Your labor and delivery is a marathon - are you training?

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My friend Liz had a midwife during her first (of three) pregnancy. Her midwife explained to her that giving birth is like running a marathon.

There is no way that you are going to have a good experience running a marathon if you just show up the day of the race and start running. If anyone has had a good experience doing this, keep it to yourself! I have ran and was glad that I trained. I hear from endless women who made little to no effort to prepare for their baby's actual birth. They planned for the nursery, the clothes, their diets, their maternity leave but completely left out the birth. I've heard pregnant women say "I'm just going to show up and get that wonderful epidural" or "my doctor is going to step me through it". I know no one in these situations who looks back on their experience as beautiful and being in control of their body. So here's the issue with those thoughts.

That epidural is usually only given during certain stages of labor. You have to be laying down and cannot move naturally to let the baby fall with gravity. Just picture which way gravity pulls. Yep, the woman's body is designed to let the baby fall vertically and not to projectile shoot horizontally. My friend Liz found herself to be in a painful position unless she was on her hands and knees. Then the pain was gone and it was just the pressure of the baby pushing out. I enjoyed laboring while dancing with my husband (actually that is the last time that I danced with him!). The epidural doesn't even alway work. I know many annoyed women who got the epidural only to find out that they could feel everything and were stuck in a bed that did not feel good to be laying in. Since it causes you to go against your body's natural flow and changes your bodies natural hormones, you are at high risk of having a longer and more complicated birth thus a longer recuperation time. All of this snowballs and causes you to have a less positive experience and less success at breastfeeding. Here are some great epidural free positions.There are many women who had to resort to epidurals during their labors but they were educated and waited until the last minute in case the baby changed positions. If they were prepared and educated then they asked their caregiver the right questions and were okay and accepting of their birth and their body. Here are some Hidden Risks of Epidurals from Mothering Magazine.

I've heard all about your great doctor that you have had since your first period. You have a vision of that caregiver by your side coaching you through every contraction. Really you should be at home until the contractions get rather close and who is coaching you there? Your caregiver might be on vacation in Hawaii and then who is filling in? Doesn't your caregiver have a whole hall of pregnant women that he or she is tending to? Good birth planning programs take weeks to finish and entail a good amount of study and homework. Here are some good birthing classes. I very much recommend a doula for first births, home births, births in need of support, and for you and your loved ones to feel less stressed and more in enjoyment with your labor and birth. My husband and mom enjoyed the massages that my doula gave them.

The more prepared that you are and the more positive planning that you have put towards anything in life, will make it a better experience. Knowledge is key.

My placenta goes home with me

The placenta of baby #2

I had heard of people eating their placenta after birth. Supposedly it is extremely common around the world and has been done for eons BUT it seemed weird and extreme! So the thought did not cross my mind (although my doula had suggested it) for baby #1.

By the time I was pregnant with baby #2 I had learned about all of the positive benefits of consuming your placenta post-partum. It is really a miracle substance that prevents postpartum depression, stabilizes hormones and keeps your vitamins and minerals in balance. My midwife highly recommended it since I had been anemic and since my life was going to be extremely busy. Not only was I about to take a newborn home to a household with a 2 year old BUT, I was moving 2.5 weeks after the baby was born and leaving the country with the family the day after the move. It was a busy time in life.

I heard about having my placenta encapsulated and that felt like a method that I could deal with. Popping a pill is easy. I called around and found that the going rate was $300 to have my placenta encapsulated. I looked up online how to do it and was surprised that it could be done so quickly at home. I followed these instructions and encapsulated my own placenta a couple days after giving birth.

The pills worked for me. For months later, if I was having a rough time with my kids I would pop a placenta pill and feel that I could better cope. There is scientific proof behind the power of the placenta but if nothing else, the placebo effect is great!

There are many other great ways to ingest your placenta such as raw, cooked or as a tincture. Ask your caregiver prior to labor, how you should get your placenta home because sometimes you have to sneak it out.

J.B.'s Birth Stories: A laughing gas VBAC & A C-section in Africa

J.B. is an American ex-patriot living in Kenya. She is the only person that I know who came into this world via home birth (one of five kids her mother homebirthed!) so she is very aware of birthing world.  I always post my favorite birth first so her second birth is first below. Her first birth was medically induced and ended in a caesarian also below and is the second story below. I love J.B.'s use of the bath to recharge herself during early and late labor. I had no idea about laughing gas during labor. Supposedly it is incredibly safe and effective during contractions but too much exposure by medical staff can be dangerous so it is not used in the U.S. Let me know if you have more info on it.


