I got a call from an OB earlier this week. He said that he received fliers for my birth class, he would like to send couples to me, he believes couples need to be prepared before delivery, but my class is just too long, would I shorten it?
I hated to give a negative answer to an OB whose sentiments, that couples need birth education, I so passionately agree with.... but I responded with, "I really cannot shorten this class. What I offer is very specific, I fully prepare couples for a healthy pregnancy, birth, and breastfeeding relationship... I don't think I can remove any information and still provide the same quality education that couples need." And because I want to be transparent in that I do help couples achieve a natural birth... I closed my eyes... as if something could possible fall on me... and said, "Over eighty percent of my couples have an unmedicated birth. My class, all ten meetings, is necessary to help them achieve that goal if that is their goal." I will not under serve some couples to reach couples who are not willing to invest in their birth. I hoped that I didn't totally alienate this doctor by basically saying "yeah it's a long class, it's staying that way... and we won't be needing your drugs now... sooo bye thanks!" but I guess I don't care enough about possibly offending people to not teach the class I teach.
I teach the longest class in my county... it's twice as long as any other series I know of. Ten classes, 25 hours of in class instruction in addition to work outside of class. The basic premise that I take with childbirth education is that this is a surrogate for decades of birth education that every girl should be receiving from as soon as she figures out she has a vagina, and wonders what it's for. However, when birth moved out of the home, suddenly it had nothing to do with our bedrooms and our bodies and became a procedure that a doctor did to a woman, hence the constant focus on "the delivery." The doctor delivers the baby, the women does not birth the baby. Hospital classes, or very short birth classes, can only really cover this perspective of birth, what will likely happen to the women. They are inadequate to truly educate, really... re-educate, a couple in what birth is, and how to take it back, make it their own... let it be what it was designed to be. I can't just teach couples what will happen to them, I need to help couples understand that this is their birth, and empower them with the tools and information they need to birth their baby, not merely "be delivered."
In lieu of decades of information lost, I consider ten weeks to be a small compromise when we consider the amount of time we prepare of other life events.
Would you plan a wedding in three, two hour sessions?
Would you dedicate only six hours on a Saturday to the decision of buying a house?
We devalue birth, therefore we devalue birth education.
Honestly, sometimes it makes me feel insecure to stand my ground and call out a wavering community. Maybe I'm not being competitive, I'm not accessible enough to all couples, that any other educator can easily get a client by saying "I do what she does in half the time." We all have thoughts like this right? I DO think about these things... I've searched myself thoroughly on these topics... you are getting in on a late night internal dialogue, instead of laying awake... I'm writing it here... what could go wrong right?
Could I teach what I teach in fewer classes?
If I could teach what I teach in eight classes... I would. In six classes? Seriously... yes... yes I would. I love spending ten weeks with my couples, but I have no interest in wasting their time or mine. I've gone over each class, and asked what I could remove. Class seven is easy right? We just cover the pushing (though I prefer "birthing") stage. Others cover that as apart of just a fraction of a couple hour class... but somehow... my class on that single topic (which seriously encompasses so much) still ends up being a little over two hours every time. No nap time, we don't sing songs, there's no art hour... There is just a lot to know about the birthing your baby out of your vagina... an incredible, seemingly impossible feat! And when given the space, couples ask many questions about it... we could easily take that class to three hours! What about the nutrition class? That's not exactly about birth. Cut it out! However, when moms are able to keep their pregnancy low risk through nutrition, that certainly affects their birth! I could go on like this about each class.
There is nothing I could take out, everything is important. So by removing important information from class in order to condense it, I'm putting my couples at risk of being under prepared. I can't do it.
Other classes teach birth in fewer classes, those couples are fine.
Sure I guess... but I'm not going for fine. Birthing women deserve better than fine! I don't know anything about scuba diving, but I know to do it safely you have to take a class. I did a quick google and it looks like it's usually a few classes. Lets say to learn to safely scuba dive you need five classes. A scuba instructor sees that a lot of vacationers want to just take a one day class, so he offers it. Will all those people drown? Probably not. Will their experience be better than if they took no class, probably. Will some people encounter negative outcomes that they could have avoided with adequate education? I'm sure. I'm not going to teach the shorter class knowing there is more information that couples need and deserve, even if they would be more popular classes in our busy culture.
But couples WANT a shorter class!
I've heard this argument a lot, from doctors, doulas, educators... couples just aren't willing to invest more time in childbirth education, and something is better than nothing. Again with the scuba class scenario... should we offer an inferior scuba class just because people want it? This is a safety issue, even if birth is normal and natural, it's not in our culture. Inductions, cesareans, birth trauma... we are avoiding very serious complications with adequate education. I think the problem here is that because so many hospitals and independent educators are willing to teach a shorter class, often times knowing that these couples need more, people believe that a shorter class is adequate. Is it better than nothing? Yes, but we are never going to see significant change in birth in our culture if we hold the bar so low.
What I would like to see is doctors, midwives, doulas, and educators valuing childbirth education and helping couples to value it too. Continue the conversation. My experience is that when you are able to make valid arguments for why comprehensive childbirth education is important, people listen. When midwives and doulas require childbirth education, that says something! As an educator, being able to confidently share that your classes do actually make a difference (because you should be keeping track of that) is also important.
Some couples just will not take a longer class.
This is true, and they will unfortunately get what they put into their preparations for birth. That doesn't mean we should abandon the message that childbirth education is important. If we keep saying it, it will seep into our culture. If from early on, well before conception, people heard that childbirth education was essential... then that's what they would believe. You know what I heard when I was young? "Oh yeah, my Lamaze class was a joke." Let's not offer classes that don't truly prepare couples (and I'm certainly not saying modern Lamaze is a joke, before you start throwing stuff at me). If we perpetuate the cycle of birth classes that are not effective then couples will continue to see them as not necessary... because really... how big of an impact will a one day class have on a birth?
There are a lot of questions in this post that I don't have the answers to. This is a conversation. I don't think a short class is adequate based on talking to couples who have taken them... but if educators who are teaching short classes are keeping stats on them and can show that six hours of education over a few weeks does significantly decrease induction, cesarean, and complication rates and has a significant role in helping couples achieve the birth they want, then that's a conversation I want to have! This is not about attacking another class. I don't want to have the best class. I can teach six couples in three towns, every ten weeks... we need a lot of great classes in order to serve this community. I'm calling to raise the bar, because I refuse to lower mine.
Many people think birth classes are only for first time moms. I have even heard midwives, doulas, and other childbirth educators say this. I believe a birth class is for anyone who hasn't achieved the birth they desire. So this would of course include a first time mom. This would also include a mom who previously had a medicated birth and desires a natural birth. Also, couples planning a vaginal birth after cesarean (VBAC) need to prepare in order to avoid another cesarean. Even the most supportive provider will not be able to VBAC for you or walk you through the whole labor as it happens. Like anything in life, when you are going to do something you have never done before, you should learn how!
I love the International Cesarean Awareness Network (ICAN). I am active in our Monterey County chapter and I recently taught a webinar for ICAN on avoiding a cesarean (based on this post). I'm really proud that ICAN featured an article on the curriculum I teach, Birth Boot Camp, in the July 2014 of the Clarion, and wanted to share it with all of you!
If you are interested in joining ICAN, getting access to the Clarion, educational workshops and webinars, and a discount at the ICAN store, you can do that here!
A fellow educator wanted to share this message anonymously, and I'm pleased she chose to share it here. I hope this helps to start a productive conversation between grandparents and their expecting children. - Cori Gentry, BBCI
Dear expectant grandparents,
Congratulations! Whether this is your first or fourteenth grandchild, you are no doubt overjoyed to hear that your family is expanding and you are anxious to be helpful and involved. What a special time! Your son(in-law) and daughter(in-law) are certainly thrilled to share this excitement with you. As you anticipate meeting this new sweet little bundle of joy, there will be many opportunities to show your support to the expectant parents. Current research shows that the birth experience has a long lasting impact on families, so please accept these words of advice to help make this exciting time as safe, harmonious and joyful as possible.
Before the Birth
You may notice that the parents of your grandchild are doing research, taking classes and exploring options about pregnancy and birth. They may make decisions for their baby that differ from the decisions that you made for your babies. Please do not take this personally. Each set of parents are entitled to make their own decisions with the information they have. Do not feel obligated to justify your own choices. This is the beauty of raising adults- they get to make these heavy decisions and bear the responsibility for them. If you have questions, ask for reasoning with patience and respect.
The mother may not give birth by the estimated due date. In fact, labor may not begin for days or weeks after the due date. This can be normal and healthy, as the average pregnancy lasts 41 weeks and 1 day. She may be emotional or even feel guilty for making family “wait” longer than expected. Try to alleviate her of any pressure and show patience and understanding.
