The Birth of Baby #3

Not a Pre-Planned Birth

During this blogging experiment, I have been planning and awaiting the arrival of Baby #3. She was due 8/24/12. Like my other babies, that due date came and past. My other two births were pushed along before my body went into labor. For this birth, I was worried that my husband would not be able to make it from work in time. My last labor was only 3 hours and I was thankful that we lived near my husband's work. Now we are in the suburbs and my hospital was even further away (a two hour trip from his office to the hospital). I could use a closer hospital but there is nothing closer that has midwives. So I tried to "plan" the birth! The day before my due date, my husband took the day off and went to my midwife appointment with me. We hoped that she would strip my membranes and send me into labor. Unfortunately the baby was not low enough yet and she worried that the cord could get in the way. So instead we had a "date" and went out to lunch and for a 3 mile hike in a nearby national park. We decided that we would just wait for the baby to be ready and run to the hospital as soon as labor started.

The Birth Story of Baby #3

The three days leading up to my labor, I felt different. I felt the need to sit down for no particular reason. My body does not tell me when I am in early labor so this might have been early labor for me. On the night of 8/30/12, I was mentally ready for the baby to come. I had done several tricks to relax my cervix and my husband was going to be working from home the following day (the eve of Labor Day weekend). It seemed like the perfect timing for the baby to make her arrival. It was almost midnight and I started to have a lot of back pain with a lot of downward pressure. When I stood up, I felt the baby drop so low that she felt like she completely opened my cervix and was between my legs. The back pains were very uncomfortable and I was exhausted from the day. All I wanted to do was go to sleep. I realized that the most intense back pains were coming every 10 minutes thus my labor had started. This baby, like my others was posterior so I get excruciating back pains (plus those regular contractions but who cares about those when my back was being stabbed!). I decided to try to talk myself out of the labor so I could get a little sleep and feel more rested.  I could not lay down because the baby was between my legs and it was extremely uncomfortable.  So I propped myself up on pillows and slept sitting up in bed. I woke up four hours later and was no longer in labor.  Labor restarted at 9am when I was getting ready for my 10am midwife appointment.

On the way to my 41 week midwife appointment, I realized that I was in labor but my contractions were only 10 minutes apart so I thought that I had plenty of time. At the appointment, I felt constant back pain and the need to do small hip rolls although the strongest contractions were still 10 minutes apart. My mom and daughters were in the exam room with me and the kids completely sensed my labor and fought the whole time (after 9 months of them being perfect at my appointments).  I had to send my mom out of the room bribing them with lollipops.  Yes, I knew I was in labor because my kids drove me crazy! My midwife checked me and I was 6 centimeters dilated!  She looked at me in confusion and surprise because I was not in the "heavy labor" that most women would be in at 6 centimeters. I must have been having mini-contractions that were just causing back pain between the larger contractions. At this point, I knew that it was time to head to the hospital that was luckily only five minutes away.

At the hospital, while waiting a few minutes for my room to get ready, I entered active labor so my husband and I did our slow dancing routine during contractions. Slow dancing with him makes my body feel fabulous through contractions and we both love how close we feel with each other. The first 20 minutes in the delivery room had to be spent hooked up to monitors according to hospital protocol. Of course this was not so fun in active labor but I was able to move around and rock my body through contractions. My husband massaged my back and pressed it with a warm pad to help ease the extreme back pain. My previous babies were also posterior so I experienced the same sharp back pains with contractions. This time the back pains did not subside between contractions. I remembered my NYC yoga instructor's advice to go right into the pain and hit it face on with deep exhales (Melissa Feldman -- I still love the Dark Vador exhale)! It is amazing how facing pain head on made my body really release natural pain killers. Or did it make me go into a trance? I don't know but it worked.