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J.B.'s Second Birth: A Laughing Gas VBAC 
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It was a beautiful, sunny morning.  I was getting ready to go to my acupuncture appointment, when I started to feel a strange feeling in my lower abdomen (aka. the part of my tummy that I could no longer see).  It did not feel like cramps. It was not painful.  It was just there every few minutes and then would go away.  I headed to the acupuncturist and had treatment to encourage me to go into labor.  By the end of the session, I was pretty sure that they were very mild contractions. The acupuncturist told me that my body felt much more ready for labor then it had a week before. I felt a bit giddy as I thanked her and headed to my next appointment of the day with my good friend and Osteopath, Claire. I had slipped and fallen a few weeks before and my sacrum had been really sore afterwards.  Claire's treatments had really helped to take away the acheness  in my sacrum.  I told Claire about the contractions and she celebrated with me. 

 We both knew that I was really hoping to have a natural birth with my second child after having had an emergency c-section with my first son and I wanted go into labor on my own this time and deliver naturally. I had read about the risks of a VBAC and felt that I fell into the low risk category due to the type of incision I had had, and my overall age and health. The pregnancy had gone great and now I was 6 days overdue.  

I went home and decided that the contractions would probably let up in the evening and then start up the next day.  Ooops.  I was wrong.  In hindsight, a long afternoon nap may have been the best plan.  However, instead I had some friends and their kids over and we all had a lovely afternoon.

That night I was tired from the day but the contractions were strong enough that I could not sleep.  I was afraid of becoming too tired if this went on for a long time and was also feeling a bit nervous of what lay ahead as I became more and more convinced that I was really going into labor.  There was nothing to be done but be with it, so I got up and figured out how to be as comfortable as possible.  I found a hot water bottle on my sacrum to be really soothing, so I alternated walking and sitting with a hot water bottle, while listening to hours of This American Life.  I told my husband to sleep, because I knew that I wanted him as rested as possible for when I would really need him.  

By 2 or 3 in the morning I decided I wanted to try a hot bath.  It felt great.  I stayed in until the water had become tepid and then it was back to the walking and leaning on the bed.  It was around this time, that I notice that with every contraction I would pee a little bit.  I had never heard of such a thing but figured that the baby's head must be pushing on my bladder.  It was a really strange sensation but as I had stronger and stronger contractions to deal with and no control over it, I just threw a towel on the ground under me and didn't worry about it.

By 5:30, I was unable to talk through my contractions and I decided that it was time to take my son to our friends and head to the hospital.  When we got to the hospital, I was admitted and my doctor found that I was 5 cm dilated.  She said my contractions were strong and that we should have a baby around lunch time.  I felt so excited that the contractions were working and 5-6 more hours felt totally doable.  Once she left, I settled into my rhythm that I had found over the night and which was working really well for me.  In between contractions I would walk slowly.  Then when a contraction started, I would  lean on the bed or a bar and rock my hips back and forth while I counted my breaths in my head.  I knew that each contraction was lasting 14-18 breaths, so I knew that by 7-9 breaths I was over the peak and was heading back down again.  So that is basically all I did for the next several hours.  My husband made sure that I ate little bits, drank fluids, and would push on my sacrum during the contractions.  Sometimes I would also put the shower nozzle on my low back and still found that hot water felt really good.

When the doctor rechecked me three or four hours later, I was dilated to seven cm.  The good news was, that I was making progress.  The bad news was, that the baby was still high and that she and I had hoped that I would be having a baby around now.  The one thing that I now added to my routine, was nitrous oxide.  I am not sure how available it is in the US., but it was frequently used in Kenya.  I had read about it in "The Birth Partner" by Penny Simkin and felt that it was safe for me and the baby.  So at the beginning of each contraction, I would take 3 breaths through the mask and then do my rocking and counting.  I found the gas helped to "smooth out" the peak of the contraction.  Other friends of mine did not think that it did anything, but I found it helpful. Side note: The one side effect I noticed, with the gas, was that my throat was a little sore the next day.  When I mentioned this to my husband, he chuckled and said that he was not surprised, considering the amount of laughing gas I had sucked down the day before.  Now I had to chuckle, because I had already forgotten about using it.

By 5 or so I was getting really tired.  I was now 8-9 cm dilated but progressing slowly.  My contractions were 16-18 breaths, with a minute and a half rest in between.  My husband filled the tub and I lay in it, on my side, for one hour.  It was so great.  It took the intensity of the contractions down and I felt like I was able to recharge a bit.  I told him to give me an hour and then get me out, so that we could get back to work.

