Category Archives: Childbirth

What about that Hypnobabies thing?

Following the publication of Katie’s birth story last week, I received so many well-wishes and congratulations.  Thank you all so much for your support.  It truly was an incredible ending to a difficult journey.

One of my friends posted a great comment, though, that I wanted to quote to kick off today’s post. Megan wrote:

So I’m reading kind of mixed reactions to the hypnobabies CDs in this post. I know that a big hope was the thinking about the process without negative words like “pain,” but it sounds like that didn’t exactly translate during labor and delivery, yeah? But at the same time you visualized the birth process almost to a T and you give some credit to hypnobabies for that. Would you say they were still beneficial, and with your experience, what recommendations would you make to someone considering them?

Really great question Megan.  I started to write a reply to your comment, but I realized that the response was complicated and probably deserved its own post.

While many Hypnobabies birth stories tell of birth with no pain, Hypnobabies itself bills its method as one that allows you to birth “in comfort, joy, and love.”  They talk about replacing negative words with positive words and the hope is that you won’t experience birth as painful.

Birthing Katie was certainly physically painful, and I did a whole lot of hollering.  Yeah, you can call it “vocalizing” if you want, but you know me.  I calls it likes I sees it.  I got loud enough that I cracked a joke to my midwives about what the OB in the office next door must have thought was going on in the birth center.

Let’s be clear though. For those of you who haven’t had babies yet, pain in childbirth is absolutely nothing like pain from cutting yourself or pain from a broken bone or injury.  It’s completely different.  So different that I think Hypnobabies has it right when they talk about not using the p-word to describe it.  If you’re an endurance athelete you can come close to relating to the type of pain that childbirth entails.  Childbirth is much more like running a marathon than it is slamming your hand in a car door.  Does that make sense?  I think in many ways people focus too much on the pain aspect of childbirth and too little on the endurance aspect of it.

I didn’t go into the Hypnobabies expecting it to be pain-free.  I couldn’t really bring myself to use the alternate vocabulary very much in real life because it felt a little hokey.  What I did expect to get from the Hypnobabies childbirth method was a positive, empowering, natural birth that was free from fear and anxiety.

In that regard, Hypnobabies delivered tenfold.

Do I really believe in hypnosis?  Honestly, I’m not sure.  But what I do believe is that in listening to the tracks I was able to find a hidden well of confidence and power within myself that I didn’t know I had.

Leading up to this birth, I never felt anything but excited anticipation. During labor, except for those few moments right before Sue told my I was at 9 cm, I felt confident and powerful.

Unlike Gabi’s birth, which I went into with the idea of trying for a natural birth but if I need an epidural that’s okay, I went into this knowing with absolute certainty that I was not only capable of doing this but that I was going to do it.  I think that self-assurance showed in my birth preferences.

Hypnobabies helped me to find that confidence.

It was incredible how closely Katie’s birth mirrored the birth I had visualized.  I visualized myself having her quickly so I could get back home to Gabi and that’s exactly what I did.  And really, y’all.  I pushed out an 11 lb baby in 20 minutes.  Damn.

Even with Hypnobabies, Katie’s birth was the hardest thing I’ve ever done in my life.  It made the half-marathon I ran look like a cakewalk.  But it was also the most exhilarating and empowering thing I’ve ever done.

So, sure, Hypnobabies didn’t give me a pain-free birth.  But would I use it again for myself if I were ever going to have another baby (which I’m not)?  Absolutely.  Would I recommend it to a friend. Definitely yes.

And for those of you who haven’t had a baby but are curious about what childbirth is like, go get yourself some running shoes and train for a marathon.  That high you get at the end of a race, the mix of endorphins, adrenaline, and tired and sore muscles, is like a smaller version of the feeling you have after unmedicated childbirth.

Katie’s Birth Story

I’ve been putting off writing this for a long time.  It just seems like such a big thing to try to process emotionally and put into words.  But I need to write this down before I start to forget, so here goes.  This is a birth story, y’all.  If you don’t want to hear the nitty-gritty details of how Katie made her way into the world, then don’t read it.  But if you do read all the way through, you will be rewarded at the end with lots of squishy baby pictures!

My sister-in-law, Carmen, arrived Monday, September 26th.  Before she arrived, I had been so worried about how we would handle things on our own if Katie decided to come a little early.  With my due date at September 30th, we knew we were cutting it close with her arriving on the 26th, but Gabi was 10 days late.

Still I worried.  I talked to my midwife, Sue, about it.  She gave us a few options, which helped to set my mind at ease.  We could switch from a birth center birth to a homebirth, but because of Juan’s discomfort, that wasn’t a really viable option.  We could bring Gabi with us to the birth center, but I wasn’t very comfortable with that option either.  I worried that with Gabi there, I would want to spend time comforting her instead of focusing on having Katie.

Eventually, we got a solution figured out.  If Katie started coming at night, we would take Gabi with us to the birth center.  Juan would hang out with her until morning, and then her teacher would come pick her up and take her to school (a home daycare) where she would stay until Katie was born.  If Katie started coming during the day, we would let her teacher know, and Gabi would spend the evening at school with her teacher’s family.

Thankfully, Katie decided to stay put until Carmen arrived on the 26th.  I truly think that my body listened to my need to have everything lined up with Gabi’s care, though, because in the wee hours of the morning on the 27th, I woke up with powerful contractions.  I knew this wasn’t a drill.  This wasn’t my body getting ready.  This was it.

