I needed less pain relief and less rest.

We moved across the country only four weeks after Ellie was born. It was hard, but I knew I could do it. In fact, the most lasting emotion I gained from this birth has been power. I feel like a more powerful version of myself. I did something I didn't think I could ever do, and I did it well. Now I am braver, more confident, and happier with who I am.

Plus I have the most darling little girl in the whole world to show for it.

how did you do it natural?

I wish everyone could be a doula before they have their own babies.

Or at least have more experience with birth ... I guess in the olden days family and friends helped out in each others' births, but now that's pretty hard to come by.  If you ever get the opportunity, go to a birth!

The birth of my little girl was wonderful.  I've had a few people ask how in the world did I do it without anything??  Well honestly, anyone can.  Your body knows how.  You just go with it.

After contemplating things a little more, I've come up with a few tips that worked great for me:

• First and foremost:  birth is 100% do-able.  Our bodies were made to do it, and we as women do know how.  We know better than doctors do.  Don't ignore their experienced advice, but do not doubt yourself.
• Hire a doula.
• Make sure your birth partner is positive and confident.  If he/she is not, definitely hire a doula.
• Ignore labor until you can't ignore it any more.
• Find some way to relax.  Either fork out some dough to do a hypnobirthing or bradley method class, or just figure it out on your own.  For me, it was moving and deep, slow breathing.  The stronger the contraction, the deeper the breath I took.  I decided if I could still breathe, then I was doing just fine.
• With each contraction, do some sort of downward motion with your body, and whisper outloud or in your head, "Open open open open!"  The thought translates physically ... give it a try.
• Don't pay attention to the clock.  Everyone else in the room will do it for you.  Just get through the contraction, and rest or joke around between them.
• Try to smile.  It will make you and everyone else in the room feel better.  Set the exapmle for how you want everyone else to behave ... I promise, you're not dying.
• Underestimate your progress.  It's always better to be pleasantly surprised.
• Worried your baby will just fall out?  You'll feel it before it comes.  That urge to push is something else!
• Worried about the ring of fire?  Yes, it's intense.  So try to back off on the pushing, give your skin a chance to stretch out a bit.  But if you're like me and the urge to push completely overrides that burning sensation, then don't worry about it ... a couple of stitches are fine.
• I'm sure you've heard this over and over again, but it's true ... once that little on is lying on top of your belly, all the pain will be completely forgotten.  And if you did it without drugs, you'll be amazed at how you feel like normal almost instantly.  Besides a slight case of the shakes.  :)

Above all, have a good idea of what you expect from the experience, do all you can to make it happen, and then just let everything go and enjoy the ride.  I promise it will be one you will never forget!

birth of my daughter

Oh, what a birth.
The arrival of this little one was so much easier than my son's ... I suppose that's pretty typical for a second birth.  My body had done this once before, we weren't as nervous as we were before, and we had a lot of prayers sent our way.  What a difference.

I wasn't scared at all for this birth. Being a doula and having been through a lot of births lately, I felt confident and knew what I wanted. My husband Mark did too; he had recently attended a seminar on adjusting pregnant women, which ended up being as much of a natural childbirth class as it was an adjusting class. He said I could have it in the car if I wanted.

Well, it all began on a lovely Tuesday morning. There went the plug. I immediately began doing laundry, Mark vacuumed the house, and we tidied things up in preparation for her arrival. I then hurried off to my doctor's appointment for some halting news. "You are dilated to a two, but her head has turned sideways. I think you will have a couple more days." Wah-waaah.

So back to the house I went, and we decided to take off to Knott's Berry Farm to get a good walk in for me and some fun for our two year old.

My "braxton hicks" contractions were starting to feel more like those lovely monthly cramps.  Nothing intense, but a change nonetheless.  Still ... I kept that to myself and decided that if labor was coming, it was coming.  I would just go about my business and ignore it until I just couldn't any more.

The rest of the day was spent with Mark consistently asking how I felt, with me consistently shrugging and saying about the same -- although a bit more blood did make an appearance -- and our boy goofing around, playing in the hot tub and enjoying his last few moments as the complete center of attention.

After he was asleep and I had some time to focus on myself, I realized these contractions were feeling different ... but nothing too crazy, so it couldn't be real labor, right? Just in case I phoned my divine friend to warn her to keep her phone on that night, as she might be getting our two year old before the sun came up.