My sense of time gets extremely foggy towards the end, but I will do my best.  Once I reached 9 cm, my doctor broke my water and soon after I was fully dilated.  I was now on the bed on all fours.  I had put the head of the bed up and was holding onto the top bar.  My body had decided that it felt best if I pulled back against the bar with each contraction and made a deep gutteral sound.   It was not something that I was trying to do or thinking about. It was extremely instinctual and I just went with it.  The contractions seemed to be coming closer together and I really felt like I was able to push.  

Then my doctor decided that I was ready to deliver and had me turn onto my back.  She prepped me to deliver and then I was told to push with my contractions.  However, on my back I could not feel them as well and they felt very weak and ineffectual.  In hindsight, I wish that I had asked to be back up on hands and knees for a bit, but by that point I was so tired, that if she had told me to stand on my head to deliver, I would have tried.  I have no idea how long I pushed (it apparently was longer than I thought) but eventually she said that the head was almost out and that she would help me to deliver with the vacuum.  She put it on and one push later he was out and I got to see my son.  It was amazing to have this new little being laid on me.  He was crying and covered in slime and totally perfect and beautiful.  We wrapped him up and he latched on and started to nurse well.   I was in total, exhausted, bliss.

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J.B.'s First Birth: Emergency Cesarian in Africa

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How was this happening to me?  I had had a clear idea of what type of birth experience I wanted, even before I became pregnant with my first child.  My mom, a nurse, who had had all of us at home, had taught me all about the benefits of a natural, home birth.  So when I became pregnant while living in Nairobi, Kenya, I went about searching for a way to have a safe and supported home birth there.  Unfortunately, I did not find any midwives who had the experience and training that I felt was necessary, so I chose to use an amazing doula in the local private hospital.  I wrote a long birth plan and made sure that my doctor knew that I wanted as little medical intervention and interference as possible.  With my doula and birth plan, I felt that I would be supported in having a healthy natural birth. 

So how was it that after all of that preparation and a happy, healthy pregnancy, I going into the hospital tonight to be induced? While I had felt pretty comfortable with the idea of the challenge of natural childbirth, I felt quite scared of the medicalization of birth.  Mixed with my anxiety, were excitement at the idea that I would get to meet my first child in the next day and an acceptance that I had done everything I could to get this little one to decide to make its grand entrance on its own.  Despite doing EVERYTHING on the list of natural techniques to get labor started, he or she was not showing any signs of wanting to come out and my doctor felt that, at 12 days overdue, it was time.  

So at 8 o'clock on October 23nd I went to the hospital to begin the induction process. 

The first night they gave me a tampon-like thing that prepared my cervix with some medication that softened and thinned it.  I slept pretty well and was happy to feel slight rhythmic contractions across my lower abdomen the next morning. Our doula arrived bringing her loving and supportive presence and I felt so excited that by the next day, I would have met my child.

My doctor came in at 10 and said I had dilated from 2cm to 4cm and that she wanted to break my waters and give me pitocin to get things going.  My husband and I both felt that we would rather wait and see if my contractions would strengthen on their own since I had already dilated 2 cm.  She agreed and said she would be back in 4 hours.  

So now we got down to the business of trying to get my contractions to strengthen.  I walked and walked.  Jennifer, our doula, used acupressure points to stimulate stronger contractions.  I visualized my cervix opening and my baby moving down.  Every hour or so the nurse would come in and listen to the baby's heart beat which always was reassuring to hear.  

My doctor came back at 4 o'clock to check me and found that I was still at 4 cm.  I was disheartened to say the least but still felt like I wanted to give my body more time to labor on its own.  We agreed that if in four more hours nothing had changed, then we would move to plan B and break my waters and start Pitocin.

Again we walked and massaged and sat on a big blue ball trying to get my pelvis to open up.  The contractions were strong enough that I could not talk through them.  A tightness wrapped around my lower pelvis to my lower back with each contraction.  I found standing, while leaning on something and rocking back and forth, to be the most comfortable position. Sitting on a bed or lying down were not an option.  I was sure that these contractions had to be working and couldn't wait for the doctor to come back to tell me how much progress I had made.  However, when the nurse checked me at 8, I was still at 4 cm.  I was so disappointed.  My husband and doula both stayed really optimistic and supportive and tried to make me feel better about the interventions that were lying ahead.