I went downstairs and hung out with Carmen for a while.  I sat on the birth ball, hung out, and chatted.  She was jet-lagged so she and I stayed up watching Say Yes to the Dress while things moved along.

At 4:45 AM, I texted our Doula and called Sue to let her know that I thought things were moving.

At some point, I woke up Juan and let him know that this was the real thing.  Can you believe that he thought I was mistaken?  Oh, no.  “Honey, I’ve already called Sue and Jessicka.  This is for real.”  I hung out a while longer, texted our doula and called Sue again, and took a shower.  By that time, it was time to go in to work.

Juan said he wanted to try to work for a few hours in the morning (ha!), but I told him that he needed to drop off Gabi at school and come straight home.  He tried to argue, but believe me when I say that you do not win an argument with a woman in labor!

At 8 AM, as they left, I called Sue and Jessicka again to let them know what was going on.  Sue suggested I hang tight for a bit to see how things progressed.  I told her that when Carmen and Juan got back I needed to come in to the birth center because we would get to a point where I was not going to be willing to go anywhere.

So that was it.  I knew exactly what was going to happen.  Interestingly enough, this was exactly what I had imagined in my hypnobabies birth visualization!  I visualized that Carmen would arrive, I would go into labor the next day while Gabi was at school, and Katie and I would be back at home in time to welcome Gabi home from school.  So far, things were going just the way I visualized.

It was around the time I made that realization that the contractions started getting a lot more intense.  I couldn’t talk through them.  I started to feel the need to vocalize a little bit by groaning during them.  I started listening to my birthing affirmations hypnobabies track.  (In retrospect, I should have done this right away instead of waiting until later.)

Oh, ha ha to Mr. Juan for trying to tell me this wasn’t really it!

Juan and Carmen returned shortly after taking Gabi to school, and I instructed them on putting together our cosleeper (I will describe that in a separate post).  They got the furniture moved and set up, and that was it!

At 9:30 AM, we called Sue and Jessicka, hopped into the car, and headed for the birth center.

Once we got to the birth center and got settled in, it seemed like things had slowed down.  Juan put the Easy First Stage CD in the CD player, but I wasn’t paying much attention.  I sat on the birth ball while Jessicka rubbed my lower back.

At around 10:15, my contractions were still spaced out a bit (6-10 minutes apart), and Sue suggested that Juan and I take a walk around the neighborhood.  Since things had slowed, Jessicka went across the street to check on another mom who was in labor.  I didn’t really want walk, but I went ahead and agreed to.  We walked.  Every few steps, a contraction would hit and I would need to hug Juan and groan a bit.  It was hot.  The sun was bright.  We walked down the sidewalk, across the very small parking lot, and I said, “Forget this.  I want to go back inside!”  So we did.

I was not a happy camper at this point.  I laid down on the bed where things became much more uncomfortable and painful.  Damn if it didn’t hurt!  But it seemed like the contractions were stronger laying down, so I stayed on my side.  Truth be told, I just didn’t want to move.

My contractions were still really far apart, so I sent Juan to Trader Joe’s to get me some snacks.  Davie, one of the other midwives, arrived during this time with a smoothie.  It tasted like hell, but I tried my best to drink it.  If my blood sugar dipped, I might start getting sick again and that was the last thing I wanted.  Carmen hung out with me and held a hot rice sock on my back.

By 10:50, my contractions were every 4-6 minutes apart and really intense.  With every contraction, I would holler down the hall to Sue, and she would come running in to hold my hand.  At the time, it seemed like I was shouting at her in a really demanding way, but later she told me that I just sounded lost like I was calling to her for help.

It was at this point that I started to freak out a little.  I asked Sue to check how dilated I was because I was really losing hope.  She encouraged me to wait just a bit.  At the next contraction, I started cursing and I hollered down the hall, “Where the HELL is Jessicka!”  “I’m here,” she said, “Right here!”  She had just come back.

It was 11:15 by now, and suddenly everyone was back.  Juan was back, Jessicka was back.  Sue, Dawn, and Davie (all 3 midwives were there), and dammit I wanted Sue to check me.  I know I said I didn’t want to be checked, but I wanted to know that something had been happening.  I was pissed, scared, I hurt, and I wanted to know what the deal was.

We waited through another contraction, and then Sue checked me.  I was at 9 cm with a bulging bag of waters and -1 station!  Well, that explained a lot!  I had been in transition!  No wonder I had been feeling so awful!

Hot damn! Davie, fill the tub!  Let’s have us a baby!

The wave of confidence and relief I felt when I heard I was almost completely dilated was incredible.  Suddenly I went from freaking out to ready to get down to business.  Sue was surprised as well.  My contractions were really strong, but they were so widely spaced that she was expecting me to not be nearly where I was.

They got me out of the bed and onto the toilet so I could pee before I got into the tub.  I remember getting up off the bed I told Jessicka, “Okay, I’m going to get up and then I’m going to hit the floor.  I’m not falling down, but a contraction is about to start and I need to be on my hands and knees.”  It helped. I had a few contractions on the toilet, and I did not want to be touched.  Walking from the bathroom to the tub, I went to the floor with each contraction.  But then at 11:30, into the tub I went!

When I finally got into the tub, Dawn put in the Pushing Baby Out Hypnobabies CD.  I wasn’t really ready to push.  The contractions were really painful and I just didn’t feel the urge to push.  The bag of waters was really in the way, and caused quite a bit of discomfort!  Thank goodness for the water though.  It helped immensely.