Ask how you can help and what the parents expect from you when the time for the birth arrives. If they do not ask you to attend the birth, do not take this personally. Birth is a very private and personal event. This does not mean they intend to exclude you, but that their priorities are for privacy and minimal interruption to the birth process. The mother needs to feel uninhibited to follow her instincts, moving and making noises freely. She may be concerned about your comfort level in that setting and needs to avoid being distracted from her goal- birthing her baby! Here are some ideas for other things you can do during the birth:
On the other hand, they may ask you to attend. What an honor! Here are some things you should know to expect:
After the Birth
The moments after the birth will be a flurry of excitement!
In the days and weeks after the birth, it is important for the mother to recover from birth and allow her body time to heal. She should remain in bed for most of the day and should be able to nurse her baby without limitation. This will help establish good milk supply and give the baby a great start nutritionally. She will need help with meals, laundry, errands and other chores. Any help you can offer or organize will be a priceless gifts to the new mama!
As you probably know, each birth and each baby are unique. I hope these tips help you know how to best show love to the new parents and the baby. There is nothing like welcoming a new child into a family. May this birth bring your family happiness and bond you as only a birth can!
~ A mama and childbirth educator
The curriculum I teach is Birth Boot Camp, the tagline on the logo is "Training Couples in Natural Birth." I thought I might share why these classes aren't only for couples planning a natural birth and clear up some possible misconceptions about this curriculum and who may benefit from it.
Natural births make up a very small minority of births in the United States. Couples who desire one deserve to take a class specially geared towards helping them achieve that goal. It's no small feat, not because natural birth is so difficult (even though it certainly can be) but because in our culture women women know little about the normal birth process and have many misconceptions about birth in general. So, that's why there is a class designed for couples desiring a natural birth. However, what about the couple who does not desire or cannot have a natural birth... what do they deserve?
They deserve absolutely everything that a couple desiring a natural birth deserves.
During my time as a natural childbirth educator I have been approached by several couples saying "We already know we will have to have an epidural for medical reasons," or "We really don't desire a natural birth, but we wan't to avoid a cesarean," or "We are undecided, we want to keep our options open," and they wonder if my class is right for them. Not only have I told them that it was, but I've taught these couples, and they have loved their births.
If I teach a natural childbirth curriculum, how could the same information appeal to couples with different plans?
No Birth is Shamed, Ever
I vilify no intervention and there is no such thing as a failed birth... which I remind my classes of often. I am very honest about the risks of every intervention. We role play getting every aspect of an epidural set up (the IV, blood pressure cuff, oximeter, bladder catheter, etc) and discuss how these interventions can effect birth... but I'm very aware that even if everyone in the room is planning a natural birth, someone may need or choose medications in labor so there is no doom and gloom in this discussion. A couple planning a medicated birth should feel very comfortable. This information helps them to know what to expect so they are truly making an informed decision. No matter what a couple is planning, we thoroughly discuss how to minimize any negative effects of any intervention, how avoid additional unwanted interventions, or how to avoid an unwanted cesarean birth.
Interventions are a Fraction of Class
I've read natural childbirth books where I feel like their main approach is to try to scare people into a natural birth by mainly focusing on risks of interventions. That is valid information, but that's not the focus of this class. A couple planning a medicated birth will still need information on keeping their pregnancy low risk with nutrition and physical fitness, they will still need tools to help them in labor before they get whatever medical pain relief they desire (and they will learn those medication options), they will still have to push out their baby and decide how they want to do that too! They still have lots of decisions to make about their birth place, what newborn procedures they want done after the birth (there are lots of them), how to breastfeed their baby, bringing baby home, establishing sleeping arrangements. And we don't just mention all this in the midst of a long lecture, we dedicate a lot of time, activities, sometimes whole classes to these topics so every couple feels very prepared. I don't want anyone to feel blindsided at their birth or postpartum! Even a couple planning a cesarean birth, or that finds out they will need a cesarean during pregnancy, will gain a wealth of valuable knowledge to prepare them for their birth and life with their baby.
A Positive Birth
I don't want couples to believe that only a natural birth is a good birth. I don't believe that. I've birthed naturally and with medications and my most powerful birth was actually a medicated birth. I think it was a great birth and I'm proud of it. What I desire for all my couples is that they have a positive birth that they feel good about. If a couple desires a natural birth, I will do everything I can to help them reach that goal. I will also prepare them for departures in their birth plan in a way that doesn't undermine their ultimate goal. Not everyone who plans a natural birth will have one, so helping each couple learn how they can have a positive medicated birth or a positive cesarean birth is really important to me. For a couple who desires a medicated birth, medications might take away the sensations of birth (also might not!) but may not help a mom with all the emotional aspects of birth. Fears of either the birth process or aspects of the chosen interventions might make even a birth with excellent pain control very unpleasant. A positive natural birth, a positive medicated birth, and a positive cesarean birth all deserve thought and careful preparations.
When I hear about a natural birth from a friend or birth professional at one of our local hospitals where natural births feel more like blue moons... there are two questions I always ask: How long was she there? (the answer is usually less than 8 hours) And what position did she birth in? (most women are made to birth on their back there). I plan to keep asking because I TRULY HOPE that one day the answers will change! But for now, when I ask the latter, it's not uncommon to hear "She was pushing upright, or in a squat, and the nurse asked her to get in a lying squat... it all went great!"
The first time I heard this... I needed the doula to clarify... you might need that too...
Are we all familiar with a birth squat? See the picture. This position is one that many women will get into to birth their babies if they have not been conditioned by their culture to lie on their backs. In other cultures it's a position that people use often... you'll see men squatting during their smoking breaks, people waiting at the bus stop in a squat, and they go to the bathroom in a squat. This is a very healthy exercise to incorporate into your day... I pick up toys, change diapers, sometimes watch tv in a squat and I encourage my students to practice often as well. You can read more about the benefits of squatting here, back to the birth squat...
I also share the many benefits of birthing in an upright position. This can be a squat, which opens the pelvis by 30%, or with one knee down for support, on all fours... lots of options. Here is a list of advantages compiled by Giving Birth Naturally, you can see the whole post here:
When studies have been done on upright vs non-upright birth positions, the non-upright positions included are usually lying flat on the back (lithotomy), semi-sitting, like leaning back in the bed, and side lying. To imagine what a lying squat is if you haven't heard a nurse tell you to get in the position, or heard your client be told to get in the position... take a woman in a birth squat and put her on her back. Or lean her back into the bed.
Imagining it? Oh geeze... what does that look an awful lot like? A woman birthing on her back or in a semi-sitting position...
Friends... the lying squat is just nurses and doctors using our language against us. They are making women feel like they are getting what they want when in reality they are being manipulated into rejecting what their body is telling them to do and doing what is convenient or comfortable for the provider. The benefits that a woman enjoys in an upright birth position are lost in a lying squat! Who cares what the staff calls it! Lets call a spade a spade here ok?
Why aren't an upright and lying squat the same?
A squat is not all about the position of the legs. Even though in these two positions the mom's legs may be positioned similarly... the lying squat (whether with mom fully on her back, or lying back into a raised bed) compresses the pelvis, changing the size and shape of the pelvic outlet. Gravity is no longer on mom and baby's side. Mom will still experience all of the discomforts of lying on her back.
Most importantly... to me at least... the woman is no longer listening to her body. Also, many women who know enough to get into a squat during a hospital birth has most likely done her research and has decided that she does not want to birth on her back... women are vulnerable and highly susceptible to suggestions in labor, shame on every nurse and provider who uses this kind of language to talk a woman out of the birth she desires.
I've noticed some apathy from some doulas on this subject. I don't know why... because it makes me really mad. We are working SO HARD to inform women, give them options, give them the tools and the vocabulary to communicate openly to their providers what THEY WANT for their birth. This is simply a trick to get women to comply without resistance. It's not fair. We need to warn women just as we warn women about breastfeeding "booby traps" put out by formula companies. Lets remember whose corner we are in.
Moms, doulas, birth educators... it's ok to be mad! Let's not be so quick to give up and get on our backs! Saying "Well I/she pushed upright for some of the time." So? Did you/she want to BIRTH upright? If that's was the desire, and it was not allowed, that is not a victory! That is not progress... because YOU/SHE only births that baby once.
So let's not buy into the "lying squat" ok? Let's not be ok with putting women on their backs when they don't want to be there. Lets choose and praise the birth places who consistently support women in birthing how they desire.
Ok I feel better now... thanks for reading guys!
When preparing for my first birth with a natural childbirth curriculum all I knew about induction was to not do it. Just say no! And no I said… and said and said. But at 41 weeks with poorly controlled, insulin dependent gestational diabetes (because all I learned about that was to eat this and that won’t happen, then it did), I knew it was probably time. We were not happy, we were not prepared, we were determined to still salvage our natural birth but that wasn’t enough. We knew what we wanted, but had no clue how to achieve it. This post is kinda a letter to me, then… and maybe you, today, will find it helpful.