During the last contraction on the monitors, my body knew that it was time to move on and my exhale turned into an orgasmic song. The midwife joyfully announced "that's the baby" and I was thrilled to finally be allowed in the jacuzzi tub that I had been eyeing. As soon as I slipped into the tub and put my back against the jets, I was so at ease. All of my back pain went away and my body fully relaxed. I felt like I was on vacation (minus the pina colada and palm trees)! My body gave me a little break from contractions. When the contractions started again they seemed so mild in the water and the tub had taken away my back pain. My husband slipped into the tub behind me so I could use his knees to hold onto. In just a few minutes, my body felt like it was ready to push the baby out and I soon felt my body pushing so I pushed too and the baby came right out in one long push.

The baby, my husband and I enjoyed a beautiful couple minutes embracing each other skin to skin in the tub. I could not believe how great my body felt from being in the tub. When I got out of the tub, and rested with the baby on my chest, I was surprised to have no tares and a placenta that pushed itself out (this was a change from my past tares and pain pushing the placenta out).

Baby Katja Elizabeth was 8 pounds 7 ounces and 20.5 inches long, born posterior after a 3 hour labor! My baby was born loving to suck and insisted on sucking my breasts for her first 1.5 hours of life!

Looking Back

Baby Katja met her sisters a few hours after birth.

It is now a week later and I am still shocked how wonderful the water birth was and would recommend that every pregnant woman get herself a good MIDWIFE and a TUB!  My hospital was far more nurturing and had much warmer staff than I experienced with my NYC hospital births. I was glad that I did not do a home birth (which I wanted with birth #2) because I really needed the distance from my kids. After they would visit for 2 hours each day, I was ready for them to leave and to enjoy quiet time when my baby allowed it.

I am thankful for my body. Genetically I have an incredibly shaped pelvis that has allowed me to easily deliver three posterior babies that most women would require a c-section for. I am also thankful for keeping my body in shape while pregnant. Up until the end (and post due!) I was at yoga class, hiking in the forest, taking my older kids for outings and eating very healthy (especially avoiding sugar and processed foods). This allowed my body to labor nicely and for it to already be in good shape post-partum. All of that coconut oil that I rubbed on my tummy paid off because I still don't have any stretch marks.

Encapsulating my placenta again was a priceless idea. The day that I came home from the hospital, the idea of taking care of a newborn that requires so much time while my older kids were crying, demanding attention, etc. was a stressful thought. I knew that I would have my placenta pills in another day and told myself to save those thoughts until I had my pills. Indeed as soon as I started taking them, I felt so much more at easy with my mothering abilities. My own mother is here to entertain the older kids and keep the house afloat so the real test will be when she leaves us!

I am reminded again that every baby is different. This is the first of our babies that wants to co-sleep.  Katja and I did not sleep well in the hospital with all the interruptions and her wanting to suckle constantly. I even tried a pacifier and sent her to the nursery one night for someone else to hold a pacifier in her mouth so I could get two hours of straight sleep. As soon as we were home in our own bed, Katja was so happy to just sleep cuddled next to me. Last night she even went 6 hours between feedings!

I thank you all for following this blog and will now search for what I should do with the roughly written information that I have posted here.

Warmest regards,
Elizabeth

Positions for labor and giving birth

Your birthing class, should have given you great information but I have a few little notes to add:

If you think of a woman about to give birth, you will notice that gravity naturally works in her favor while she is standing or squatting.  While you are in labor, you should try various positions that feel comfortable in the moment. Moving your hips in a circular motion while in some sort of supported upright position will help your hips and pelvis widen to help the baby move down for birth.  I always alternate positions as the labor progresses but especially liked slow dancing with my husband or leaning over a chair (while getting a back massage for my back labor).

Sadly, most hospitals around here like to hook up monitors and IV tubes that confine a woman to her bed. If a woman gets an epidural then she is bedridden and does not get to have gravity and natural hip movements help the baby get into position. This is one of several reasons while epidurals can cause a lot of other birthing complications.