Sue suggested doing some gentle pushes with the next contraction to see if that would get my water to break.  I tried.  Really, I did.  But it hurt and my heart wasn’t in it.  She checked me again, and I was almost totally dilated except for an anterior lip.  The bag of waters was pushing so hard and was so uncomfortable with every contraction that I asked her to go ahead with the AROM.  A few contractions later, she was ready with the little hook thing, and during my next contraction, she broke my water.  This was 11:56 AM.

Now I was ready to get down to business!  At 12:05, my body started pushing and I started pushing, too.  Sue and Dawn really let me do my own thing.  They didn’t try to direct my pushing or my breathing and they allowed me to trust my body to do what it needed to do.

And now I really started vocalizing.  I was actually not aware that I could make sounds like that!  I think I sounded like a cow!  I grunted and groaned and growled.  In retrospect, I feel a little embarrassed about it, but nature really did take over, and I was just along for the ride.  I really think that the Hypnobabies practice was helping me to allow my body to do what I needed to do.

I pushed for a few minutes, but I was kind of on my back.  I remember at one point reaching down and feeling her head.  I felt a ridge and was really worried that the cord was getting pinched.  Sue checked between contractions and reassured me that the ridge I felt were the plates in Katie’s skull compressing as she moved through my pelvis.  Our bodies were both doing exactly what they were supposed to do.

I was having trouble pushing.  I was sitting up, but I had slid down a little so I was reclined a bit, and that made things more difficult.  Sue tried to get me to curl around Katie more to help push, but I had a hard time doing that.  I just kept sliding down in the tub, and my motivation to move was nonexistent.  If there were a next time, I would tell Sue to zap me in the butt with a cattle prod.  I think it would’ve been easier if I would’ve been in a different position.

I think at some point I yelled at Dawn (or Davie?) to shut off the CD.  The noise was bugging me and I wasn’t paying attention anyway.

Around the time that Katie started to crown (or maybe before?) Sue reached down to see if some perineal massage would help give some comfort, and she had only barely touched me when I screamed at her, “DON’T TOUCH ME!”  Which in retrospect is kind of funny since I had written into my birth plan that I definitely wanted her to do that.  It’s amazing how your body tells you what you do and do not need.  I could feel myself tearing a bit, and when she laid hands on me (gently I might add!), it just intensified the feeling.

Again, I surprised myself by how I was able to vocalize.  I was able to tell my birth attendants what I needed without feeling too shy to do so, and I was able to allow my body to make the noises it needed to help push Katie out.  A few times I felt myself panicking and the pitch of my sounds would rise up into a higher register.  Each time that happened, it seemed like Sue or Dawn would get my attention very gently by laying a hand on my shoulder and quietly saying my name.  And I would bring my voice down into the low, belly sounds.  Keeping my voice low and deep helped me to feel more in control and helped keep the pressure low in my belly to help me push.  I think the Hypnobabies class really helped me to feel comfortable using my voice during Katie’s birth.

Katie crowned pretty quickly, but she didn’t come out all in one push.  Her head stuck out under the water, and Sue said, “You need to get up out of the water now.”  Something about the way she said it motivated me, and Juan and Jessica helped me to stand up.  I think Sue was expecting me to get all the way out of the tub, but as soon as I stood up, I had another contraction, and… BLOOOP!  OUT SHE CAME!

(For those keeping track, the time was 12:24 PM)

Sue made it around in time to catch her, and half a heartbeat later, Sue was passing her between my legs for me to hold.  At first I felt really confused and I didn’t want to take her.  I couldn’t really figure out what had happened, but I reached down and grabbed her because Sue was telling me to. As soon as she was in my arms and I felt her weight the confusion lifted, and I realized who she was and what we had just done.

And we sat down for a good snuggle in the tub.  It was the most amazing feeling.  It told Juan later that it was about a hundred times harder than running a marathon.  It was like I had walked through fire and come out a new person.  It was amazing.

Bless her, little Katie was such a little cuddle bug!  I just held her and cuddled her and a few minutes later I nursed her and I cuddled her some more.  It was awesome.  She was so warm and soft and covered in vernix (sorry about your shirt Sue!).  She was so alert, too!  She just looked around quietly taking everything in.

Sue, Dawn and Jessicka were making bets on how big she was.  To me, she just looked like a squishy newborn, but apparently she looked pretty big.  Sue bet that she was 10 lbs 11 oz and Dawn bet that she was 10 lbs 6 oz.

We waited quite a while in the tub.  In my birth preferences, I wanted to wait for the cord to stop pulsing before we cut it, and it pulsed for a long time!  It was a big, strong placenta!  Finally, at 1:04 PM, it stopped pulsing.  We clamped the cord and Carmen cut it.  Juan was too squicked out to do that and I was high up in Happy Babyland.  So Carmen got the honors.

Katie kept trying to kick the scissors, so I had to hold her leg still.

When my body started pushing the placenta out (1:15), I remember groaning and saying, “Why?  Why won’t it just leave me alone?”  But we got that done, too.  Apparently it was a huge placenta, and I got a nifty placenta anatomy lesson from Dawn a little later, which was very cool.

Sue and Dawn gave me plenty of time to relax and snuggle with Katie.  When they did the newborn exam and weighed Katie, it turned out that no one had been right about her weight.  She was 11 lbs!  Eleven.  She was huge!  She was the 3rd largest baby Sue and Dawn had ever delivered and the biggest Jessicka had ever assisted with!