Before we get started, I am completely opposed to inducing labor for non medical reasons due to the risks of induction for mom and baby. Being tired of pregnancy, being over 40 or even 41 weeks, suspecting a big baby or an impending holiday are all reasons that I personally would not consider legitimate enough to justify the very real risks of induction. If you are planning an induction for a non medical reason, please consider letting your baby come when he or she is ready. However, there are times where the risks of continuing the pregnancy outweigh the risks of an induction, and for the health of mom and baby it is necessary. To the mom facing a medically necessary induction, you don’t have to give up your birth! You can still be an active participant and have a positive birth! You are not a failure, you just might need to adjust your game plan.
There are many different ways in which labor can be induced. In my classes I cover 10 natural induction methods and 6 medical induction methods. Chances are my students will not need the information, but if they do then they can make informed decisions with their provider about what is best for them. I hope you have taken a truly comprehensive class that covers the pros and cons of these options, and you have a knowledgeable doula to help you… or you will have some late night researching to do. Briefly, medical induction usually begins with a cervical softener if your cervix is not already soft and dilating. Though less common in some areas, sometimes a Foley bulb is used to mechanically open the cervix up to 3cm. Some doctors choose to go straight to Pitocin, a synthetic form of oxytocin that creates contractions. These contractions can be longer and harder than natural contractions, and that is one reason inductions are hard on mom and baby. Some doctors begin Pitocin after using a cervical softener or Foley bulb. There is also a pill that can be used called Cytotec, though because of the risk of uterine hyperstimulation and rupture, some doctors and midwives no longer use it. Take some time to research the risks and benefits of these options, one method will not be ideal for everyone. If you have that information, let’s get on to our survival guide!
You need an induction, first take a time out.
You have been preparing for this birth for 9 months, maybe longer. You might have very specific visions for your birth, like laboring at home and arriving at the hospital late in labor… or maybe you were planning a home birth and you are now having to transfer care. It’s ok to take a minute and be mad, or sad, or frustrated. For one of my births I gave myself from the doctor's office to my home to blast my favorite pity party song and cry and be super angry that I wasn’t going to have the birth I had originally planned. I just happen to do my best crying on the road but you do what you need to do. Get it out, and then collect yourself, because you can do this. You are already an awesome mom. You are making a hard decision for the health of you and your baby. You may have to induce your labor but you still have options and can still have a positive birth.
If you have time, revise your birth plan.
I was given less than 24 hours notice for my induction, though I managed to negotiate 2 more days so I could try to induce labor at home, and pull myself together. Chances are if your induction is medically necessary you will not have weeks to prepare, you may only have a couple days. If you have a birth plan, look it over. If you can do this with your provider, please do. You may have “no IV,” “intermittent monitoring,” or “use tub and shower,” and depending on your hospital's policies and the type of induction, these may no longer be negotiable. Pitocin is administered by IV, because of the risks associated with Pitocin, it’s very important that baby is being monitored continuously, and most hospitals do not have wireless, waterproof monitors so water may not be a tool available to you. It’s better to know this now, and make a new plan, than to be disappointed when you arrive. You may still be able to use other tools like movement, massage, counter pressure… and if your doula is skilled with a rebozo, peanut ball,
essential oils… yeah… you still have lots of options even if they were not a part of
your original birth plan.
Prepare for a long stay.
Inductions are usually a long process. Shame on the doctors who love to say, “We’ll have this baby by dinner time!” when a mom is checking in for a 7am induction. Sometimes this is the case, but not usually with first time moms and it does no one any good to be unrealistic. Inductions usually take a couple days. This is ok, you probably won’t be in active labor that long. The first day, or night, depending on when you begin your induction, will likely be spent with a cervical softener like Cervidil, or on a low dose of Pitocin. Even on maxed Pitocin sometimes contractions just don’t begin for a long time, 6, maybe 12 hours. So prepare for a lot of waiting. In the evening, have an eye mask and ear plugs so you can sleep. Bring your own pillows and blanket if you like, and it’s ok to ask the nurse for a medication to help you sleep. In the day, bring a book, magazines, cards if you like to play card games (I do!) and your laptop or tablet with some favorite shows and movies. Maybe arrange for a friend or family member who is supportive of your birth plan to come give you a pedicure if not much is happening. Maybe you WILL have a baby by dinnertime, but you might not so come prepared.
Induction Day: Celebrate!
Celebrate? What? Your whole birth just came crashing down around you! Well… no… it didn’t, you have looked over your options, you are prepared, and guess what… you are having your baby! This does call for a celebration. Inductions are best started in the evening, so request an evening appointment and make dinner reservations at your favorite restaurant. Relax at home before, take a long shower or bath and a nap if you can, maybe you and your partner can get a massage. Massage stimulates oxytocin! Go out to dinner and be sure to order something with plenty of carbs and protein. If you are an athlete you know how important carbs are for an endurance sport! If you aren’t… trust me… you will be burning lots of calories in labor and some doctors will not let you eat during your entire induction (though more on that later). This meal is important, but also enjoy it. You might not be eating out in a nice restaurant for a while. Toast (maybe with a little wine) the baby you will soon have in your arms!
Check in and pass out.
I mentioned sleep above, but I want to stress how important it is that you sleep as much as you can in the hospital before labor is established. This isn’t easy… nurses are in and out, it might feel like there is a cord attached to every limb, machines are beeping… but please try. If you are inducing in the morning (and you can request inducing in the evening) but had a restless night, nap once the nurse has you set up in your room and started your cervical softener or Pitocin. If you are over tired and anxious, this may make your labor more difficult and painful. Put in some ear buds with some relaxing music and zone out. If you have had a full night of sleep and feel energized, then choose a relaxing activity. This is not the time to be walking halls, save up your energy for once labor begins.
Now what might happen next?
Scenario 1: Labor begins!
Whoo hoo! You are having strong contractions with a great pattern! Your body was ready to have this baby and all it needed was a nudge in the right direction! Be in contact with your doula and decide together when she should arrive. If you can smile and talk through contractions, continue with the relaxing activity you have chosen, though try to remain upright and use movement occasionally. If your contractions require you to stop everything and focus, use movement, upright positions, and establish your rhythm. Tap into those tools you learned in birth class, but don’t exhaust yourself if you don’t truly need them yet. These contractions may be harder than you expected or saw in birth videos, there might not be breaks like you prepared for. Some women will need pain medications, but some women will still be able to have a natural birth. Both scenarios are ok, don’t be hard on yourself. If labor is well established, you can always ask for the Pitocin to be turned down, or turned off and be unhooked from the IV, to see if your contractions continue naturally. You can labor the way you planned to originally, work with your doula and partner to stay on track for a vaginal birth!
Scenario 2: Contractions begin, but you can’t feel them!
Sometimes during an induction contractions begin to show up on the monitor but mom doesn’t feel them. This happened for a full day for me on the maximum dose of Pitocin. Had I known this was possible I may have not had an embarrassing meltdown after 12 hours of not understanding what my body was doing. So, this can happen, it’s ok. Rest or do a relaxing activity. You might not begin to feel contractions for a while. Choose an upright position, hang out on your birth ball, use your doula’s peanut ball, this is all still normal!
Scenario 3: Approaching day 2 and still pregnant!
This is also ok! Hopefully you have been resting and passing the time with enjoyable activities and you are not exhausted (like I was). If labor has not begun, you can ask to be unhooked from Pitocin so you can walk around, have a hearty meal (send dad to get it, they probably won’t feed you in the hospital), and take a shower. If mom and baby are doing well and your water has not broken, ask if you can go home to recharge for a bit and return in the evening. The uterus is most receptive to oxytocin in the evening, so this is a great plan. THIS is when choosing a supportive provider will really pay off! It may feel like this will just delay meeting your baby, and while it might add a few hours to the whole process, it’s better to go into labor relaxed and energized than discouraged and exhausted. No one has ever been pregnant forever and you will not be the first.
Tips for a positive induction!
Keep your waters intact as long as possible.
Once the doctor breaks your water, you may be on the clock for a cesarean. It’s true that this can really kick up labor, but it can also cause baby to distress, a cord prolapse, maternal infection, or more painful contractions. There is a time and a place for it. I chose to induce my third child at 42 weeks and 2 days by just having my water broken with no medications. I was already 5cm and I weighed the risks and benefits. For me, it was right. For most moms, saying no to having their bag of waters ruptured will help them have a more positive induction experience, for some it will be the right decision. Weigh the evidence you have gathered prior to your induction and consult your doula during your induction.
Stay nourished and hydrated.