The nice part about avoiding unnecessary medical intervention is to allow your body to labor and birth in natural positions that nature intended them to birth in since humans have been around. It is best not to jump at an epidural unless you really cannot continue without it. You should also be aware of the "transition" stage of labor that occurs right before it is time to push. This is when most women are really tested in how well they can handle labor and a good caregiver will let the woman work through this and not respect her screams for medicine :)  After transition, you are in the pushing stage while feels completely different!  Women only started laying on their back with legs up when doctors in hospitals starting doing births because it was convenient for the doctor! It is good to just be aware of this in the back of your head!

Which birthing class to choose?

In the movies it seems like a woman goes into labor, runs to the hospital, lays on her back and then has her baby. In reality, most women have an early labor that lasts for hours (and often days) in which it is in their best interest to stay home and work through their labor before going to the hospital. So what do you do at home?  Well a good birthing class will teach you what to do during each stage of labor and delivery. Most importantly, birthing classes give moms and partners the self confidence that they need and the tools to empower themselves. I am sure that most of you reading this are looking for a natural un-medicated birth and a good class will teach you how to be in control of your body and not experience "pain." There are several options that you should investigate to see what is the best option for you.

image: www.123rf.com

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Doula
For my first birth, I had a doula who came to our home and gave my husband and I private birth preparation classes.  She prepared us psychologically and physically for the birthing process using various methods that cross over with the other birthing methods. She wanted us to be ready to use whatever method would feel good to me during each moment of labor. Before the doula came, my husband was adamant that he would not cut the cord and he was not in favor of seeing the baby crown or the idea of a slimy baby coming out of me. When we had to watch a home birth video as our homework, we compromised and watched it on double speed.  At the end of the video he not only thought that birth was a beautiful family process but that he would consider a home birth for our future kids! Yay! The added bonus of going the doula route is that the doula is present during your labor, delivery and postpartum so she was able to support my husband to feel empowered in the process (did I mention that she gave my husband and my mom massages while I was in early labor!). There are different types of doulas and you can hire one for just a portion of the process but I encourage first time moms to get the whole package (well worth it)! The birth was not painful, we had someone to help us deal with stuffy hospital staff, and my husband remained calm, helpful and with beautiful memories.


Hypnobirthing
From www.hypnobirthing.com: "HypnoBirthing is a childbirth method that focuses on preparing parents for gentle birth.  In HypnoBirthing classes, you will learn proven techniques in a well-thought-out program of deep relaxation, visualization, and self-hypnosis. All of these are designed to help you achieve a more comfortable birth. HypnoBirthing encourages a calm, peaceful, and natural pregnancy, birth, and bonding experience for families. Unlike other childbirth methods that teach you how to cope with and manage pain, HypnoBirthing is based on the premise that childbirth does not necessarily need to be painful if the mother is properly prepared and relaxed. When women understand that pain is caused by constrictor hormones, created by fear, they learn, instead, to release fear thus creating endorphins—the feel good hormones. They are then able to change their expectations of long, painful labor and are able to replace them with expectations of a more comfortable birthing.  Rather than exhausting, shallow breathing and the distraction techniques of typical “prepared childbirth” programs, HypnoBirthing parents learn deep abdominal breathing and total relaxation, enabling the laboring mother to work in harmony with her body and her baby. This allows her to achieve a shorter and more comfortable labor for herself and baby."


The Bradley Method^®
From www.bradleybirth.com: "Natural childbirth is an important goal since most people want to give their babies every possible advantage. Without the side effects of drugs given during labor and birth. The Bradley Method^® classes teach families how to have natural births. The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient. Of over 1,000,000 couples trained in The Bradley Method^® nationwide, over 86% of them have had spontaneous, unmedicated vaginal births. This is a method that works!" The classes are 12 weeks long so plan ahead and be prepared to do some homework because you will have a 130 page workbook.


Lamaze
Www.lamaze.org is a practice that my mother learned in her birthing classes in the 1970's. It teaches women six practices: let labor begin on its own; walk, move around, and change positions throughout labor; bring a loved one, friend or doula for continuous support; avoid interventions that are not medically necessary; avoid giving birth on your back, and follow your body's urge to push; keep your baby with you -- it's best for you, your baby, and breastfeeding. Personally I get the impression that these are the basics for a natural birth and that all of the other methods go into deeper insight and support in the areas.