Weighing Katie. She's almost too heavy for the scale!
What a little beast!
Relaxing before the newborn exam
Cuddles from Papa

I had to get some stitches. I was pushing like the blue blazes, and she was 11 lbs after all.  But Sue got it done quickly.  By 4 PM that same day, we were home and settled in.

Going to bed for the first time
Gabi meeting Katie for the first time

A few days after she was born, Juan said, “Are you ever going to stop bragging about how big she is?”  Nope!  I had an 11 lb baby without meds!  I feel like superwoman!  Sometimes I wonder if I’m still riding high on the hormones from Katie’s birth!  No, by now it’s just the oxytocin from nursing that keeps me feeling so good!

It was an incredible experience.  9 hours of labor start to finish. 20 minutes of pushing.  One enormous and beautiful child.  Who could ask for more?  Juan was awesome.  My midwives were unbelievable. Jessicka was incredible.  I think I had the best birth team on the planet!

Gabi and Carmen making a Thank You Cake for Sue, Dawn, and Davie
Sue and Katie at my 6 week postpartum check

Baby Katie is Here!

I am quite delayed in posting this.  It’s been a little hectic around here.

On September 27, 2011 at 12:34 PM Baby Katie was born.  She was born in the water at the birth center without the use of drugs and weighed 11 lbs.  That is not a typo!

She’s absolutely wonderful.  Big Sister is doing quite well with everything, too.

I will write more later.  We’re very much in the hectic newborn stage, so I appreciate everyone’s patience.

“Old Wives’ Tales” to Induce Labor

I love old wives’ tales.

Sure, some are a little silly.  For example, you shouldn’t lift your arms over your head or you’ll strangle the baby with the umbilical cord.  Or another favorite is, if you take a bath your baby will drown in your belly!  Those are quaint, amusing, and completely untrue.

But for every very silly old wives’ tale, you can find one with a grain of truth.  Old wives’ have been making and having babies for thousands of years.  It stands to reason that they’d have some pretty decent ideas.

For fun, I thought I’d come up a list of old wives’ tales for inducing labor.  No, I’m not trying to induce labor.  I’m doing my best to remain lovingly patient and let my baby choose her own birthday just like the Hypnobabies program coaches me to do.  But it sure is fun to look at this stuff, isn’t it?  As an added incentive to avoid trying these, we tried just about every natural method we could to get Gabi to come out, and she stubornly stayed in there until she was darn well ready to come out.  Two weeks after her due date!  So again, this is just for fun.

So here are some natural, old wives’ tales for ways to induce labor:

  • Walking – This is actually really good for you and can help the baby move into position and begin to descend.  Just don’t wear yourself out walking.  Take it from me, if the baby’s not ready, no amount of walking will make her come out, and if you overdo it your body will punish you for it later.
  • Walking up and down stairs – same as walking!
  • Driving over a bumpy road – I had zero luck with this with Gabi despite my mom driving me up and down a cobblestone road in Old Town.  This gets a big meh.
  • Eating eggplant parmigiana – Something about the oregano?  Eggplant does not agree with my stomach.  I skipped this one.
  • Eating this special salad from a place in LA – I am so trying this!  Apparently, the salad is actually really yummy, so I plan to try to sweet-talk my sister-in-law into driving us down for lunch next week.  A friend of mine tried it with no luck, but still.  Just for fun, eh?
  • Sex – Okay, now this one is something that my OB with Gabi recommended and something that my midwives are recommending as well.  Apparently semen contains proglastins which help trigger the cervix to begin soften.  Additionally, the female orgasm can trigger uterine contractions.  More info here.
  • Bouncing on a birth ball – Kind of like walking.  The birth ball can also help open the pelvis to allow the baby to settle comfortably in position.  Birth balls rock.  Maybe not so much for inducing labor, but for getting comfy and getting the baby positioned correctly.
  • Castor Oil – This is a huge one that a lot of people try.  Here’s why I think it’s a terrible idea: think horrifying diarrhea and nausea and puking and stomach cramps and just generally feeling awful.  Is this really how you want to start your birthing time?  No thanks!  I’ve had enough of that with the HG!  Plus, you’ve got the very real risks of dehydration from the diarrhea and vomiting and fetal distress!  Just say no!  That’s my opinion on this one!
  • Nipple Stimulation – Nipple stimulation causes a release of oxytocin which, in turn, causes uterine contractions.  I tried this a bit with Gabi, and yes, it did cause some contractions, but they weren’t terribly productive.  My OB at the time actually recommended against this tactic cautioning that in his experience it will cause contractions but those contractions are hard and not very productive.
  • Herbal supplements – This is something to approach with caution.  Herbs can carry some very real risks.  I am currently taking an herbal supplement that contains several of these “inducing” herbs (black cohosh, red raspberry leaf, etc), but I am doing so under the guidance of experienced midwives and taking them in very specific and careful amounts designed to tone the uterus, not bring on labor.  I’m not just glugging cohosh tea or pills.  So if you are interested in some of the herbal remedies, do your research and only take them under experienced guidance.  It’s really not worth the risk otherwise.
  • Evening Primrose Oil – Evening primrose oil (EPO), is not going to induce labor.  It will, however, soften and ripen the cervix.  Again, like any kind of supplement, talk to your healthcare professional about this.  EPO is pretty benign, but only you and your doctor know your medical history.
So what old wives’ tales have you heard of for inducing labor?  Did you try them?  Was it successful for you?