As we layed around, we decided to time them, just out of curiosity. 6-10 minutes apart. But they weren't really intense, so it couldn't be labor ... at least that's what I kept telling myself.  I felt sure that if I went to bed they would slow down or go away, and so we decided to attempt some shut eye. But I needed a couple of things from my wonderful husband beforehand ... an adjustment, and a priesthood blessing. And so he lined me all up between contractions with those magic hands of his and massaged the bajeezes out of my back. And then he gave me the most wonderful blessing I can remember. I am so grateful to be married to such an incredible chiropractic priesthood holder ... I fought a few tears, and then we decided to try to get some rest.

But those contractions kept waking me up. Finally, around 3:30 am I told Mark I just couldn't lie there any more, so I jumped up and he did as well. We went downstairs and watched infomercials while I paced, rocked, and bounced on my birthing ball while Mark timed. They were about every 3-5 minutes apart, and Mark asked what I was waiting for. I explained that I did not want to wake up my friend or our little man, and decided that I could make it till he was up and fed and taken care of. Then we could go.

So almost exactly at six, we heard our son crack open his door and sneak down the stairs. For once, that was perfectly fine with me.

Mark fed him and dressed him while I took a shower to try to relax through a few more contractions. We finished up at about the same time, and all piled into the car. Once at our friends', Mark simply hoisted the entire car seat out with the little man still in it and carried him up to their front door.

I started crying.

Just a little. I guess it really hit me that our last moments of just my boy and me had truly ended. Next time I saw that big-headed sweetheart of mine, I would be forever trying to split my time. He was no longer the sole focus of my attention.

When Mark returned, he seemed a little worried that labor was starting to kill me ... but once I explained the tears he calmly and a logically reminded me how good the whole situation would be for everyone. Of course he was right, but still ... it felt good to cry a little.

And so on we went for our twenty minute drive to the hospital. It wasn't so bad, no screaming or squeezing the crap out of Mark; mostly a lot of deep breathing and grimacing whenever we hit a bump. Before long we were there, and made our trek up to the third floor. I was still able to walk through the contractions, but I was starting to feel a little bit like jello.

The check-in process took some time. I don't think the gal in the office believed I was actually in labor. We filled out the necessary paperwork between contractions. At one point she asked me why I believed I was in labor. "Contractions," I told her, and she just nodded. I secretly wondered if she was right and I was just over-playing it, but that sounded like the worst thing in the world, and I didn't entertain the thought for long.

Our doula Elizabeth met us in the hallway on our way to the room. Having her there, I felt a second wind. I was excited to have her knowledge added to my own, and felt ready to get to work.

Apparently the hospital was quite busy that morning; a dangerously pre-term baby was born, and the fire inspector was on the way. It took about 45 minutes for a nurse to come in and get us all settled. But that was fine with me; my one fear with this labor was that the nurses might make me stay in bed the whole time ... I definitely did not want to be trapped. And so while we waited I paced, squatted, lunged, and did everything I could think of to create space and help that little gal get in the best position to make her entrance smoothly. Mark and Elizabeth were wonderful; always watching me, providing a little conversation and some laughs between contractions, and all sorts of physical support.

Finally two nurses came in, and they were incredible. Right off the bat, I knew I would like them. They were fine with everything I wanted to do. I showed them my birth preferences I had all typed out, and they asked how my doctor felt about them. I told them he said it should be fine, and to show it to them as they would be the ones with me through the labor. They laughed at that, but agreed.

So the nurses said they'd like to keep me on the monitor for a little while to make sure my little one handled the contractions alright, and then checked me.

I was at a seven.

YES. I felt relieved and a little surprised, but didn't have much time to dwell on it as another contraction came on. I decided not to get too excited or to look at the clock much ... just breath through the contractions as they came along. Elizabeth told me she had never seen anyone that far along and so ... with it. It's sure nice to have a doula around to give you a little confidence. 

I braced myself to start losing it as I thought back on my training. But until then, I would just keep breathing. Mark eventually asked me if I wanted to stay lying down or get up. I asked him to get the birthing ball (which is just a big exercise ball to sit on ... creates all sorts of movement in your hips without having to put forth much effort). So off to the car he went, while Elizabeth and I worked through a few more contractions.

Eventually our nurse came back again and hooked me back up to the monitors and checked me. I was at a nine. She had the other nurse notify the doctor, and told us to call her if anything changed; like my water breaking (which it still hadn't) or any crazy pressure.