My doctor arrived and she broke my water.  Then everything changed.  The amniotic fluid, rather then being clear, was tinged with fresh meconium.  My doctor said that this meant there had been a period of fetal distress in the recent past.  Considering that I was only at 4 cm and this was my first child, she needed to get the baby out faster then an induced labor could.  She said the baby needed to be delivered by c-section.  I was immediately filled with fear for my baby.  Was he or she okay?  I just wanted to hear the hearbeat so that I could know that he or she was still okay in there.  My mind was racing while I was also dealing with contractions that had just gone from a 3/10 pain to an 8/10.  

They told me to lie on my left side while they made preparations for the c-section.  Every time a contraction would hit, I would swear like a sailor and squeeze the bars of the bed.  The nurse listened to the baby's heartbeat, which was rapid but okay. Hearing that the baby seemed okay was an indescribable relief.  Things started happening so fast, I did not really have time to think about the fact that I was about to have major surgery.  I just wanted my baby out and healthy.

I tried not to think too much about the surgery and focused instead on my excitement at meeting my first child.  After what felt like a while, the doctor said that she was ready to deliver the baby and one of the attendants started to push on my stomach to try to get the baby to come out.  I was amazed at how hard they had to push. Then it was out and it was a BOY!!! The pediatrician took him immediately and checked him over.  He passed all the tests with flying colors which was a huge relief. Then they wrapped him up and my husband brought him to me.  

Wow!! Thinking back, I really cannot find words to describe the feeling of seeing him for the first time.  He was so perfect and I was completely in love.  I started crying. I was so happy and so relieved that he was okay.  

During the surgery, the anesthetist had offered to put me under light sedation during the sewing up part of the surgery.  I asked if I would be able to nurse afterwards and if I would get sick from the drugs.  She told me I would be fine to nurse and that I would not be nauseous afterwards.  So after I had met my son, my husband took the baby back to our room and I slept through the rest of the surgery.  I woke up as I was being taken back to my room and just wanted to get back to my baby and husband.  When I got back to my room, my husband, parents, and a good friend were all there with my son.  We were all so happy.  The nurses had to help me to settle into bed, as I was just beginning to be able to move my legs again. I held my son and brought him up to my chest.  The doula and my mom were both watching expectantly as he latched on and started sucking away.  They both seemed relieved that he had latched so well.  I had expected nursing to come easily and naturally, but after talking to other moms, I now know that I was really lucky in the nursing department.  

I said good night to everyone and then curled up with my baby and fell asleep.  Though my birth experience was not what I had expected, I had felt supported, listened to, and cared for.  I could not have been happier as I lay there with my son.     

H.H.'s Birth Story: The natural high

H.H. in her birth story below shares how hard it was for her during the rough transition phase of birth not to choose the opiate that the medical staff was pushing on her. Thanks to her inner strength and the support of her doula and spouse, she was able to stick with her plan for a natural birth that resulted in a fast and easy delivery.


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H.H's Natural Birth
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So I woke up on my birthday August 22 with what I thought were contractions. I thought this is my birthday gift, the birthday of my first daughter.  I remember making a wish the year before blowing out my candles wishing for a new life and new chapters, well I got my wish, a new chapter was unfolding. My birthday was the day that I was to have my first prenatal massage, what a luxury that was. My husband picked me up from my massage and we went to an Italian restaurant for dinner where I had some of the most amazing pesto ravioli that I have ever had. It was a warm night and it was about an hour walk home. I felt good and decided I wanted to walk home. By the time we got home my contractions were becoming more intense. I was up all night going to the bathroom and wondering if my water had broken slightly. My spouse slept. He woke up at around 6 and said we have to call the doctor, I was concerned that my water had broken, and that I needed to go to the hospital. I did not want too early to the hospital because I wanted it to be as natural as possible, no unnecessary interventions. But I did have GBH and I was supposed to take antibiotics when my water broke.

A taxi came to our home in Brooklyn and brought us to Downtown Hospital near Chinatown, Manhattan. The cab driver seemed to take a lot of back roads and hit a lot of potholes.  When we arrived my doula was there waiting for us. She was a friend of mine and a fellow dancer and pilates teacher who had already given birth.  She decorated my room, we got my big pink ball out, and the music on. I had prepared for many performances in the past and I did feel that this was my biggest performance coming up. I remember the first thing that we did was to take walks down the hallways stopping frequently to do hip figure eights.  