Many doctors will not allow a mom to eat or drink during an induction. This is a recommendation, no one can tell you that you cannot eat. Even though you are in the hospital, you are an adult with a right to fulfill your basic needs. I have heard nurses say “the doctor says you can’t eat, but there is a lot of time that I’m not in this room and what I don’t know won’t hurt me.” The fear is that should you need a cesarean under general anesthesia, which is very rare, you could possibly aspirate. This fear is not supported by evidence. Bring snacks, send your partner or doula out for light, easy to digest foods that will give you the energy you need to birth your baby. I personally have not asked permission to eat or drink since my first birth. I just do it, and I have not had a nurse say anything, even during an induction.
Use movement and position changes during your induction! Most of us have an image of a woman in a gown laboring in bed. Staying in one position in bed may prevent your baby from getting in an ideal position for birth. Some positions like squatting open your pelvis by up to 30%! Rock, sway, slow dance with your partner… even hooked up to an IV and monitors. Once those contractions begin you don’t want to exhaust yourself, but you also don’t want to be completely sedentary.
Never give up your birth.
This is my biggest regret in my first induction, and something I refused to do again. Often times when enough of a mom’s birth plan has been compromised she gives up on everything else. To every mom who desires a natural birth, I believe you can do it and I hope you do! However, even if you have an epidural, your whole birth is not lost! Once you have rested, or if you are fully dilated, ask them to turn it off. Get up in a squat using the squat bar and support from your partner and doula and bring this baby into the world on your own power! If baby is poorly positioned and needs to be turned with forceps or a vacuum, once baby is on your abdomen bring him or her up to your chest for skin to skin yourself! Even if your induction ends in cesarean, ask that the curtain be lowered and baby be brought straight to you. No matter what happens, this is still your birth and a day that you will cherish.
I hope this post helps to make what might be a scary experience a more positive one. I would love to hear what has helped other mothers through their inductions or what doulas have found helped their clients!
If you are a birth worker and you use social media you have seen posts like this:
I've done it myself for sure. So if you aren't revealing anything about the couple, or you have gotten permission in advance, then what is the problem?
Even vague posts may violate privacy.
You may have followers or mutual friends with your couple that you are not aware of. If you post that you are headed to a birth, and others know a couple have hired you and are due around then, you could be alerting family and friends of the arrival of a baby before your clients are ready. I have been able to easily figure out when my students or friends have birthed based on very vague details from other birth professionals. So even if you are just snapping a quick pic of the entrance of your favorite birth center, you may be revealing a lot more than your clients are comfortable with. In a society that puts everything on the internet for display it can be easy to forget that birth work needs to remain sacred.
Your experience may not be your client's experience.
Maybe for you this was an amazing birth to attend and you are buzzing on an early morning birth high, but that might not be how your client feels. Maybe she is mourning an aspect of her birth that didn't go as she imagined, but she isn't ready to talk to you about it. This birth could have been harder or faster or in some way, not what she expected. Seeing her trusted midwife, doula, or photographer post that her birth was wonderful may cause her to doubt her feelings about her birth. She deserves time and privacy to process her birth.
Tragic outcomes sometimes happen.
A military spouse once shared with me several instances where because of social media, military spouses found out their their loved one had died overseas before they could be formally contacted. I don't like comparing birth to war, but in both tragedies do sometimes happen. This is not for the couple to dwell on, but it is an aspect of birth that birth workers should always keep in mind. So if you post that you are off to a birth that ultimately ends in loss, not only is there is issue of possibly violating the privacy of a couple as I covered above, but if people ask how the birth went then you are put in the awkward position of trying to not reveal more than you should. You also deserve this time to process and heal in privacy.
It can be boastful.
Birth work is humbling, and I admit the vast majority of birth posts I see show the birth worker's humility and gratitude to be doing the work that they do. I love those posts, so that is one reason I had a hard time with my friend's perspective. But there are times when a birth worker seems to be posting every time they are at a birth to show how popular and busy they are. Sharing how many births you have that month or that every couple who attended a recent event hired you may cross the line between sharing your life and bragging. I admit this is a very fine line and I need to assess whether I do it too often as well. I want to see childbirth education, midwifery, and doula work talked about and promoted, but consider your true intentions before you share.
I hope that like me, these points will make you think and consider what you, or more importantly, what your clients feel is an appropriate way to share your birth work on social media. What is right will likely look different for different professionals. This is a great dialogue to keep going in our community, so what do you think as a birth professional? Moms, how would you feel about your birth being posted about? I'd love to hear from you.
May 2017 Update
Three years later, I don't feel differently about anything I shared here, however, social media is an important marketing tool, so we should be thinking about how we can use it effectively while protecting the privacy of our clients. I have discovered some excellent compromises:
Take pictures, keep notes... and wait. Do your postpartum visits and hear your clients experiences. Include in your contract that you may share on social media, but you will do so after a period of time, like 1 month, and with permission. This way they have had time to process their experience. People don't need to know that you are attending a birth in that moment that you are, but I do think it's powerful for images of birth workers supporting their client as they have their desired birth experience is a great way to change our culture's perception of birth, and to show that you are effective at your job.
Instead of posting yourself, include in your contract that if your clients do share about their birth on social media, they please tag you and/or your business page. I feel this is even more effective than you posting yourself.
Provide links to your yelp, facebook, and google review pages and ask your clients to post there. I provide a birth summary form for clients to fill out with their thoughts and I provide a place for them to choose whether I may or may not share their reviews.
Sharing our images is really an essential part of marketing. I do feel this is a totally different category, however, I do think leaving time between the birth and posting is important.
If you have found a way to both honor your client's, give them space to process their birth experience, and share your work on social media, please share in the comments section!
Wendy's journey is a good reminder that our birth stories begin long the first labor contraction. Thank you Wendy for sharing your story, I'm honored to know you... and happy 10th Wedding Anniversary!
After trying to start a family for nearly two years, my husband and I were diagnosed with a rare cause of infertility. Our lives changed forever in that moment. We spent the next two years meeting with doctors, undergoing testing and treatments. We finally succeeded with IVF and our perfect baby was born in December 2011.
During that extremely difficult time in our lives, my mantra was this - Someday a family. Someday a yard littered with toys. Someday the sweet pure love of a child. Someday the loving embrace of my husband with a little one tucked inside. Someday a Christmas Card with our family picture. Someday.
This past year, especially this past month have been full of "last year at this time" memories. The most significant being in March, on our anniversary, when our IVF transfer occurred. Then on April Fools Day when Dom got the call that our beta was positive and had doubled - he texted me a smiley face that I'll never forget. My baby shower in October that was so overwhelming at the time, but such an amazing day, a dream come true so full of love and friendship. Our office Christmas party, that I missed last year as it fell just after my due date after I'd mentally checked out.I worked until 39 weeks at which point I was so tired and uncomfortable, and mentally checking out.
My due date - that passed without any fanfare. and then the waiting, and waiting, and waiting. 40 weeks, 41 weeks, 42 weeks, with not any hint of any sign of labor on its way. I'd spent a good portion of my pregnancy willing this baby to stick with me til the end, begging it to stay put and grow big and strong, not fully believing that we would actually have a baby at the end. I remember our midwives telling me that it was okay to let go, to let the baby know it was time to join us, and realizing just how much mental energy I'd been devoting to keeping that baby growing inside.
Somewhere around 41 weeks we started talking about scheduling a biophysical profile to check on the baby. Since we'd planned a home birth, it was a bit of a to-do to get an appointment with an OB. Luckily I had some connections and was able to get in fairly easily. It was stressful to go to the hospital, but everything looked great and the OB even asked us about our dates, convinced from the BPP that we must have miscalculated conception based on the results. As if! HA
We went back a few days later to test again, with things still looking good, but the 42 week mark making the OB uncomfortable sending us home. They pushed induction, but we decided to wait. Christmas was quickly approaching, we were hosting, and we had to make the call to cancel. We were trying everything in the book to induce labor at home. I asked my midwives to do a stretch an sweep, at which point we discovered that my cervix was shut tightly closed, still tilted far back, and that the baby hadn't dropped yet. My Bishop score was not favorable for induction, which was stressful.
We inquired about the OB schedule for our preferred docs and made an appt to induce on Christmas evening at 42 1/2 weeks. Dom and I spent Christmas driving down the coast, just the two of us, looking out at the ocean, stopping for hot cocoa and asking a stranger to take our photo - our last as a couple. I panicked at the thought of a hospital induction and we canceled the induction. Instead we went in for another BPP the day after Christmas and while things still looked good, we were approaching 43 weeks. As much as I wanted a natural birth in my own home, I wasn't about to do anything to put my baby in danger. I'd done massive amounts of research about the risks we were balancing. It was not an easy choice, but amid many tears, we decided to pack out bags and again schedule an induction for that evening. I cried on the drive to Natividad Medical Center.
We arrived, birth plan in hand, and got settled into a room. From the get go, I retained as much control as one can when you are checking yourself into a hospital. Knowing that they couldn't turn me away I felt empowered to assert my right to respectfully refuse anything that I wasn't comfortable with, starting with the hospital bracelet they wanted me to wear but that I promptly took off. I'd read a ton of birth stories, including many of minimally invasive induced births. I was committed to birthing my baby.