So I decided to try the bathroom one last time, (empty bladders leave all sorts of space) and that walk to the bathroom about did me in. I didn't stay long before I was up and Mark was holding onto me through some intense contractions. I started shaking and sweating and feeling incredibly flushed ... and decided I needed to make my way back to the bed. That little walk brought on a monster contraction that ended with a hint of that undeniable, all-consuming urge to push. Mark and Elizabeth noticed and weren't surprised one bit when I whispered what I felt, and Mark headed out to the hall to tell our nurses. They all came in just as another contraction came on. Wow. I couldn't believe how hard I wanted to push ... and then suddenly a lot started to happen at once. The nurse began demanding I get on the bed or that baby was going to be born on the floor. My water broke all over myself and Mark as he tried to help me get up into bed. All sorts of nurses came in the room, and lights were turned up. And everyone seemed to be saying one thing: "Don't push!!"

They all had little tips too; "High breaths", "Don't look down," "Keep it short," and so on and so on. I wanted to yell, "You people are CRAZY if you expect me to do that!" But instead I just listened to Mark. He was right by my head whispering, "Just do what you're doing. Keep doing what you want to do, you're doing just right."

Mark later told me he thought it was funny that I just completely ignored the nurses ... but in all honesty I didn't. I did try to stifle the urge to push; but it is impossible! There was no way I could ignore it. I tried some of their breathing suggestions, but they always ended in a grunt. Oops. Suddenly a nurse told me to lie on my side. "It'll be easier on you; hopefully less tearing," and then Mark was saying, "Oh I see her, I see her, she's right there!" Then the nurse again: "Mama, give me your hand. Would you like to feel your baby's head?" And then another contractions, more hollering at me to not push, and more of my light-breath-grunt ridiculousness, and then it just didn't end ... the contraction didn't stop, it got stronger and lighter and stronger and lighter, and then burning ... but that was quickly pushed aside by that larger-than-life urge to push, and then people are exclaiming and then the urge gets stronger and then WHOOSH!

There she is, lying on my thigh. I'm shaking and almost laughing. Mark and the nurse placed her on my lower abdomen, but as they didn't want to cut the cord without the doctor there, and as the cord was wrapped around her little body and the placenta hadn't been delivered yet, that was about as far as she reached. I asked if she was still a girl, and Mark confirmed. I then said, "Oh sweetheart we did it!" And the placenta was delivered and they moved her up closer to me. Mark and I oogled her while the nurses all waited for the doctor to come in before deciding what to do.

Our doctor made his arrival about ten or fifteen minutes after she was born. He stitched me up (just a little tear), had Mark cut the cord, and left. And there we were. Three hours of labor in the hospital. Six minutes of pushing. And it was all over at 10:57 a.m.

She was here. Our newest little member, with all her dark hair and big eyes and olive skin. She wasn't even swollen. I don't think either one of us felt she could be any more perfect.

Welcome to the world, Miss Belen Christine Gunn. We are sure glad you have joined us.

a couple thoughts on vbacs

My opinion is that in nearly every case of a physically healthy and mentally prepared pregnant woman, a vaginal birth is completely achievable after a previous cesarean section.  If you don't believe that, then you probably shouldn't try it.  It might be too stressful to be a good experience for anyone.

The one thing I hear people are worried about when attempting a VBAC is that their incision will burst.  There was a time when this did happen to multiple women; and it can be deadly for both the baby and the mother.  But according to my doula instructor (who is also a nurse ... among countless other things), this happened because doctors began trying out cytotec.

Cytotec is a drug that was made for a completely different purpose, but someone noticed that it caused horrifically strong contractions in pregnant women.  Stronger contraction will get the baby out quicker, right?  Well, whether or not that is true, your body can only handle so much.  A weight lifter can only lift so much before they will tear something.  A runner can only run so hard before they will collapse.  And your uterus was built to handle a certain amount of stress.  Drugs can do all sorts of crazy things to make your body change and/or simply ignore the limits that exist to protect it.  While this can be quite useful, it can also be deadly ... as in this case.  This drug caused contractions so strong that the incision burst in laboring women, and also wreaked some serious havoc on those without an incision.

Cytotec now has "Not for Pregnant Women" all over it's labeling, as was shown to me by a midwife recently.  She told me she keeps it on hand in case a woman is bleeding uncontrollably after the birth ... the contractions will close up the uterus and hopefully help stop the bleeding.  "It's something we would do as we were calling 911 at the same time ... I never use it otherwise."

Another newer trend that is contributing to the VBAC fear is that some doctors are favoring a single row of stitches in the uterus, instead of the previously required a double row.  The reasoning is that it is much faster; less time bleeding and having your insides on the outside.  Is it really better?  I don't know, but from what I've been told it's not widely accepted.