The day went on and physically everything got more intense. At one point I wanted brownies, I regretted this latter when my body wanted to purge everything. As everything physically got harder, mentally it got harder. I began to wonder if I could do it. I felt like I was going through a rite of passage. The nurses were not supportive of me walking around, making a mess, they wanted me drugged and in bed, I think that they thought I was a bit crazed. One nurse came in and said, "you really should have some Stadol, so you can get some rest". I felt so vulnerable and so scared at the moment that I looked at my husband and said yes. My doula and my husband reminded me of my birth plan, and then I felt the need to push. A half hour later I gave birth. 

Surely if I had taken the opiate my whole birth process would have been radically slowed down, and who knows how it would have ended up.  After giving birth I felt the biggest high, I often felt this after a performance, but this was intensified by 10. My husband was amazed by the transformation, an hour ago I was so deep in my own world, scared of the unknown and now I was laughing and eating brownies.  I truly feel this was a rite of passage, where I had to face my fears, doubts, and physical pain and come out the other side to a new life with a new life.

J.S.'s Birth story: An illegal home birth

Below J.S. has shared her birth story with us. I applaud her for realizing that there was too much medical intervention that caused her to have a caesarian for her first birth so this is the story of her second birth. She followed her inner feeling that her body could do it and she did. Sadly she lives in a State that does not allow the type of birth that she wanted even though home births are proven SAFER than hospital births!

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J.S.'s Illegal Home Birth
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It was a Thursday. I had my 38 week appointment that morning. Everything looked good. It seemed that we still had another couple of weeks, which was nice, considering that was only the second time I had met my midwife. Little did we know, I would see her again in less than a day’s time. Our son would be born before sunrise. His birth was the easiest part of this story.

The pregnancy of my older son, about three years earlier, ended with an unwanted and unwarranted c-section. Although I was educated and did my best to avoid medical intervention, I became part of that staggering statistic. When I found out I was pregnant again, I knew I wanted to have a home birth. I quickly discovered that it is illegal for a licensed midwife to attend a home birth after caesarean section (HBAC) in the state where I had moved. (Just three months prior to getting pregnant.) After endless reading, many phone calls and online searches, I found a midwife who would consider a HBAC. We talked in depth about my first experience and she agreed to attend us as long as I received parallel care with a practice that had hospital rights. I had planned to do this anyway because my friend’s children
were temporarily taken away by DYFS when she was transferred to a hospital during a HBAC. She had no record of prenatal care; she did not want to give up the midwife who was assisting her. I
began seeing a highly recommended group of midwives.

The juxtaposition of care was striking and each visit solidified my original choice to birth at home. While my home visits were warm and involved, the office visits were quick and my concerns about the possibility of a second section were brushed off with a smile, saying, “we will do our best.” I met 4 different care providers and constantly had to retell my story and remind them of my history, each time feeling like I was defending myself. This stood in stark contrast to the intimate home appointments where I reconciled the events of the birth of my first child and where I actively participated in my care, building trust in myself and my body.

At 36 weeks, I met a 5th midwife in the hospital practice. She insisted that I was measuring small and that a sonogram was necessary. I showed her the measurements from my first pregnancy; they were identical. The road of medical intervention that led to my c-section began with a sonogram at 36 weeks
indicated by measuring small for dates. I asked to be measured again. She seemed annoyed by this but a second midwife came and measured; 2 centimeters higher. A third was called in; her measurement was right in the middle of the other two. Again I voiced my concern about the sonogram. I said that given the 2 cm margin and the estimated due date being plus or minus 2 weeks, along with the coincidences with my first pregnancy that a sonogram was unwarranted. I was told that the first midwife I saw that day got to make the call. Even though it was the first time I met her, because she was a founding partner she was allowed to decide my fate. It did not matter that the other founding partner got a higher measurement or that the midwife who got the highest measurement had done the majority of measurements, establishing the baseline for fundal height. I questioned the possible outcomes. If the fluid was low they would do a section that day. No questions asked. She scheduled
the sonogram before I left the office.

The next day, I was eager to talk with my home birth midwife about the scheduled sonogram. But she had something else to discuss. She explained that given the current climate in the state and because of extenuating circumstances surrounding another midwife, she would not be able to attend our birth as
promised. She gave me the option of continuing with the hospital midwife practice with her as my doula or helping me find a midwife who would attend me at home. Considering that my concerns were dismissed and the decisions regarding my birth were out of my control with the hospital midwife practice, I decided I would rather birth at home with someone who believed I could do it. I was the one who would be birthing that baby and I needed to be in an environment that would support that. Amazingly, we found someone willing to help. A lovely midwife who, it turned out, was also pregnant. 32 weeks. As long as we both delivered close to our expected due dates it would work out. She ended up delivering 2 weeks early...luckily so did I.