Dom set up our room, with a sarong over the bright light, my blanket on the bed, our music on the iod, snacks for the nurses laid out by the sink, copies of our birth plan distributed widely... We claimed the space as our own. I dressed in the special nightgown that Bestie had given me. I texted my mom and the midwives to come join us.
Sometime around 8pm the OB, one we trusted to support our desire for as natural a birth as possible, inserted a cytotec pill near my cervix. Shortly thereafter he attempted to place a foley bulb in my cervix, but because it was still closed up tight was only ably to fill 5cc (vs the usual 50cc) in the bulb. I rested with monitoring for a bit, then got up to walk around. I started having regular contractions, strong enough that I had to stop and breathe thru them, strong enough that I wanted to be back in the comfort of our room. By midnight I was on all fours on the floor, leaning on the birth ball, working hard to get through each really intense painful contraction. I felt a pop, on the inside, and everything intensified. We didn't realize that my water had broken until I got up and my waters leaked.
The nurse had wanted me on continuous monitoring, but I wasn't willing to get in bed, so she had to work hard to manually monitor me a few minutes a few times every hour. She also was under orders to get an iv placed, but I didn't want one and kept asking to put it off for a while longer. She was doing her job, and I was doing mine - with both of us remaining respectful of the other. I had a lot of support, with Dom and my mom, and the midwives too, which I can only imagine made her job easier, but she did have to document every time I refused her requests.
The waters showed signs of meconium, which was to be expected considering we were nearly 3 weeks past my EDD. I knew that there were risks with meconium, but also knew better than to worry about those risks at that point. I do recall that the nurse mentioned putting the NICU on call for delivery due to the meconium, but was so consumed with the labor at that point it was all I could really pay attention to. Since the pop everything was so much more intense, during the contractions, and in between the contractions. The nurse took the foly bulb out and noted that I had dilated a little to about 1 cm. I was struggling thru each contraction and needed to get into the shower. I remember feeling really happy that labor had started and proud of my body for working to deliver my baby.
I spent the next 8 hours laboring in and out of the shower, mostly staying in the bathroom where there were safety bars I could hang onto. I really don't have words to describe how intense that experience was. I was screaming through each contraction and had very little relief in between. It was so way beyond harder than anything I had prepared for - so much more intense that any labor I had read about, or birth video I had watched.
I was giving absolutely everything I had to birth this baby.
At some point I started feeling nauseous and began vomiting in between contractions. I told myself over and over that each contraction was bringing me closer to meeting my baby, the baby I'd waited so long for, the baby that I'd fought so hard for. I believed in my body, I knew that I could do it. And at the same time I was astounded by the intensity of the experience.
The passage of time is fuzzy in my memory, but I do have clear memories of Dom and my mom at my side the entire time, the shift change of nurses although I was so immersed in myself that I was unable to acknowledge it, the text affirmations that Bestie was sending to my mom and my mom was reading to me, closing the door to the bathroom so that I could labor with Dom without any distractions. More than anything though, the intensity of each contraction taking over my entire body and the lack of what I'd thought would be a break in between each contraction are what stand out in my mind.
Sometime in the morning I emerged from the bathroom and perched myself on the birth ball. I was exhausted and desperate for a break. As if my body knew, the contractions started to space out a bit and I give me some time to regroup. There was talk among the midwives and nurse about possibly being complete and this being a break before the need to push. I was afraid to move fearing that the contractions would pick up again, but agreed to climb onto the bed so the nurse could check my cervix. It was the first check that I'd had since the foly bulb was removed the night before.
I was spent, exhausted, feeling like I had given everything I had in me, wondering how in the world I could possibly have anything left to push the baby out. Contractions that radiated down each leg consuming my entire torso came back with a vengeance when I climbed onto the bed. I was crying, vomiting, and no longer able to hold my bladder. Intense is the only word I have, but doesn't come close to describing the experience.
Expecting to find that I was fully dilated, the nurse turned with shock to look at my mom and announced that I was barely 2 cm dilated. No one could believe it.
At this point I was on the bed, gripping the bed rails, and looked at Dom and begged "Please help me". I was ready for some pain relief - I was desperate for some relief - I wasn't sure I could manage another contraction.
I don't remember details, but I was so grateful that no one questioned my request for drugs. We had a birth plan that specified as natural a birth as possible and had talked a lot about the possibility of holding me off for a bit if I asked for medication. Looking into Dom's eyes I could see that he was going to do anything in his power to get me some pain relief as fast as humanly possible. Things happened quickly. The IV that I'd refused earlier was quickly placed and the anesthesiologist was called for an epidural.
While I received IV fluids to prepare me for the epidural, they gave me a dose of some medication telling me that it would act quickly and 'take the edge off'. My desperation and sobs intensified when it did no such thing. How the hell could I have been so unprepared for this labor?
An epidural was soon placed, which I really don't remember much of, and although I could still feel the contractions they were so mild and manageable. Dom climbed into bed with me and we must have slept for a while. The epidural was amazing.
Not sure when exactly but I started itching all over, a side effect of the epidural. It was so strange to not have sensation on your skin, but to feel it itching. The nurse gave me a medication to calm the itching and it basically made me loopy and sleepy.
I was having to roll from side to side every 20 minutes to keep the epidural working correctly and we joked about the "epidural rotisserie."
Six hours into the epidural and pitocin I was still only barely 2cm dilated. Talk about 'failure to progress' and the possibility of a c-section began. I was really out of it, and honestly felt like I'd given it my all and wouldn't have any regrets about how our baby finally came into this world. The doctor came into the room and there was a team meeting. It had been over 20 hours of really hard labor and 18 hours since my water had broken. I was exhausted and still barely dilated. But the baby was holding up well enough.
They asked me what I wanted to do. If I wanted to proceed with a section. The anesthesiologist had reviewed our birth plan and was willing to accommodate all of my requests.
I honestly didn't care what happened next. But I knew that I wasn't in any shape to make such a big decision so I deferred to Dom. I can remember everyone weighing in on the decision before us, and ultimately taking a vote. My mom, a home birth mom herself, Bradley natural childbirth teacher, super advocate for natural birth, had never seen such a hard labor and was ready to send me in to surgery - but she abstained from the vote.
My amazing support team believed in birth. Believed in me. Dom listened to them and it was decided to wait another hour before making any decisions. As long as the baby was tolerating the labor we would wait another hour and hope that I made some progress.
The contractions were gaining strength, and getting stronger than the epidural. I was once again moaning through them, asking the nurse to turn up the epidural. Once she had exhausted the amount of increase that was up to her she was going to call the anesthesiologist back to increase the dosage but decided to check me one more time. It had been almost an hour since "the meeting."
Again the nurse recoiled in shock when she reported that I was fully dilated with a baby descending down the birth canal. No one could believe that I'd gone from 2 to 10 in less than an hour, with a baby ready to deliver.
The room was suddenly full of activity.
The epidural was turned off.
A pushing bar was set up on the bed.
A mirror was pulled into the room.
I could reach down and feel the head of the baby I was about to deliver. Against all odds I was about to become a mother.
I remember pushing, but feeling like I wasn't doing it right. I kept wanting to change positions because it was so uncomfortable, because I felt like it should feel more natural. Everyone talks about an 'urge' to push, but I don't remember feeling anything like that. And everyone also talks about how delivery is nothing like the movie scenes, but all I could do was scream and push. I can only imagine that I looked just like a crazy movies scene - a naked women screaming through every contraction, pushing with everything I had left in me, clutching the sides of my hospital bed.
Before I knew what had happened, there was a baby laying on my chest. It was shocking.
What was this and where had it come from? It was lying on my chest, all wet and warm. I was so relieved to be done with the labor, but completely shocked at the outcome.
All I could do in those moments were to focus on Dom. The intensity of love I felt for him in those moments was overwhelming. And yet there was a wet warm baby laying on my chest. Oh my god, a baby, our baby. While I was trying to get my head around the fact that there was a baby lying on my chest, someone asked 'what is it?' and Dom lifted our child to announce:
There was still a lot of activity in the room. The OB, Dr. Liem, was calmly yet firmly shouting orders at people, and I could remember my midwives telling me that delivering the placenta was an important next step that would require my attention. Apparently I was hemorrhaging, losing more blood than anyone was comfortable with and the OB was methodically doing everything he needed to do to get the bleeding under control. I don't recall exactly what all was done to address the situation, but it was finally deemed okay. Significant tearing took the OB the next hour to sew up. Many multiple second degree tears was what he called it later - on the internal vaginal walls, labia, everywhere. He didn't even bother to count stitches.
All this while, there was a baby lying on my chest. Our son. He looked up at me and Dom with clear bright calm eyes.
Our someday was upon us.