Whatever method your doctor may have used in the past, you can't do much about it now.  But there is a lot you can do.  Stay healthy.  Walk, walk, walk.  And learn everything you can.  Read "Understanding the Dangers of Cesarean Birth: Making Informed Decisions".  Scour these websites:
www.dangersofcesareanbirth.com
www.vbac.com
www.childbirthconnection.com

Take control.  Nothing contributes to a successful VBAC more than a prepared, positive mother.

another wonderful VBAC

My sweet friend Chelsea called me a few times throughout her pregnancy to discuss a VBAC.  She was excited, terrified, and seriously wanting one.  Though she did wait till the end to make her final decision, once her doctor expressed some real support, she was gung-ho.  She had a beautiful experience and said I could share her family blog post about it here:

"I want to hurry and type my whole story out before I forget all of the little details. I like details. In fact, expect this to be way too long, full of things that no one really needs to know but that I can't help to include.

So a week ago, I was sitting in my doctor's office and told that it would probably be another week or so, but that I would most likely deliver Nolan before his August 13th due date. I was super excited until I did a little research and found that most women stay dilated 3 to 4 cm for weeks and that I shouldn't get my hopes up to be any different. 

36.3 weeks, the day I went into labor

I stubbornly stuck to my work-outs, hoping that it'd help further some cervical change. On Sunday, I *ahem* had some alone time with my hubby. Sometime later, I had the strangest sensation as my mucus plug worked it's way out. That did not happen with Boston and even though it was kind of exciting, it was mostly really gross. I noticed some strong pressure and what I thought could be contractions almost immediately afterward. Again, some scouting around on the internet and asking my trusted doula friend told me that it was common to lose your plug and it could mean labor within the next 24 hours or not for another month.

I debated whether I was just having false labor or if I should go get things checked out. My doc told me that once I started having contractions, I shouldn't sit around at home but go right in. He made it sound like things would happen pretty fast. We had dinner plans with my family that evening and I decided that if these pains continued for a couple of hours, we'd hit up L&D afterward for a quick check. 

So to dinner we went, where I told everyone what was going on and got lots of cheers that "a baby was coming tonight!" No pressure. Haha. I still wasn't convinced that it was true labor until the night wore on and when I couldn't stand without fidgeting in pain, it was time to go and pay a visit to labor and delivery.

We went home and got my bag packed, just in case. It was something I put off doing because I was only 36 weeks (and 3 days) along. I still had plenty of time, I thought! We live like a block away from the hospital and thought that since they were going to send us home anyway, we might as well just walk over. In fact, my mother in law joked that we should leave my bag...being unprepared meant they would keep me. Sage advice. :) So we kissed Boston good-night and told everyone we'd see them soon.

Walking up to the nurses, I felt so dumb. I explained that while I was probably just having false labor, I wanted to get checked and be assured so that I could try and get some sleep that night. They were totally obliging and led us back to none other than the room I labored in with Boston. Deja vu! Or bad luck, I can't decide.

One uncomfortable exam later and the nurse declares I'm at 5 cm. So wait, I'm really in labor?? Now what? Then she lays the bad news on me: Dr. W is unreachable until Monday afternoon. The on-call OB, Dr. P, doesn't do VBACS. Ever. Are you bleepin' kidding me?! Since I'm pretty far dilated, I'm not quite allowed to leave yet. She says Dr. P. wants me to hang out for two hours to see if I progress. If no change, I could go home but if I dilated further, then we would be completely at the mercy of Dr. P and what he wanted to do.

While my original plan was to walk and move for as long as I could, now I was determined to make labor stop! I sat in a bath for 40 minutes, willing my baby not to come until Dr. W was back. Then I laid on the bed in an almost comatose state for the rest of the time. Thinking I had succeeded, the nurse comes back and tells me (almost grimly) that I'm now a 7! Wow, doing nothing moved me that far along?! Pretty cool, but then dreadful as I realize this means I'm stuck with Dr P. I beg and plead for her to call Dr. W, pretend I'm a four and let me go, tell her I refuse to sign a c-section waver. She nods at me empathetically and says we just have to wait and see what Dr. P wants to do.

I can't remember how long we waited for the answer, but I divided the time between crying in despair to Shane (I'd worked so hard for this labor!) and contemplating an escape plan. Shane comforted me and gave me such a wonderful blessing. I could feel his faith in Heavenly Father and in me as he blessed things to go well.