Late in the evening after our 38 week appointment, I started to notice some waves. It was so vastly different from the intense back labor and vomiting (the result of intervention) I had experienced the first time that I thought it was very early labor and expected at least another day or two of this. After an
hour I told my husband about the waves and decided to take a shower. He called the new midwife even though I insisted that he wait. It was midnight and she needed her rest. But after speaking with me, she decided to head our way, while I still maintained that it was unnecessary. She arrived a few hours
later and told my husband to fill up the birthing pool. I couldn’t believe it. Last time after laboring 20 hours I barely made it to five cm; this time I had not felt anything remotely similar to that type of pain. He filled the pool, lit some candles and turned on some music. Our son was sleeping in the next room. After a few hours in the pool, it was impossible not to push and I soon felt the head emerge. I was astonished. After some final pushing she told me to scoop up my baby. It was surreal. I kept saying, “I just can’t believe it. It was so easy.”

My hands were the first to touch him. As the sun rose I held him in our bed and he nursed. This was what I wanted, not to wait seven hours to touch him as I had with my first son. My time and energy would not be spent fighting about bottles as it had before. The events leading up to the birth of our son were dramatic and complicated but the time of his birth and the days following were peaceful and full of ease. It was worth it.

My birth stories: The easy birth & The other

When I was pregnant for the first time, a new mom was talking to me and shared the story of her beautiful and happy birth. I had always thought that birthing was a negative experience that you had to go through one way or another (except for the exception of my mom who had me drugless 30 minutes after entering the hospital). This friend loaned me some books and I began asking other moms about their experiences. What I found was that, the women who went into birthing well prepared and educated with all of their options were the ones who can out HAPPY with their birth experiences even if it did match their birth plan because they were empowered. This posting is the first of several postings where actual moms share their birth stories with you.  I am the first to share, so here are the stories of my first two births:

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My Second: The Easy Midwife Birth

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My second birth was easy (a relative term of course) and I admit it! It was also fun and exciting! Yes I was lucky but I set myself up for success by my choices.

I went to a private practice midwife, Beverly Woodard, as soon as I found out that I was pregnant. She was so caring and wanted to know every detail of how my body responded during my first pregnancy and birth. It was the first time in my life that a medical staff treated me as though I was the person who knew my body best. I was in love with Beverly as my midwife but I really wanted a home birth and she did not do homebirths. Then we decided that we would leave NYC for the suburbs and I realized that planning a homebirth while not knowing where I was going to be living was impossible so I stuck with Beverly as my NY birthing option. She put together the pieces of the puzzle with my previous birth and the structural shape of my hips and pelvis to predict how my birth would be this time. She convinced me not to have a doula since my labor would be extremely short and she would have me run to the hospital to meet her as soon as labor started.

A day after my due date, I had an appointment and was not yet in labor. I was on a time crunch logistically because we were moving out of state in 2.5 weeks and would leave the country on vacation the following day (yes, we are crazy like that!). I needed enough time to get the baby's passport and get my body healing before embarking on the journeys. Beverly knew that my first baby had not responded well to being overdue and thought that my baby would benefit from coming out now. She stripped my membranes and sent me home with directions to take castor oil a few hours later. I would be in labor that evening hopefully after rush hour traffic since I had a long journey to the only hospital that she delivered at.

As I was home showering (5 minutes after taking the castor oil, too early for it to have kicked in!) three hours after my appointment, I started having regular contractions that were already regular at 8 minutes apart. Within about an hour they were 6 minutes apart. I dropped my toddler at a friend's house and my mom and husband drove me during rush hour from Queens, through Manhattan then over the Brooklyn Bridge to the Brooklyn hospital that I would give birth at. We passed 5 hospitals on the way there (I counted to distract myself from the back labor). Thank goodness Google Maps had the traffic feature that showed us which way had the least traffic because we had very little traffic considering that it was rush hour in New York City!

