Saturday, August 13, 2011

Labor of Love

I'm excited to announce that I was fortunate enough to attend my first birth center birth at Labor of Love Lutz on Friday!!!

On Monday the mom called me to let me know that she had her membranes swept. Great, was my initial thought and then, OH NO!, because Tuesday and Wednesday were my last two days of class for the semester and I had finals both days. With a positive intention that everything would work out, the mom made it to Thursday, when her labor started at work sometime around noon. Around 6 pm I called her to see how she was doing. She had been able to take a nap and was at home relaxing. I ate dinner and headed to her house around 8 pm. We were on our way to the birth center around 8:30 pm with strong contractions.

Only at the birth center for five hours, and having only been in active labor for about six, the baby was born gently, in the water, at 2:25am on August 12, 2011.  What an amazing family, midwife and birth assistant! They worked so beautifully together throughout the labor and the birth- it was such a powerful experience for everyone involved. I feel so lucky to have been a part of it!

Baby boy Bastian, 7.5 lbs, 21.5 inches

Side note: On August 4th, Kim Turner, a photographer, had emailed me that she read my blog and wanted to branch out into birth photography. She wanted to know if any of my clients would be interested in birth photography and I immediately thought of my doula clients. They had awesome pregnancy photo's taken and I thought they would be excited about birth photography, and I was right.

I have seen birth photography online before but had never been to a birth that had a photographer present. Kim did an amazing job at being "a fly on the wall" and more of a documentarian rather than an active participant in the birth. Her photographs are breathtaking. I cannot say enough positive things about having a photographer, who is solely there as a photographer, at your birth. I eagerly look forward to working with Kim in the future and cannot recommend her more highly. Below is a sample of her photographs, I cannot wait to see the rest!





Monday, August 1, 2011

I'm still the optimist.

Not only is today a Monday and the first of the month, it's also my birthday month! How exciting!

I just want this semester to be over. I am done learning about the muscles of the pelvic floor and the physiology behind gastrulation. My friend Angie told me that I turn into a restless 9th grader by the end of the semester and I'm starting to agree with her. I need a break!

So in less than a month I will be the age my mom was when she had me. Kinda makes me stop and think. What am I doing?! I have spent the last 20 years of my life in school. I want to be done. I have plans and goals and things waiting for me when I'm through (hopefully). Graduation cannot be here soon enough.

A great person recently told me that I need "to stay up and keep dominating your life goals." Good advice! So on this awesome day, I make a resolution to do just that.  Seriously, I got things to do and people to see! 

Sunday, July 31, 2011

Dead woman walking: Obstetric Fistula



“When I reflect back over the years, certain faces come swimming unbidden out of the tide of memory. Even though everyone’s story was amazing, some were even more so. One young woman arrived at the hospital and handed us an envelope with a letter inside that had been written by a missionary doctor down near the Kenyan border. It introduced her and asked us to treat her fistula. There was nothing especially unusual about her. Like so many of our patients, she was dressed in rags and weak from hunger. The sealed envelope was so worn and grubby you could hardly read it, but inside the letter was clear and legible enough. To our surprise it had been dated seven years ago.
“Why has it taken you seven years to get here?” I asked. She told me she had been begging at the bus station for her fare. That was how long it took to raise the money.”

The Hospital by the River—a Story of Hope by Dr. Catherine Hamlin with John Little

I just finished my paper on obstetric fistula. I'm sure it could have been better but I must say I've learned so much along the way about the plight of the poor women afflicted with this devastating condition.  Dr. Catherine and Reginald Hamlin are PIONEERS in fistula repair and opened the greatest fistula hospital in Ethiopia in the late 1950's. To this day Dr. Catherine Hamlin still works there and in 2007 they opened a midwifery school to help train birth attendants to prevent prolonged labor. 

Follow below to read my paper.