I am a nurse, I worked in labor and delivery for five years. I currently work for a high risk maternity home health care company. Not only have I seen a lot of births- I've seen it all. The good (a beautiful normal delivery), the bad (a full term baby that passed away for no reason), and the ugly (labor wards are full of drama).
Given my experience I think it blew everyone away when I decided a home birth was the way to go. Thankfully, my husband was great and backed me 100% as did my family. Everyone else thought I was nuts (and said so) but I knew it was right for my baby and me. I never once questioned my decision.
What’s ironic is that had I had a baby 6 years ago I would have thought I was nuts too! When I first started working LD my attitude was "If you don't have to be in that amount of pain, why would you be? Bring on the epidural- can they meet me in the parking lot???" Then a few years ago three things happened in under a month that changed my mind.
Now, before these three things ever happened I had already noticed something. The LD unit I worked on induced a lot of women. I worked on a small unit with five labor beds and Monday through Friday we induced two to three patients A DAY with the doctors pushing to add more patients to the schedule. It can make one think that babies wouldn't come out if we didn't kick them out! However, my favorite patients were those who came in on their own in labor which, given our induction rates, were few and far between. Those were always the best labors though- the babies almost always looked beautiful on the monitor, the mothers very rarely pushed more than 15 minutes, and the babies almost always came out without assistance and were healthy as could be.
The first of those three things that happened to start to change my mind was not so much a "thing" but a patient. I came on shift one night to a woman having her fourth baby. This woman was from Jamaica and had all of her other babies on the island completely natural. Her doctor had sent her over for induction because she was 40 weeks and the doctor was going to be out of town that weekend. My orders were to watch the patient and start Pitocin in the morning to get her delivered. I felt so bad for this woman because I knew there was no reason to induce her but come 5am we would start Pitocin. Thankfully, her body wasn't thrilled with the thought of being induced either because she went into labor on her own around 2am!
Standard protocol at our hospital is to ask all patients what kind of pain relief they want. Once my patient went in to labor I asked her if she wanted an epidural and she said no and kept breathing through her contractions. I was fine with this and helped her cope but when my charge nurse came in the room she practically brow beat the poor woman about an epidural. Finally the woman said "What is this epidural!?!" So we explained what the epidural was and when I got to the part of "A needle goes in the space around your spine" she looked HORRIFIED. "In my spine!?! No, no... I'm ok." The woman delivered within an hour of this conversation but something in my head had clicked- an epidural isn't normal. I saw it every day and assisted with starting them all the time but it was not normal. Light bulb on- somewhat dim- but on.
The second thing that happened was stumbling across a documentary called 'The Business of Being Born' directed by Ricki Lake. I'm not going to lie- I had heard of it and thought to myself "What does a talk show host know about birth that I don't already know?" Apparently- a lot. I had never seen a homebirth before and the only experience I'd had working with them were those brought to the hospital that needed assistance of some sort (IV fluids, vacuum assistance to deliver a baby, c section, etc.). In my head they weren't safe and working every day in LD with women who “needed” constant monitoring supported this. Now I realize how faulty this logic was- it's like sitting outside a mechanic shop seeing cars brought in and thinking all cars are going to break down at any moment. Wrong- they were only there because they needed to be and I never saw the other hundreds of women who delivered just fine at home because they didn't need to be brought in. Light bulb was starting to glow a bit brighter now...
The final thing that happened to push me over the edge was a conversation with a fellow nurse. It was one of the rare slow nights we had and we started talking about inductions and how few normal deliveries there were and she just casually said she planned to go all natural when the time came. We talked for a couple hours about unnecessary inductions, how epidurals affect labor, c sections, the birthing documentary, my Jamaican patient- everything. Light bulb was now fully glowing and by the end of the conversation I had decided when I gave birth it would be all natural- and I was instantly petrified. It might be how nature intended it but I just knew I was in for a world of hurt.
Fast forward a few years and I had gotten married and my husband and I decided to start a family. I honestly don't even remember the conversation we had about doing a homebirth once I was pregnant- it just wasn't a big deal after all the research and statistics I had seen over the years. Kind of ironic considering the fear I used to have over a natural birth. Sometime in the previous few years the fear had dissolved and now it wasn't this eccentric, risky thing- it just seemed normal and felt right. I didn't want to pack a bag to go be delivered- I wanted to prepare my home to birth my baby in.
Once I was pregnant the reading began in earnest and I read everything. I requested and checked out a stack of books from the library then went and bought my favorites. I devoured tons of homebirth stories online- I couldn't get enough. I also read birthing preparation books including Hypnobirthing, The Bradley Method, Birthing From Within, Ina May's books- anything and everything on natural labor. My husband asked me why I was doing all the research since I knew what to expect and what to do. It was something I couldn't put my finger on and then I finally figured it out- I was preparing for a right of passage and I wanted to hear everyone else's stories now that it would soon be my turn. I wanted to know what worked, what they wished they had done more or less of, how they felt during birth, EVERYTHING. I was no longer afraid- I was excited and could not wait for my turn.
One birth story I read a woman said she had envisioned her birth and it went exactly how she had imagined it. I've never been one to meditate or envision anything and, even though I do believe there is a very real mind-body connection, I don't think anyone can bring on labor just because they're ready (it's a nice thought though and I know many women would LOVE that). This being said- it did make me think. If I could envision my perfect birth what would it be? In a perfect world my labor would be on a Sunday because that's the most relaxing day of the week. I would labor all day at home with my husband while cooking (in early labor) to keep busy. I would watch a Dallas Cowboys football game to keep me distracted and maybe go for a walk (I was due in November and we live in Ohio- I may not have thought that through all the way). Then, once I was far enough along, I would get in the birthing pool in the living room and labor while overlooking the lake out of our back window. I also wanted a fast birth but not so fast it was overwhelming- I figured 3 hours would be good. Who was I kidding though? The average first time mom labored for 14 hours and I figured I would too.
The Birth Story
A few days before I went into labor I just felt off. Not bad or anything- but off like something could happen any moment. Even with this feeling though and only slightly increased discharge (which I attributed to my husband and I trying to speed things along by remaining active in the bedroom) I was only 37 1/2 weeks pregnant and the average first time mom delivers at 41 weeks, 1 day. Knowing this, I chalked it up to wishful thinking and the only people I let know about my little off feeling were my parents who lived 14 hours away and planned to be here within 24 hours of the baby's birth (we didn't know the gender) and my birth photographer since we still hadn't nailed down a few details. In hindsight, I also should've told my midwives but I really did think I was being silly. This baby wasn't coming for another few weeks!
Sunday morning I woke up around 5/530am and went pee. When I went back to bed I felt like I could've wiped a little better but I was 9 months pregnant and tired and didn't care- I would take a shower when I got up in a few hours. 830am rolled around and I finally get out of bed and when I pee I see what discharge that looks like amniotic fluid. Not a lot, just a smidgen that I probably would've missed had I not worked LD. I coughed and nothing came out so I decide to take a shower. After my shower I put on my thong (yes- I wore thongs my whole pregnancy) and then a few minutes later I thought to myself “if my water breaks, I'm screwed.” So I grabbed a pair of underwear I bought the week before and a pad and as I went to change I felt a pop and managed to plop on the toilet right as I gushed fluid. I called my husband and told him my water broke but we could still go to his parent's house for lunch... which was about 45 minutes away... in the middle of nowhere. Once again, in hindsight, I may have been in denial and there was no way in hell I should've been suggesting that but my logic was I was a first time mom, no contractions, water just broke- I figured the baby would come in the middle of the night sometime. Thankfully my husband very nicely said no to my suggestion.
At this point I let my parents and the birth photographer know what was going on. I don't suggest this, but I delayed telling my midwives for a couple of hours because I wanted to see if contractions would start soon and then I could tell them how far apart they were. Around 1030 I realized I was having contractions that were no stronger than the Braxton Hicks I had been having for the last three months but they were about five minutes apart- so mild I almost missed them. At that point I let the midwives know what was going on and that baby was moving well so they didn't need to come. They said ok and to let them know when something changed.
I started cooking (banana pancakes, honey roasted sunflower seeds, bacon, general yumminess) and my husband scrubbed the house down- and I mean SCRUBBED. I think he nested for me! At 1pm the Dallas Cowboys game started and I got on the birthing ball still only having mild contractions and watched the game while snacking and texting/calling a few friends and family. I told my husband I thought the baby would come in the middle of the night and since I wasn't hurting anyway he went and took a nap to make sure he was nice and refreshed later on. I should've joined him but my team was playing and my best friend was available to talk so that wasn't happening. I believe it was while he was lying down that I remembered a girlfriend of mine had given me a few essential oils- one of which was clary sage. Once again, in hindsight, I should've mentioned to the midwives I was going to use a bit to see if it would bring on stronger contractions- oops. Anyway, I mixed the clary sage with some coconut oil and applied a few drops to my wrist as well as my lower abdomen in hopes of bringing on stronger contractions. It was time to meet this baby!