I arrived at the hospital at the same time as my midwife and was already in active labor as she was trying to take my vitals. The castor oil had started to kick in so I started laboring over the toilet. Sadly my labor was progressing so fast that they told me they would not have time to fill the birthing tub to have a water birth. The next thing I knew, I was in transition. The funny part is that I only had two transition contractions then my midwife told me it was time to push. I told her that I didn't feel like it. Another contraction came and I felt the baby crowning out of me while I was standing and having the contraction! So I waddled with help over to the bed and had to lay down with my legs up to slow the baby from coming out so I would not tear myself. I pushed during two contractions then my midwife told me to reach down and pull my baby out! It was not something that I had not envisioned doing and it was an extremely spectacular event to pull my 9-pound-sunny-side up baby out. I held my slimy baby up against my bare chest and warmed her with my body heat. She was healthy. My labor was exactly 3 hours from start to finish, I spent 1 hour in the hospital before giving birth, and I never had even an IV put in me.

This baby was completely different than my first. She was easier to breastfeed and she was easier to soothe. She did become slightly jaundice and had to spend a night under the lights. It was strange to see her under the lights but we were put in a private room and I felt like I was having a mini-vacation away from the world that I was about to return to of moving boxes, vacation suitcases, and an active toddler!

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My First: The OB

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My husband works at a hospital that was convenient to my job so it was an easy decision to seek an OB that was affiliated with that hospital. It is an ivy league medical training hospital with "top" OBs.  When I went for my appointments, it felt just like I was seeing a regular doctor and that was fine with me. I verbally presented my birth plan to the doctor and she was fine with me requesting everything natural (no drugs, moving free during contractions and birthing in any position).

After speaking to several moms about their births I realized that if I were to give birth at a hospital that I NEEDED a doula to be my medical advocate and to coach my husband and I. Our wonderful doula Karen Kelly (now a midwife), gave us private birth coaching to get over our unconscious, get into the present and really plan for how this birth was going to happen and what we would do after the baby was born. It was so reassuring that she would be there during the birth to remind us and help us with what to do.

During our preparation, Karen gave us homework to watch a home birth DVD. My husband was grossed out by the idea of watching the birth and on the day that we found out that I was pregnant, announced "do not ever ask me to cut the cord." I respected this. But I could not lie to Karen and not watch the video. So then it became the 45 minutes before she was supposed to arrive and we had not watched the hour long video so we compromised and watched it on double speed! It was a beautiful video and completely changed our mind about home births! My husband's every prejudgement about birth was changed and he saw it as a beautiful and natural process. Thank you Karen!

I became more and more educated and realized that my birthing hospital was ivy league and the "#1 maternity ward in NYC" but had the highest caesarian rates in the city! I did not feel comfortable switching to a midwife in my third trimester but I felt that my doula would balance the situation.

My due date came and went. Five days after my due date, my doctor sent me to the hospital for a standard post-due monitoring to make sure that my placenta was not deteriorating as they sometimes can after a due date. The monitors showed that I was having contractions that I did not feel and that the baby's heart rate was falling at the wrong time during the contractions. On my due date, five days prior I was 3 cm dilated so the doctors wanted to keep me in the hospital and give me Pitocin to speed up the birth and highly monitor the baby's heart to make sure that the baby was safe. I had read so much negative information about Pitocin that I with all my heart did not want it.  I asked for other options and the OB said that there were none (I later found out that this was a LIE). I convinced the on-staff doctor to let me be monitored for another 5 hours and eventually the heartbeat was fine again but they did not want to release me from the hospital.  My doula had arrived and during this time and we decided that there were instances in which this drug was made for and that I was a prime candidate since I was dilated enough and we did need to keep an eye on the baby's heartbeat.

So I started on Pitocin and my doula did her magic to get my contractions moving faster naturally. This allowed me to get only a low dose of Pitocin and 12 hours later to be taken off the drug.  Although I had an IV and the Pitocin for much of the time, I was able to move rather freely and labor in any position. This was probably because I was such a pain in the bottom of the medical staff that they decided at some point to leave me alone (expect for that annoying nurse who came in during transition and told me that "you do not know what real labor feels like, it has not started" because I kept refusing the epidural).

My husband and mom enjoyed massages from the doula.  The massages were also amazing for me since I was back laboring and her magic fingers (as a professional Mayan Masseuse) knew exactly where I needed them. She also was amazing to keep moving me into positions that helped me as the labor changed. From the time my active labor started until birth was 5 hours.  Twenty minutes of that was transition and I barely pushed (maybe 5 times). The baby came out sunny side up which explained all of the back labor. Without me knowing, my husband cut the cord and was thrilled to do it.

In hindsight I was thrilled to have a healthy baby girl and to have a good birth. What I would have changed was the medical staff (the OBs were really rude to me and not fond of me wanting to go natural) and more natural options than Pitocin.