Saturday, July 30, 2011

(Home) Birth Observe #10

My first placenta print with paint

Thursday I went on prenatal visits with my midwife. One of my favorite mama's was 39 weeks and 5 days and eagerly awaiting the birth of her first baby. She wanted to be checked and was 1cm, 60%, +2. Exciting but nothing to write home about. Later Thursday night the midwife forwarded me a text that she lost a big glob of mucus. Yay, we are getting closer.

Friday morning around 8 am my midwife called me to let me know that our mama had been contracting since about 4 am and that she was going to head over and check her. I went to teach childbirth class and headed to St. Pete around 11am. I arrived at her house at 11:45 am right after she was checked: 80% and 4cm. The mom SROM'd right after the check and was handling her contractions like a CHAMP!

At 1:15 pm she wanted to be checked and was COMPLETE! By the way this mom was handling her contractions you wouldn't in a million years be able to tell she was where she was in her labor. It was AMAZING! First time mom took 10 minutes to push our her baby! It was so beautiful! I am so happy for this young couple and excited grandmother! At 19 years old this mom owned her birth. "I can't believe I just had a baby," was her postpartum catch phrase! Totally awesome! 


Wednesday, July 27, 2011

Infant formula and divorce attorneys

Exhibit A: Infant formula given to an exclusively breastfeeding mother
(she donated it to the local pregnancy center)


So my newly formed family of three recently got home from the hospital but before they left they got a little parting gift. A bag of infant formula. This is a breastfeeding mother on her way home to nurse for the first time- now with a handy supply of artificial breast milk for when the going gets tough. SERIOUSLY, what is this?

Research shows that the last thing a mom that is nursing needs is free formula as she navigates the ins and outs of breastfeeding. Giving a breastfeeding mom infant formula as she leaves the hospital is like the wedding planner handing the newly married couple business cards to divorce attorneys as they leave the wedding reception. Have we no faith? Not when infant formula is a BILLION dollar a year industry in this country.

Lactation resources need to be made available to newly nursing moms, not the easy solution of formula for when there are issues with breastfeeding. Although breastfeeding is natural it isn't as instinctual as some would think and both mom and baby need to learn this new skill. Practice makes perfect!

It makes me so angry to know that profit is put first over the health and wellness of both mothers and babies. Breastfeeding is the perfect nutrition for baby and it also helps protect the mother from breast and uterine cancer among its running list of other amazing benefits!

There is formula available to every person 24/7. Anyone can go to the store to pick it up in the event of an "emergency"- day or night! Giving breastfeeding moms formula as a "just in case" is helping nobody except the formula companies bottom line. Major THUMBS DOWN to any person and organization that supports this unethical practice!

Sunday, July 17, 2011

Something to prove

"We have a secret in our culture, and it's not that birth is painful. It's that women are strong. "
Laura Stavoe Harm






After my hospital birth last Monday, I went downstairs to All Children's to talk to my friend who still works there. While I was sharing a picture of the baby and the details of the birth, a former co-worker questioned why anyone would want an unmedicated birth, "does she have something to prove?" His comments stopped me in my tracks. Was he serious? What does this mom have to prove? What do moms who plan unmedicated birth have to prove? Well, a lot actually. 

When women plan an unmedicated birth they are proving that birth is normal. When you are in labor there is not a DAMN thing wrong with you. Why would you want to use drugs during physiologically normal process? The pain of labor is gradual and rhythmic. Non-augmented labor pain will only take you as far as your body can handle and no further. Your body doesn't know that there is an epidural waiting for you at the hospital. There is an end to every contraction.

Moms who are having unmedicated birth are often surprised at how fast it can go. Once a steady rhythm has been established unmedicated birth is often quicker than those with epidurals. The great thing about unmedicated birth is that you can move. You can walk around, get in the shower or tub, do whatever position your body is telling you to do! This is probably one of the reasons why it can go a lot faster than the births where the mom is strapped to the bed.