At 3:55pm (I checked my phone records) I was on the phone with my best friend when she said I stopped talking in the middle of a sentence. I said "No, I didn't" and kept talking. Then she said I did it again a few minutes later. At that point I realized my contractions were getting strong enough to distract me but they still weren't even as painful as period cramps. She had to go anyway so I got back on my labor ball and continued to watch the football game. About 45 minutes later the contractions were a bit more uncomfortable so I text my midwife and photographer to update them that the contractions were a bit stronger- maybe a 3 or 4 out of 10 on the pain scale but not horrible. My photographer was super nice and offered to come and I insisted no because I wasn't even really hurting and I didn’t want her to have to sit around for 12 hours waiting on me. By now it was almost 5pm and I got in the shower to relax a bit and clean up since I had been leaking all day (icky feeling) and shave my legs. About 20 minutes later I got out of the shower and the first contraction I had out of the shower I got on my hands and knees in the hallway and swayed my hips- I felt like that was my first real contraction and I thought “Here we go!” My water had been broken for 12 hours and I finally felt like I was in labor!
*Side note: Most hospitals insist on augmenting labor if your water breaks and you don’t start contracting within a couple of hours to prevent infection- numerous studies have shown that as long as vaginal checks are kept to a minimum (I refused all) the risk of infection is quite small and 95% of women will start contracting on their own within 24 hours of their water being broken. To expect a first time mom to be delivered within 24 hours of their water breaking is very unrealistic. Now back to the story.
My husband and I had a blow up mattress in our living rook from the time I was about 6 months pregnant on because it was better for my back so I laid down on it to rest and listen to the rest of the football game (he was next to me in the recliner- he asked if there was anything he could do but all I wanted was to breathe). During my next few contractions I would get on my hands and knees and sway my hips and breathe until it passed. I tried staying on my side for one contraction and it was horrible and I don’t know how women in hospitals strapped to beds do that. At one point I was in the middle of a contraction when the Lions quarterback snuck the ball in for a touchdown when everyone thought he was going to take a knee and won the game… and I dropped a F bomb. My husband thought it was a contraction until I told him I was just pissed we lost! On a scale of 1-10, my contractions were about a 6 and more intense but kind of a weird pattern where two would be close together and then nothing for about five minutes (on LD we called this 'coupling') and it can sometimes mean the baby is in a funky position so I asked my husband to text the midwives and have them come over to check me (this was at 545pm).
Right after this my contractions went from intense to painful so I got in the birthing tub. I thought to myself that I was being a baby and getting in way too early and I would probably have to get out again once the midwife came and checked me and said I was 3 cm but I didn't care- I was hurting and I was getting in.
About 15 minutes later we hadn't received a response from the midwives and I had started moaning through contractions. I never thought I would be vocal during labor-I figured I would mostly turn inward and just breathe which I did until this point. Now that I felt the urge to moan I did and it felt so good. All I kept thinking was "keep my jaw loose and my moans deep to let my cervix open up"- thank you, Ina May! I asked my husband to call the midwives since they hadn't responded and later on I found out when they asked how I was doing and heard me in the background moaning they said they would send the apprentice out to check on me without him even asking (they weren’t getting our texts and were wondering how things were going anyway). With their practice each patient normally has two midwives but since we agreed to an apprentice we had three which worked out well. I also had my husband text the photographer and ask her to come over. In the meantime, I just kept moaning and swishing my body around in the water during contractions while on my hands and knees.
After my husband got off the phone I had a few more contractions and started to feel slightly nauseous and asked for a bowl. I got a bit snippy when he put it on the floor instead of the tray he had set up next to the birthing pool but I didn't think much of it. The next contraction I had I felt myself start to bear down and push. I thought I was imagining things since I had only been hurting maybe an hour so I put my finger in to check. I didn't feel anything but then it happened again with the next contraction. That time when I checked I felt the baby’s head! Shocked doesn't even begin to cover how I felt in that moment. Well- shocked and elated! I was almost done!
I told my husband to call the midwife back and tell them I could feel the baby’s head an inch in. He said her response was "Oh shit, we're on the way." My husband came and sat next to me and I had him feel the head. At one point in between contractions I looked at him and said "don't get me wrong- this hurts but it isn't near as bad as I thought it would be!" A couple contractions later the apprentice midwife showed up and she could see about a quarter of the baby’s head crowning. With that contraction I finally fully pushed- I felt the head go out then slide back in a bit which was actually fine with me because it had just dawned on me- a head... a SKULL was coming out of me. For a split second I faltered. From that moment until the baby delivered (which wasn't long) I thought to myself over and over "6.5lbs, the baby is only 6.5 lbs." I had no way to know if that was true or not but mind over matter, right? The apprentice told my husband once the head was out she would check for a cord, then with the next contraction he could deliver the baby. The next contraction I pushed again and got her head half way out then I had to wait for the next contraction. While I was just hanging out waiting for another contraction (with a head half way out of me) the other two midwives arrived and asked how I was doing. Of course they were talking to the apprentice but I looked at them and said "the head is half way out." When the next contraction finally came I pushed and out shot the baby- I turned over and she had a loose nuchal cord (around her neck) that my husband and I unwrapped and then I brought our baby out of the water. Arms spread out, eyes wide open, and blue (very normal). I rubbed the baby's back and a few seconds later we heard a healthy scream then saw a nice pink color. The apprentice asked me to get out of the tub because I was bleeding more than she would've liked and my husband helped me out and onto the mattress which the midwives had covered with a chucks pad and towels on top of our sheets. I felt like I was high as a kite- those endorphins are amazing!
After a few minutes of bonding my husband and I figured we should look and see if the baby was a boy or girl and as I held the baby up we realized she was a girl! I didn't realize how much I thought I was having a boy until I double checked for boy parts. I then looked at my husband and said "What the hell are we going to do with a daughter?" Don't get me wrong- I was thrilled, but teenage girls scare me! I was immediately in love with Scarlett though- all 6lbs 12oz of her. About 10 minutes after Scarlett Deja was born the photographer arrived and got some great shots of our first hour together. I still hate that I waited too long and we missed getting the birth on video but I am so grateful for the pictures we do have. Apparently my husband was even sneaking pics of me in labor so I have those too!
In the end, I got exactly the birth I wanted just not the video of it... I went into labor on a Sunday, got to see my Cowboys play (even if they did lose- I should've been more specific) and I got a fast but not overwhelming labor. Maybe it was coincidence, maybe not. All I know is there is very little I would change. I got the perfect labor and perfect daughter and I can't wait to do it again!
I just got this in my inbox and I'm excited to share it with you! No one thinks their birth story will take a long time to begin, but prodromal labor, or labor that starts and stops over a period of days or weeks, is more common than you'd expect, we just don't hear of it happening much because so many women opt for an induction instead of trusting the process. Prodromal labor can be a real trial, but knowing that it is a normal variation in labor is important. Thank you to Sam and Aaron for sharing another birth story here, you also read about the birth of their first son, Epic, who was also born at home.
Ace’s Birth Story
From the moment I saw the little blue plus sign, I knew what was to come. This was my second baby--I had gone through this before and it was a walk in the park. Two years previous I had a textbook pregnancy and at home water birth. To quickly recap that moment, 5 days before my due date, contractions began, slowly grew stronger (with breaks between them of course!), and 7 hours later (2 hours of which was pushing), my 9lb baby was born. This was my “birth pattern” and I fully expected #2 to follow in those footsteps and hopefully not push 9lbs much further…but he had another plan.
Once again we decided to stick with the at home birth along with the same midwife, and family friend, who delivered Epic, Leslie Drew. The nursery was ready, the supplies gathered, the tub inflated, we were ready. The last month of my pregnancy, my pelvic floor was killing me. It hurt to walk, it hurt to lay, it hurt to roll over. Baby was buried so deep into my pelvis, I thought that I could sneeze him out, but my cervix held him back tightly.
At 4am on Sunday (6 days before my due date) I was awaken by strong contractions. Could this be it?!? Grab a stopwatch!! 10-15 minutes apart. Awesome, I still have time before I call the midwives. I decided to go back to bed only to awake at 8am with no more contractions. Well, that was odd. Contractions didn’t stop with Epic. Maybe it’s just a case of that “false labor” I always hear about. The rest of the day I had irregular, random contractions, but nothing to write home about. I decided to call Jill, an acupressure masseuse, who put me into labor with Epic. I was determined that this birth would be the same as the first. She was available the next morning-Great! We will send Epic to stay with the Grandparents for the night.