Prenatal yoga
Most studios that offer prenatal yoga offer a yoga based birthing class usually as an afternoon session. I found that the special breathing that I learned in my yoga classes in NYC with Melissa Feldman to indeed make the contractions painless by me mentally embracing the contractions (she had the greatest "pain" position). My current NJ yoga classes are less preparatory in embracing pain and laboring breathes so it all depends on your instructor. Generally the instructors do save most of their tricks for the preparatory classes. If you feel that you just need a little class to get you rolling, then this is it.


Hospital Birthing Class
Hospitals offer these classes and it is a coin toss as to what you get. I would think that they are general Lamazee sort of information. Since the hospitals in my area have a 37% C-section rate, I am not so keen to follow their natural birth advice!


Birthing Refresher Classes
During my second pregnancy, my husband and I took an afternoon natural birthing refresher class because my husband was nervous that we were not having a doula. Our previous doula, Karen Kelly, was taking her midwifery finals during my due date and my midwife swore that my labor would be so fast that I would not have time for a doula because she would be with me the entire time (and she was right). We found the refresher class useful to mentally prepare us. This third time around, we feel that we remember what to do and are excited for labor and delivery!


What methods did I not list? I would be interested to hear about more.

Creating a birth plan

image: http://www.freeimages.co.uk

What is a birth plan?


A birth plan is a list of what you want during labor, delivery and postpartum. It is helpful for you to sit down and decide on what decisions you want made in advance so you are not having to make spur of the moment decisions in between contractions and no details will be forgotten.  During my first pregnancy, I had so much to learn and found it useful just to read through the options that my doctor never told me about. I became very educated by just researching what those options meant!


Free birth plan template.


This one is really good from Earth Mama Angel Baby: http://www.earthmamaangelbaby.com/free-birth-plan


Should I create a birth plan?

During my first pregnancy, my doula had me review all the birthing options. She was adamant about me not being too set on a fixed "birth plan" because she wanted me to be flexible and not get too disappointed if my dream birth did not happen. Since my doula was at my side the entire time, I felt like she was my living birth plan and it was fine that I did not have one in writing.

With my second pregnancy, I darn well knew what I wanted and wanted everyone to know it!  Plus I had no doula so I had to be my own advocate at the hospital. Thankfully my labor was super speedy and my midwife was incredibly respectful of making my birth plan work 100%.

Now with my third pregnancy, I am again going to have a birth plan to let everyone at the hospital know what I want and to remind my midwife since I am now with a practice of midwives versus a single midwife.

What is a doula?

I had no clue what a doula was. Then two moms both raved about their doula. As soon as my husband heard the other husbands rave about their doulas, he was sold and instantly made me call her and hire her. The story that got me was the couple that went for the cessation with a breach baby. Of course that was not in their birth plan but they said that the doula kept them both calm and turned it into an embracing and positive experience where it would have been horrifying without her. I had a doula for my first birth and she was priceless.  And of course she shared her wonderful pregnancy tea recipe with me! I will speak more about her when it is my turn to tell my birth story. For my second birth, my midwife told me not to have a doula because she (psychic or really talented?) predicted how fast my labor would be and told me that as soon as my contracts started, I needed to run to the hospital and that she would be at my side the entire time! It was true!

Here is some information about doulas from DONA Interational:


What is a Doula? The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.

A Birth Doula

• Recognizes birth as a key experience the mother will remember all her life
• Understands the physiology of birth and the emotional needs of a woman in labor
• Assists the woman in preparing for and carrying out her plans for birth
• Stays with the woman throughout the labor
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
• Facilitates communication between the laboring woman, her partner and her clinical care providers
• Perceives her role as nurturing and protecting the woman's memory of the birth experience
• Allows the woman's partner to participate at his/her comfort level

A birth doula certified by DONA International is designated by the initials CD(DONA).Research evidence shows that the quality services of a postpartum doula can ease the transition that comes with the addition of a baby to a family, improve parental satisfaction and reduce the risk of mood disorders.