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

ronen

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).

Homemade pregnancy brew

image: www.openphoto.net
Adrian van Leen

This is a recipe for pregnancy tea that my doula, Karen Kelly (now a midwife!) shared with me.  I ordered the individual dried herbs from Mountain Rose Herbs and there were enough to last through my multiple pregnancies and several gifts to other expectant moms. It is much more cost effective than buying store bought pregnancy tea bags, you know that you have fresh organic ingredients, and you know that it is the right combination of herbs. This mineral rich tea is also a great tea for labor, after birth and lactation!


Pregnancy Brew

Ingredients

• 8 parts Red Raspberry leaf 
• 3 parts Alfalfa herb 
• 3 parts Peppermint leaf 
• 2 parts Nettle leaf

Simply add in 1 to 2 tsps of the premixed herbs to 1 cup of hot water. And let it steep for 5 to 10 mins. Sweeten with raw honey if you desire. Drink daily from 16 weeks on!


Red Raspberry leaf

• used as a basic herbal foundation for all female organs and problems.
• decreases profuse menstrual flow (when you are not pregnant!).
• strengthens wall of uterus and entire female reproductive system.
• good during all stages of pregnancy. It is used to relieve nausea, prevent nausea, prevents spotting, to tone the uterus in preparation for childbirth. Has been used as a preventative for hemorrhaging during labor. Assists labor, reduce the pain of childbirth, makes delivery easier and faster, and relieves after pains. Tones and regulates before, during and after childbirth. It is effective in restoring the womb after delivering.
• increases and enriches milk for lactation, can be combined with marshmallow tea.
• positive medicinal affects on men, like increase fertility.
• good for stomachaches, bowel problems, vomiting and flu in children. Fordiarrhea in babies.
• soothing to stomach and bowels and cankerous conditions of mucous membranes in the alimentary canal.
• high mineral and vitamin source. An excellent herb source of manganese.

Alfalfa

• means “Father of all Foods.” It has been called the King of plants because it is extremely rich in minerals including iron, calcium, magnesium, phosphorus, sulfur, chlorine, sodium, potassium, silicon, and trace elements. And it is a good source of Vitamin C, niacin, Vitamin B-1, beta- carotene (Vitamin A, which strengthen the epithelial cells of the mucous membranes of the stomach) and Vitamin K (the blood clotting vitamin which has been known to help peptic ulcers).
• has eight of the essential amino acids and the highest chlorophyll content of any plant.
• contains natural fluorides, prevents tooth decay and helps rebuild decayed teeth.
• a folk medicine for all inflammations including arthritis and rheumatism.
• It is also thought to be hypocholesterolemic and hypoglycemic. It is most popular as a blood purifier.
• contains the digestive enzyme betaine, aid the process of digestion.
• a detoxifier of the blood. The high molecular weight alcohols (octacosanol) help to reduce cholesterol and serum lipids while the coumarin derivatives provide an antothrombotic effect.
• the flavonoids relax the smooth muscles and alkaloids reduce blood sugar levels. These systemic effects are accompanied by the regulating effects the saponins have on colonic flora.
• lower blood pressure and balance estrogenic hormones.
• used to treat debility, anorexia, arthritis, weak digestion, hypertension and gout.

Peppermint

• one of the oldest and most popular remedies for simple colic and minor bloat in children and adults. It promotes relaxation.
• good for all digestive problems, helps stomach pain caused by indigestion and is soothing to the stomach. It expels stomach and colon gas.
• excellent for fevers, flu, colds, diarrhea, ulcers, and colitis.
• strengthens nerves and heart muscles.
• cleanses and tones the body.
• can be used instead of aspirin for headaches. And it stimulates blood circulation.
• useful for relieving muscle cramps, menstrual cramps, nausea and loss of appetite.

Nettle leaf

• stimulate hair growth.
• a blood purifier.
• contains bitter compounds that increase the production of urine.
• has mild laxative effect
• increase the efficiency of liver and kidney function.
• treat imbalances of the mucous membranes.
• has traditionally been used to treat asthma, ulcers, bronchitis, jaundice, nephritis, hemorrhoids and spasmodic dysmenorrhea, urinary tract infections, respiratory tract infections, inflammatory skin conditions, diarrhea.
• contains astringent compounds that shrink inflamed tissues and stop bleeding.
• a significant source of vitamin C, vitamin A, and minerals including calcium, silicon, and potassium chloride; protein, and dietary fiber.

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!