My Current Medicine/Vitamin Regimen and the Finalized Birth Preferences

The Med/Vitamin Regimen

It’s been a while since I’ve updated you all on what I’m currently taking med-wise.  The good news is that right now the vitamins are outnumbering the drugs.  Hooray!  This means I can keep down vitamins!

Remember: I am taking all of these under the very specific guidance and direction of my midwives.  With any vitamin or medicine you need to consult your medical care team before starting.  Some of these interact with each other and must be taken on a specific timetable.  Always ask before taking a medicine, vitamin, or herb.  Especially if you are pregnant or nursing!

So, without further ado, here is what I’m on:

Drugs:

  • Nexium 20 mg – 1 tablet at night
  • Zofran 8 mg ODT – 1 tablet before rising in the morning

Vitamins/Herbs:

It’s a lot of pills and tablets to swallow, and I’ve really had a hard time remembering to take everything.  I noticed, though, that when I miss doses my body lets me know.  When I forget the cal/mag/pot I get horrible leg cramps at night.  When I miss the multivitamin and the iron I feel dizzy and out of breath.  Or at least more dizzy and more out of breath than usual.

To help me remember to take these, even when I’m out and about, I’ve started putting the day’s worth of vitamins into a little plastic gladware cup.  I toss the cup into my purse, and wherever I happen to be at vitamin time, I can break out my little plastic cup-o-vitamins and start swallowing pills.

Taking my meds and vitamins every day at the correct time has really helped improve the way I feel both physically and emotionally.

 

The Finalized Birth Preferences

In other news, we got the results back from my group B strep test which allowed us to finalize the loose ends of the birth preferences.

The test came back… NEGATIVE!!!!!!!!

I could not be more thrilled.  This makes things so much simpler.  No needles, no IVs, no extra stuff to fiddle with, and no need to put the gunk in the baby’s eyes.  We did find out that we did have a relative with a clotting disorder, so the vitamin K shot for her is back on.

I provided individual explanations in my original post on the subject: Writing My Birth Preferences, so if there’s something you wonder about, click on over to that post for the reasoning behind each item.

So, with that, here is the finalized version of our birth preferences:

  • I don’t want to know baby size until after she’s born.  
  • I don’t want to have internal checks until I am ready to push.  
  • Please feel free to suggest position changes! 
  • Please avoid using the word pain.  
  • Please no AROM.
  • I would like to birth my baby in the water.
  • Please no purple pushing.  
  • For the baby:  Yes to the Vit K shot.  No to the eye drops.
  • Please delay cord clamping.
  • I would like an unmanaged 3rd stage if at all possible and deliver the placenta on my own.  Would also like to avoid the shot of pitocin unless it’s really and truly necessary.

We’re ready to go.  Aside from a few general items like converting the crib into a cosleeper, installing the carseats, and remembering that I will need shirts and pants in the bin I’m packing to go to the birth center, we could have this baby tomorrow and we would be just fine!

So close!

Writing My Birth Preferences

This is one of those posts that I’ve actually been pretty excited to write about.  Birth preferences!

Writing out my birth preferences this time around is so different from writing my Birth Plan from when Gabi was born. 

The hospital where I had Gabi provided a template, so I based my plan off of that so that I could give them information in a format with which they were already familiar and comfortable. 

With the hospital birth, there was so much more to worry about.  The Birth Plan, while certainly not adversarial, was much more of a defense against unnecessary interventions.  I had to specify things like no episiotomies, no continuous internal monitoring, give the baby to me immediately instead of delaying with newborn procedures, don’t give the baby formula or pacifiers, etc.  Even using the format provided by the hospital, the Birth Plan was very much a defense for Gabi and I against the standard protocol of the hospital.

I don’t have to do that this time and it’s blowing my mind!  All of those things I have to prepare for and defend against?  Those are things that my midwives don’t do anyway.  This notion of having my midwives working with me as a team that I already know and am totally comfortable with as opposed to a nurse I’ve never met who may or may not respect my right to informed consent is just incredible.

I’m not The Patient in Room 326.  I’m me.  They know me, and they respect me as an individual.

Because of all of this, my birth preferences are much shorter than they were the last time around.  I’ll list them here, and include my reasoning for each one.  The preference itself will be bold, and I’ll follow with the reason behind it to make it easier for you to skim.  If there’s something that’s not on this list that you’re curious about, let me know and I can talk more about that item and why I didn’t include it.  I promise I’ll be better about responding to my comments this week.

So, without further ado…

My Birth Preferences

I don’t want to know baby size until after she’s born.  No estimates please.  I know I can birth her “big” or not.  Baby size estimates can be off by more than a pound, and since I’ve already had a baby vaginally, I know that I don’t have a pelvic issue that would prevent my pelvis from opening to allow the baby to pass.  At 8 lbs 6 oz, Gabi came out at a pretty respectable size.  Women have “big” babies all the time.  It’s just not something I want to have to worry about.

I don’t want to have internal checks until I am ready to push.  Last time, knowing that I was walking around for a month at 3 cm weighed on my mind, and when I got to the hospital I found I was “only” at 5 cm.  Knowing this just shattered my belief in myself, so I’d just rather not know.  Realistically, it’s perfectly possible to go from 5 cm to 10 cm in an hour or less.  I know this rationally, but emotionally, those kinds of cold, hard numbers can be disheartening.  If I’m in active labor, I have faith that my body is doing its job in its own time. 