Monday morning, 4am, I awoke to more contractions. This will be good! I won’t go back to sleep, Jill will come, and this labor will begin just like last time! Contractions are 5-8 minutes apart...better than yesterday. Good sign. I decided to eat an early breakfast, do some laundry and other ‘nesting’ chores, and go for a walk. Aaron and I went on a mile and a half walk so that my contractions would keep up. By 9am, Jill came and set-up for the massage-Yippee! I am getting my baby today! As soon as I lied down, I could tell my contractions were beginning to die off, but I wasn’t worried because this worked last time. I had a few good contractions throughout the massage, but it wasn’t happening like last time. Labor wasn’t beginning right now. As she finished her massage, I knew the effects could take up to 24 hours. We still have time. Throughout the day more irregular, random contractions, but still nothing to be concerned about. Aaron and I went on another walk. Epic stayed another night at the Grandparents.
Tuesday morning, once again at 4am, more regular contractions. THIS is it! It has to be! We are still less than the 24 hour window since the massage! Grab the stopwatch! GREAT! 3-5 minutes apart! I went to the bathroom only to find a “bonus” sign of labor—my bloody show. I will call Leslie this time. I was confident that my contractions would continue to get stronger and closer, so I decided to go lie down and rest for the big event ahead of me. Leslie told me to call back in an hour. I woke up 2 hours later, contractions at 10 minutes apart and getting further. You got to be kidding me. This baby is NEVER going to come. He is just playing with me by this point.
Family and friends keep asking how I am feeling…do you really want to know? AWFUL! JUST TERRIBLE! I have been a prisoner to my own house for the past 3 days, my pelvic floor hurts sooooo bad that I can’t even walk around the house, I haven’t seen my eldest son in 3 days and miss him dearly, and between my hormones, false labors, and the strange quietness that fills a home when a two year old is gone, I am going insane! INSANE! I just may punch the next person who asks me how I am feeling (which 8 out of 10 times is my poor, unsuspecting husband. I am pretty good at putting on a happy face no matter how I am truly feeling). How long can this drag on? I could have accomplished so much more work these past few days, but no…who knows when these contractions will really turn into labor. This is frustrating. I just want to be left alone.
Wednesday morning, 4 am, contractions 2-3 minutes apart. By this time, I felt defeated. So what? They will probably go away too, but I better call Leslie. She seems to think my labor will go fast once it truly starts (if it ever starts). She decides to come over, prepares her necessary items, and we wait. And wait. And then I went back to bed. They stopped once again and she measures me at barely 1cm. This is ridiculous. I have had contractions for four days now and have gotten, not even, 1cm. She suggested I go to an acupuncturist that she has had a lot of luck with. I call and get an appointment at 1pm. It’s worth a try.
By the time we got to the acupuncturist, it began to sprinkle rain. I wobbled my way up to her second story office to take my place on the table. She placed about 25 needles deeply throughout points on my feet, shins, hands, ears, neck, and scalp. She then “intensified” them by hooking up a machine that sent an electrical current through two needle points. She left me on the table for about 2 hours so that my body would really take it all in. I had about 6 contractions during that two hour time period…woohoo?
After the session, I decided to make the best of getting out of the house. I wanted a hot cocoa and a couple of toys that baby brother could give to Epic. My sweet husband ran through the rain to get me a delicious hot cocoa, toys for Epic, rented a movie, and even brought me flowers. These little things cheered me up. It felt nice getting out of the house. I wanted to see Epic too, so we picked him up from daycare. It was great holding my first baby. I snuggled him close as we drove him back to the Grandparents house for him to spend yet another night. I watched him play as everyone was getting settled down to begin eating dinner. I felt a couple more random contractions and then was ready to go home across the street. I was tired. It was 5:30pm.
When I got into our house, I had the urge to go to the bathroom (a very common occurrence with pregnancy). As I went, another “bonus” labor sign—diarrhea. Lovely. Let’s see if contractions begin. Sure enough, a contraction began…and held…and held…dear goodness has my uterus seized up?? My toes began to curl, I couldn’t get off of the toilet. “Aaron! Get me a stopwatch, call the midwives, and fill the tub!” He was on it. Ahhh, finally a break. Let me get off of this thing…I refuse to have my baby born in a toilet.
As I am leaving the door, another contraction hits me. I began the timer. I wasn’t able to start the stopwatch with the first contraction, but I knew it had been less than 2 minutes. I just got my pants up for heaven’s sake! I threw myself upon the bed into a hunched position to endure the uterine hug. After 2.5 minutes, the contraction began to release. Dear lord these are strong and last FOREVER. I feel like I have just been hit with a bag of bricks. I have to make it to the tub...nope, I need to go back to the toilet, another contraction is coming, and it has only been 45 seconds since the last one ended! BAM! Another contraction, once again not letting up for another 2.5 minutes. This is it! I AM IN LABOR! A smile filled my face…only to be followed by a frown. I was in labor 7 hours with Epic. This is going to be a looooong night.
I finally made my way down the hall to the other bathroom (between the master bedroom and my ever cherished birth tub). I underwent a few more contractions on that toilet. “Aaron! Where are those midwives!? Shouldn’t they be here!?!?” It had only been 20 minutes, which meant it was at least another 10-20 minutes before they arrived. These contractions are ridiculous! I don’t remember Epic’s birth having contractions this strong to begin with. They started out slow and grew as labor progressed. They were not like this until right before the pushing stage.
I finally made my way to the partially filled tub. Aaron was still boiling water to add to it. I didn’t care. I needed that tub now. I climbed in and instantly felt some relief. I took a deep breath. Another contraction. I was paralyzed with each one. As I tried to change positions between the short breaks, if I didn’t quite make it to my desired position, then that is how I would have to labor through the next contraction. I had to be quick during those breaks. It was hard to be quick though as the contractions were taking every ounce of energy I had. They were so intense, so strong. There is no way I have experienced this before. Epic’s birth was not like this. How in the heck did I survive my first home birth?? Am I crazy?? There are no drugs here. Well, maybe…the midwives did leave everything ready from this morning. I bet there’s something in those bags of theirs. If only I could get to them. Never mind, there is no time for that. Just go get a shovel from the garage and beat me until I pass out. Please, I beg someone. Another contraction, this time with an urge to push.
I can’t be pushing yet.
Hold off the urge.
The midwives arrived. Oh thank goodness a witness to these crazy contractions! No time to say hi—another contraction once again ending in an urge to push.
I need to be checked. It has only been an hour since this madness began. I can't be wanting to push. Don't push. I look to my midwife. She doesn’t check me...she doesn’t need to check me. “You are ready to push.” No…no I am not. I have at least 5 hours left. I’ll wear myself out if I begin to push! No pushing. Not yet. No way.
Another contraction, my body still wanting to push. I reached down and felt the tip of his head only about a knuckle deep. This was really happening. He really was coming. My body really was ready to push. I got into a frog like squat position. I slowly relaxed with each contraction to allow the baby to descend deeper and deeper. As soon as I felt burning, I would blow air upwards and out to allow stretching to occur. The pushing phase felt much more relieving. This was all going to come to an end soon. I could see the light at the end of the tunnel. I felt a pop—my water had just broken. I flashbacked to that feeling from my first birth and the thought that my uterus had just burst. I giggled under my breath. A few pushes, and his head was out. I could see his right ear and his fuzzy, hairy head. I waited for the next contraction to push his body and to catch him. Aaron was behind me helping to bring him forward. As I gave the final push, he rotated to sunny side up. We brought him out of the water, and I fell backwards into Aarons arms as our new baby lay across my chest.
Ace (still thinking of a middle name) Magenheim was born at 7:16pm, approximately an hour and a half after my first set of contractions. 9lbs 1oz and 21.5 inches long, he didn’t make a peep. He just looked at us quietly, no need for crying. Everything was at peace.
As I sat in the tub, I waited for the after burn. I recollect it more than anything else from the first birth--The two weeks of not wanting to pee because it hurts so much. The constant frozen ice packs between your legs. The throbbing from all of the swelling. But it wasn’t there. Nothing was burning. I slowly got out of the tub to get dried off. I didn’t need that much help. I wasn’t hurting like my first birth. Leslie checked and sure enough, there was no tearing. Not even swelling. Oh praise the Lord! I will still be able to somewhat chase after my two year old!
During my check, Ace began rooting on Aaron’s chest. Aaron handed him to me and he immediately latched.
After getting all cleaned and dried, we had all four grandparents and Epic come down to see the new addition. It was so nice being able to share this special moment with our whole family—especially Epic, who was now a big brother!
Natural Birth Series
Sept 28 – Nov 15
Infant Sleep for Expecting & New Parents
6:30pm - 9:00pm
Gentle Cesarean: Planning & Recovery
Toro Park, 3-6:30pm
Natural Birth Refresher
Salinas, 1– 4pm
Preconception & Early Pregnancy Class
Salinas, 1– 4pm
Sibling Prep for Parents & Kids
November 4th & 5th
Toro Park, 2:-4pm
Fall Home & Birth Center Birth Series
Nov 7 – Dec 12
Natural Birth Series
Nov 29th – Jan 17th