Profound relief and even excitement came when the nurse said Dr. P would allow me a trial of labor (I later found out that it was the nurses who championed my cause and talked Dr. P into giving me a shot, bless their souls!!) I can so do this! was the mantra in my head. It was probably close to midnight when I was officially admitted, tethered to an i.v. and roaming up and down the halls. I was amazed at how little my pain was. Part of me was nervous that things were too easy and something bad was approaching, the everlasting cynic in me I guess.

At one a.m. I reached 8 cm and decided that it was probably a good time for the epidural. I was required to have one, but wanted to wait as long as I could before getting it. I wasn't in a whole lot of pain but wanted a restful sleep before all the action began.

The epidural was a little more painful than I remember. So many strange sensations. My back is still aching from it. But I did start to feel tired and heavy. The annoying thing was every time I'd drift into sleep, my evil angst-ridden side would nag me awake with worries that my contractions weren't strong enough and that I'd get stuck at a 9 again. That I'd end up back in the OR. This went on for hours.

At 4 a.m. I'd reached a 9 but still wasn't all the way effaced and baby was still at 0 station. My contractions were a little bit weak since he wasn't putting much pressure on my cervix. My bag of waters was still in tact and I kept wondering when they would break it since I was so far dilated.

Two, three, seven hours later...no change. I was in a bit of a state of weepiness and despair as I felt the all-too-familiar stall of labor. I cursed that stupid room where the same thing happened two years ago, I cursed the doctor for not being my doctor (he hadn't been in to see me once!), I felt my fantasy of pushing my baby out and holding him on my chest slipping rapidly away.

Well, my second most-amazing nurse of the day refused to let me get discouraged. Coincidentally, she had had a VBAC herself and reassured me that we weren't out of options yet. Finally, at 11 a.m., Dr. P came and ruptured my membranes. Contractions and pressure increased but not quite enough and an hour later I was given a low-dose of Pitocen. OH MAMA those contractions picked right up. When I was given the epidural, I requested it low enough that I could move my legs and feel the contractions while my nether region stayed nice and numb, but when those transition contractions started coming every minute or so, I began pushing my epi button like there was no tomorrow. Eventually the anisthesiologist came in after hearing my animalistic cries of labor down the hall and gave me not one, but two more doses! I remember my mind being divided between trying to focus on the baby moving down the birth canal and doubting myself that I could go through with this as each contraction peaked. I had Shane on one side trying to rub my arm, my leg, my head to calm me and my mom on the other trying to get me to "Ommm" the right way. Haha, bless her heart, she thought that if I got my vibrations just right there'd be no pain. I almost chucked the tennis ball I was clutching at her.

I'll never forget the utter joy and shock I felt when my nurse annouced I was 10 cm and fully effaced! Tears literally ran down my face. The anisthesiologist said my pain shouldn't be making me cry after two doses of medicine, but I just laughed and told him I was so happy! I'd gotten past the dreaded 9! It worked, even though a big part of me doubted I'd ever see this point! And it was time to push.

Can I just say to ladies who are pregnant: exercise, especially yoga, works!!! I know that's what gave me the strength to be able to push effectively after being through such a long labor and being extremely exhausted. Ok, and it doesn't hurt if your baby is tiny. Once I got over my self-consciousness (I was convinced I'd be one of those mothers who poops all over, scarring and eternally turning off my husband), I pushed like an Amazon woman. The doc did end up giving me an episiotomy (ouuuuch!) but little Nolan's head crowned after about 20 minutes of pushing. Dr. P told me to stop and pretty much just lie there, which was SO hard! I didn't know at the time, but the cord was wrapped around his neck twice and he was a scary shade of blue. Luckily, Dr. P was quick to get it cut (sad for Shane that he once again missed out on cutting the cord) and to pull Nolan the rest of the way out. He went straight to the NICU nurses while I strained to look at him through the afterbirth and stitching up of tender areas.

Thankfully, baby was given a clean bill of health and I got to meet my teeny tiny bundle. A priceless moment, to say the least.

It was such an incredible experience that I'll cherish forever. I'm so thankful to have been able to have the delivery I dreamed about and that everything came together to make that possible. Our bodies are truly amazing, especially if we do all we can to help them out. And modern medicine is such a blessing. There is a fine balance between too much intervention and just enough to enable a successful delivery. The first time I believe I was on the wrong side of that balance whereas this time I wouldn't have been able to do a VBAC without it."