For those of you who may be considering this as a preference, you may encounter a health care provider who just really wants to start doing internal checks once you reach a certain number of weeks.  They may do this just out of habit or they may tell you they need to “establish a baseline.”  This is completely bogus.  The baseline for dilation is… not being dilated at all!  This isn’t a subjective thing.  You’re either dilated or not.  This is a measurement on a ruler.  There is also absolutely nothing you gain from knowing this number as it will give you no indication of when you’ll go into labor.  You could go from 0 cm to 10 cm in the space of 8 hours.  Or you could walk around dilated to 3 or 4 cm for weeks.  There’s no value in knowing this number, and every time someone reaches up in there you deal with risks: introduction of bacteria, accidental rupture of membranes, the temptation to strip your membranes without your consent, etc.

So no thanks on the internal checks for me!

Please feel free to suggest position changes!  I tend to freeze up when I’m in an unfamiliar situation and don’t know precisely how things are going to go.  I know that everyone says your body will tell you what to do when you’re birthing, but I really do tend to freeze up.  I’m so glad to have a great doula and team of midwives who will be willing to make recommendations if they notice me getting stuck.  Last time I felt like I just sat on the bed and didn’t know what to do.  I asked for the epidural so quickly that I didn’t really get the chance to see what my body would tell me.  I’m just not sure what to expect, so I’m very open to suggestions!

Please avoid using the word pain?  Instead, I prefer to talk about things like “intensity” and “pressure.”  This is a Hypnobabies thing.  In so many of the Hypnobabies birth stories, it seems like the mom is doing great until a nurse comes in and asks about pain level.  Then, suddenly, she loses her focus and starts feeling out of control.  Since “pain relief” in the form of medication really isn’t an option, I just prefer not to visit this area at all.  We can use words like “intensity” and “pressure” instead.

Please no AROM.  AROM stands for Artificial Rupture of Membranes.  That’s when they go in and manually break your water.  There are about a gillion reasons why this is not a very good idea, but rather than list it all here, I’ll simply refer you to this article from Midwife Thinking in Australia: In Defense of the Amniotic Sac.

I would like to birth my baby in the water.  That’s right!  We’re planning to have a water birth!  There are many reasons why water birth can be a great option:

  • The warmth from the water serves as a natural way to ease the discomforts of labor.
  • The weightlessness that the water provides allows women to move and change positions easier.
  • The water helps to soften the tissues allowing the perineum to stretch more easily to accommodate the baby.
  • The warmth of the water provides a much more gentle transition for the baby from the womb into the outside world.

I’m just really pleased to have the opportunity to use the birth pool at the birth center to have this baby.  I know this will help me so much during my birthing time to stay comfortable and composed.

GBS+:  I’d like to get the IV line placed and the antibiotics run as fast as possible.  Then I would like to have the line pulled completely.  I just don’t want an IV hanging off me.  They’re distracting and upsetting to me right now.  I don’t know for sure if I am GBS+ (group B strep positive), but I’m operating under the assumption that I am.  This way, if I am, I won’t feel disappointed, and if I’m not I can feel pleased about having one less thing to deal with.  I am also exploring the options of hibicleanse during my birthing time to help with this.  It’s a bit up in the air at this point, but since I don’t know if I have group B strep or not, I think that’s okay.

Please no directed pushing.  I would like to follow the signals of my body and allow it to do its work gently and naturally.  Also please don’t count while I push or have a contraction.  What I’m really trying to avoid here is “purple pushing.”  That’s where you hold your breath and pushpushpushpushpush until they tell you to stop.  This can reduce oxygen flow to the baby, and it’s really exhausting.  On top of that, this kind of hard pushing can cause tearing as the baby moves too fast down the birth canal.  So I just don’t want to do it.  My body will tell me when to push.  We’ll just listen to that and go with the flow.  In Hypnobabies, we learn about “Aaaahing” the baby out.  That’s just what I intend to do.

Please delay cord clamping. Since we donated Gabi’s cord blood, delayed clamping was not an option for us.  This time, however, we won’t donate the blood.  Instead, we’ll be allowing all of our baby’s blood supply time to move from the placenta into her body.  According to this article, around 21% of her blood is in the placenta.  She needs all of that iron- and oxygen-rich blood.  It’s hers.  I often wonder if some of Gabi’s early sleepiness and weakness during nursing would have been helped by delaying the cord clamping.  For this baby, we’ll wait until the cord stops pulsing, and then we’ll clamp and cut the cord.

For the baby, no Vitamin K shots and (if I am not GBS+) no eye drops.  Vitamin K shots are really only needed if your family has a history of blood clotting disorders.  That’s not an issue for us.  Unless the baby comes out with significant bruising, there’s no reason to give this shot.  The eye-drops are only needed if the mom has chlamydia.  They’re also recommended if the mom is GBS+.  I definitely don’t have any sexually transmitted diseases, so as long as I’m not GBS+, there’s no need for the eye goop.

I would like an unmanaged 3rd stage and deliver the placenta on my own.  Would also like to avoid the shot of pitocin unless it’s really and truly necessary.  The 3rd stage of labor is the part where you deliver the placenta.  During a managed 3rd stage, the healthcare providers may tug on the cord or “massage” the mom’s belly to help the placenta come out more quickly.  The “massage” is pretty forceful and brutal, so banish the thought of a comfortable, relaxing belly massage.  Picture instead people shoving against the mom’s belly with all their strength to manually push out the placenta.  Really unpleasant.  The cord pulling and the “massage” can also cause increased bleeding, hemorrhage, and the risk of the placenta breaking up and leaving pieces behind.  Hello infection!  I’ll pass.  The pitocin shot is something to help curtail bleeding.  If I’m not bleeding heavily, I’ll just skip that as well.  As they say, “If it ain’t broke, don’t fix it.”