A Postpartum Doula

• Offers education, companionship and nonjudgmental support during the postpartum fourth trimester
• Assists with newborn care, family adjustment, meal preparation and light household tidying
• Offers evidence-based information on infant feeding, emotional and physical recovery from birth, infant soothing and coping skills for new parents and makes appropriate referrals when necessary

A postpartum doula certified by DONA International is designated by the initials PCD(DONA).

Why should I have a midwife if I am not a hippie?

Here is the stereotype:
Back in the old days, women used midwives and almost always gave birth at home (true).  Then modern medicine came along in the 20th century and doctors provided a supposedly healthier way of giving birth in hospitals. Now we are in the 21st century and only crazy hippies would use a midwife so they could give birth at home without medical support.  THIS IS SO WRONG!  GET THIS OUT OF YOUR HEAD NOW!


Don't get too comfy with your OB.
One of the most common things that I hear from women is that they love their pre-pregnancy OBGYN so they stick with that care provider because they feel comfortable.  Or they know one friend who just gave birth with an OB so they use that doctor.  Although this makes sense to these moms, I challenge all of you pregnant moms to look at the data and hear the birth stories of women on both sides of the caregiving spectrum.


Lower your chances of a cesarean by using a midwife!
The World Health Organization says that the cesarean rate should not be higher than 10-15% while most hospitals with OBs in my area are close to 40%. The national U.S. cesarean section rate was 4.5% and near this optimal range in 1965 when it was first measured (Taffel et al. 1987).  Here is a link with some reasons why the cesarean levels have risen so drastically.  Here is a link where a study showed midwives having a 3-4% cesarean rate with women of a normal health.


There are also a lot of statistics that any sort of medication (even painkillers like an epidural) during labor greatly increases the mother's chance of having a cesarean and that the medication is transferred to the baby.  These medications also cause the women's body to not react as it normally would and often causes a snowball effect of needing more intervention.  The movie The Business of Being Born is a great visual example of this.  It is a must see movie for pregnancy couples.  I forced my husband to watch it and he was so thankful at the end of the movie that he had watched it!


If you are curious what your state's cesarean rate is, go to www.cesareanrates.com.  The site also lists your state's hospitals that allow vaginal birth after cesarean (VBAC). Midwives and doctors can do VBAC deliveries but not all doctors are trained and practiced in doing them so you may need to do some research if that is the route that you want to take.


What is a midwife?
Midwives are trained nurses that have furthered their education in midwifery. They deliver babies in hospitals, specialized birthing centers with medical backup or at your home (known as a "home birth") with a backup plan to transfer you to a hospital if needed.  Midwives listen to your body and if your body shows signs of trouble then they get you the medical help that you need. Midwives are also more versed with natural birthing positions, and working with the woman's specific body to allow for the baby to come naturally and with minimal discomfort. There are many great reads about midwives including Ina May's Guide to Childbirth.  This is a must read for all pregnant moms.


My story
I have had one birth with an OB and one birth with a midwife.  My first birth was with an OB because the hospital was "convenient", rated the #1 maternity ward in NYC yet only had OBs.  In hindsight those were the worst reasons to choose an OB. By the time in my pregnancy that I realized my decision, I was too nervous to change caregivers (again, not a great reason).  Thankfully I had a doula who was fantastic and was the only reason why I was able to have the birth that I wanted.  My second birth was with a midwife. I fell in love with my midwife at first meeting.  She truly cared and understood how my body was working.  She perfectly predicted every detail about how my birth would be and made it incredible.  There was no question in my mind that my third birth would be with a midwife.  This time I am with a practice of midwives in a new state and I am extremely happy with their level of care and involvement.


I will be writing more about doulas and sharing birth stories in the coming weeks so keep following and thank you for all the great support that I have been receiving for this blog!