There is this great myth that epidurals will save you from the pain of labor and birth. I've been to over 15 births where epidurals have been used and I can tell you first hand that that's not always the case.  Some epidurals leave spots of sensation, you still have pressure and sometimes they don't work at all. However, even if your epidural "doesn't work" that doesn't mean that you're again free to move around the room. In fact, once the epidural is placed you are now tied to the bed, almost literally. IV to saline (often Pitocin as well), blood pressure cuff, fetal monitor, contraction monitor and pulse ox are almost routinely required once you get an epidural. Not to mention the joy of the indwelling catheter to collect your urine now that you can't feel your lower half.

Epidurals are a great resource. I'm not anti-epidural. They can truly help preserve vaginal birth, in some rare cases. However, epidurals are often the first step in a cascade of interventions that lead to an operative deliver, either via cesarean or vacuum/forceps. When women are accepting an epidural are they truly doing so under informed consent? Have they weighted ALL the risk (increased risk of invasive interventions like Pitocin, major abdominal surgery, effects to the baby?) When you have a woman who hasn't eaten deli meat, soft cheese, or had any caffeine for the past 8 months but gladly accepts an OPOID epidural, we have a major dichotomy on our hands which leads me to believe they haven't been properly consented. Why would you subject your body and your baby to the increased risk of complications and additional interventions when there is a better way?

Having a doula at your birth has been shown to reduce the incidence of Pitocin, operative deliveries and the mothers request for pain medication. Epidural anesthesia has become the hospitals version of a doula. It offers pain relief while leaving the mother attached to the monitors, which have become the new labor and deliver nurse.  A doula is your labor partner, your coach, your cheerleader, your tour guide as you navigate something you may not have experienced before. "You can do this, you are doing this," is often all a mom needs to hear as she goes through the most intense time of her life. Why would you not want to be completely present at your birth? This is the most powerful day of your life!


The question shouldn't be what do moms who plan an unmedicated birth have to prove, the question should be what do moms who plan a medicated birth have to fear?

Monday, July 11, 2011

Two for Two

Woo Hoo! I'm batting 1,000 for unmedicated, vaginal births. Well, if you count my last two hospital births, anyways!





 This morning I woke up early because I had a potential doula client interview and I was going to have a birth plan meeting with a client who was a couple of days past her due date. Her plan was to stay at home as long as possible but this morning when I looked at my phone I had a text from her from earlier:


Shoot! I hate when my moms run to the hospital as soon as they get a single contraction. I was upset because I know what kind of time restraints people get put on in the hospital but this birth went great. She SROM'd around 6am but was only contracting every 10 minutes when I got there around 9am.

Walking, standing, singing, sitting on the toilet and nipple stimulation got our mama to 7 cm by 5:30pm (with no pain medication or Pitocin). Around 6:30 pm she started feeling pushy so the nurse checked her. She said she was 8-9 but the baby was still "very high." I knew that this mom had hit transition. She was feeling extremely pushy and pushing uncontrollably with every contractions. The nurse reassured me that she still had a while to go and that we could keep walking around and even go sit on the toilet for a while. Seriously? This mom is bearing down! There was no way I was going to have this mom sitting on the toilet because the last thing that I need (as a doula) is to catch a baby in the bathroom of a hospital!

Less than 30 minutes later I paged for the nurse to come back. A new nurse came in (it was after shift change) and the mom was complete at a +1 station. The doctor came in very shortly after that and he had the nurse push with her. Boom, head crowns. Less than 15 minutes later the baby was gently born.


Soon after the birth the mom was nursing the baby with a great latch. This was such a happy birth. I'm glad that I got to be a part of it! It's amazing how intuitively I'm starting to understand where moms are in their labor. The physiology of normal, unmedicated birth is becoming clearer to me the more births I experience. It still amazes me when hospital nurses (who see THOUSANDS of births) have a hard time 'reading' physiologically normal birth! Truly undistirbed birth is still a hospital rarity. I'm glad that this doctor was hands off and let the mom labor at her own pace, in her own time. It was beautiful!