 

Those are my birth preferences.  It’s a fairly short list.  I’ll be talking about these with my midwife at my 36 week appointment later today.  It’s so refreshing not to have to worry about defending myself against unnecessary hospital policies.  I love that I am included as a member of my own birth team this time around.

Look what came in the mail this week!

I went ahead and ordered the rest of my JustFussy cloth pads.  Remember, these were the awesome bamboo velour cloth pads I was trying out to see if I wanted to use for postpartum.  And remember how I fell in love with them?

Well, I ordered enough for postpartum, and they arrived on Thursday!

Aren’t they gorgeous?  And that bamboo velour is so, so soft.

And feel free to admire the quilt below as well.  My mom made that!  Nice, eh?  Love those batiks!

So here is my cloth pad count right now:

All in the most gorgeous colors!  I love, love, love those deep, saturated colors.

She was also sweet enough to send me an extra wool-backed panty-liner as well.  I love the wool backing.  For some reason, it stays much cooler and feels more breathable than a cotton-backed liner.

Depending on how often I find myself doing laundry, I’m hoping that this will be enough to cover my postpartum needs.  I don’t remember how much lochia I had to deal with last time, but Christy’s got a fantastic turn-around time.  If I need more, I can always order more!

One more thing I can check off my to-do list.

World Breastfeeding Week – What am I doing to prepare to breastfeed the new baby?

Gabi and I did not have an easy start to our breastfeeding relationship.

My milk was slow to come in (thanks pitocin).  She struggled with latch due to flat nipples.  I got engorged.  Then I got mastitis because she wasn’t able to latch to remove the milk.  I didn’t know enough about pumping and thought that the milk I was pumping was “not real milk” because of the whole not-coming-in thing so I dumped what little I did pump.  Gabi got dehydrated (no poops, no wets over a couple of days)  so we supplemented with formula through a bottle and then through a supplemental nursing system via finger-feeding.

Then, right as she was starting to latch, I got thrush, which took forever to figure out because Gabi never showed signs.  It was all in me.  By then, my milk supply was almost gone, so I essentially had to relactate.  The Boppy nursing pillow that I got was sliding all over God’s creation, so I was trying to hold the pillow in place, hold the baby, deal with the stupid nipple shield, get the baby latched, keep the baby latched, ignore the agony in my back (thanks epidural), and just fight fight fight fight fight.

Meanwhile, the “help” I was getting from hospital “lactation consultants” was vague and not helpful.  We could manage to nurse in the office, but not once we got home.  And when I would call for help they wouldn’t call me back.

It was a really difficult time.

Finally, we managed to turn the corner at around six weeks.  I ditched the Boppy for the My Breast Friend pillow (they’re WHO code compliant and the BEST nursing pillow on the market!), I threw the nipple shield across the room, I found the kellymom.com forums where I could get some real help, and suddenly Gabi was alert enough and started latching and nursing.  I also dropped in to a local baby shop that had an IBCLC on staff, and she proved to me that I actually had milk by doing pre- and post-feed weighs.  Having this confidence is what ultimately saved our nursing relationship.

Gabi’s latch was never great.  I think the nipple shield had a lot to do with why.  But we managed.  She was exclusively breastfed from 4 and a half weeks until she was a little over 8 months old.  As she grew older, her perpetual bad latch became worse, but she got enough.  I’m so proud of the fact that I managed to nurse her for 3 and a half years, and I’m so grateful that those resources (seriously! the pillow ruled!) all came together at the same time.

I was so lucky.

This time, I don’t intend to leave things up to luck.

What am I doing differently this time?

Unlike last time, I have developed a network of support.  I co-founded a Lactation Support Group at my workplace, and I know that I can reach out to my co-leaders for help if I need it.  I’ve also become an active member of the Kellymom.com forum community.  I cannot say enough good things about this community.  If you’re interested in nursing or plan to nurse or are thinking about it, join this group.  This–and the Kellymom.com website of course–is hands down one of the best resources out there.  Don’t bother buying a book.  Go to Kellymom.  The information, compiled by Kelly Bonyata, BS, IBCLC,is accurate, carefully vetted and moderated, and evidence based.  It is truly second to none.  

I’m also planning an unmedicated birth.  The IV fluids and pitocin were both, I believe based on several years of reading up on it, at least partly responsible for my severe engorgement and the delay of my milk coming in.  The terrible back pain I suffered was, in large part, from the epidural.

I know now, having observed the way my body reacts to these interventions, that they are harmful to my ability to breastfeed.  To promote the gentlest and least invasive birth possible, I’m using the Hypnobabies childbirth method and birthing at a birth center with the help of midwives and the support of an experienced doula.  Based on my experience and research, I believe that these and other birth choices I’m making will help our breastfeeding relationship to have the best possible start.

In addition to surrounding myself with accurate information and having a natural birth, I will have personal support from my midwives.  They’ve got extensive experience helping moms and babies get off to a good start with nursing, and I will not be cut adrift once I go home.  They will visit me in my home the day after the baby is born to check on both of us.  Following that, they will call daily and be available for me to call if I need help.

I’ve also found a local La Leche League group and I will begin attending meetings starting this month!

I know so much more now than when I was pregnant with Gabi.  Now I don’t say, “I hope to breastfeed.”  This time I know that I can.  It is simply what we do in our family.  I know that if I run into difficulties that help is a phone call or keystroke away.  Whatever we may stumble upon, we will overcome.  Just like Gabi and I did.

***

celebrate-wbw-npn-450

I’m celebrating World Breastfeeding Week with Natural Parents Network!

You can, too — link up your breastfeeding posts from August 1-7 in the linky below, and enjoy reading, commenting on, and sharing the posts collected here and on Natural Parents Network.

(Visit NPN for the code to place on your blog.)

Birthing Positions and Water Birth Positions

I’m going to be sharing a full write-up of my birthing preferences a little later, but I wanted to take some time to talk about birthing positions.  This is a really important aspect of birth.

What you see in movies?  The woman flat on her back, legs up in the air, yelling her head off?  That’s a terrible way to push out a baby.  This position actually closes the pelvis off and forces the woman to push uphill.  No part of that is good for childbirth.  There’s only one reason to birth a baby in this position: to make it easier for the doctor.  You know, he doesn’t have to bend down that way.  He can sit on the chair or stand up.  Much more comfortable for him, right?  And that’s what’s most important after all: making sure your doctor is comfortable.

Before I go into this further, take a look at this article that lists the pros and cons of different birth positions.  Scroll down to the bottom to read the pros and cons of birthing on your back with your legs in the air.  Do you notice anything?  There are no pros for this!  That’s right.  There’s nothing good about this.  Only cons.

So you might gather from all of this that I want to push our baby out in a position other than flat on my back.  Honestly, I’m not sure how I will want to birth the baby.  On all fours?  Squatting?

I very much intend to use the birth pool.  So how does that work with birthing positions?  Honestly, I have no clue!  With Gabi, I had an epidural.  I was paralyzed from the waist down.  I was, you guessed it, flat on my back with my legs up in the air.

I have a hard time doing things if I can’t try it out ahead of time, or at least visualize it.  It’s why I never asked to use the squat bar at the hospital before getting the epidural with Gabi.  It’s why I asked my midwives to let me try out the birth stool during my second appointment.  It’s why I really, really need a doula.  If I’m not sure how to do something, I just freeze up.  I’m not sure why.  I just do.  So this is why I’m trying to familiarize myself as much as possible with water birth and various birth positions.

Like they say in my hypnobabies course, I’m having to retrain my mind to remove the flat-on-the-back, legs-in-the-air positioning from my concept of “normal” and replace it with a new normal which includes movement and various different positions.

To find out what birthing in the water looks like, I did some YouTube searching.  I’m going to post some links to some videos that helped me get some ideas on some of the different positions you can use if you’re in the water.

These are birth videos.  There is some potential for nudity.  I found the videos to be empowering and inspiring, but if you don’t want to see women giving birth, just don’t click the links.  And if you don’t want to see woman giving birth, but you click the links anyway?  Don’t come whining to me about it!

  • Here’s the first video I found.  It’s a home birth and a Hypnobabies birth (yay!), and she spends most of her birthing time outside the tub and only enters the tub to push.  Right around the 4:50-5:00 mark, you can really see the position that she is using to push her baby out.  She’s resting on her knees, leaning forward.  She actually partially stands up for the time when he was born.
  • Here’s one that is a photo montage.  She gets in the water at around 45 seconds in and from the look of it she’s on all fours, leaning forward against the side of the tub.  It’s difficult to tell, but it looks like she pushed her baby out in a seated position, leaning back against the side of the tub for support.
  • Here’s a third one.  This one is a hospital birth.  The dad wasn’t allowed to film during the pushing, but there are still photos and starting around 1:36, you can see that she’s seated, leaning back.  I also want to say that I love this dad.  He is so completely chilled out during this whole thing.  Completely calm and just allowing his wife to have a quiet, peaceful environment for her birth.
  • Here is a fourth and final one.  The thing that I find interesting about this one is how much the mother can move in the water.  She’s moving the entire time!

There seems to be an incredible variety in how women choose to birth in a tub.  I have to wonder if the water helps facilitate that.  I’m only 31 weeks, and already I feel huge and awkward.  I have to wonder if the weightlessness of the water allows them to move their bodies more easily for greater comfort during birth.

Seeing people actually giving birth in the water helps me so much to visualize what I want.  I think I may ever fill up our bathtub here at home at some point and do some of my Hypnobabies practicing in the water.  I really hope doing this kind of visualization and practice will help me to feel more confident during my birthing time.  I plan to talk to my doula and let her know that I do tend to freeze up.  I want her to be able to watch for this and give me a nudge if she sees this happening.  But I also want to find some empowerment on my own, and watching the women in these videos give birth really helps me to find that within myself.

Another Milestone! 30 Weeks!

Tomorrow, I will have made it to 30 weeks.  There’s something that feels nice and final about being in the 30s finally.  30 weeks is solidly third trimester.  30 weeks means I’m on the downhill slope.  30 weeks means I’ve only got 10 weeks left!

I had an appointment with the midwives today, and I got the opportunity to meet midwife #3.  I had met midwives #1 and #2 several times, but this was my first chance to meet midwife #3.  I really liked her.

For the most part, the appointment went as they usually do.  I weighed in (172.5 lbs) and then I got my urine dipped.  My numbers are still looking a little funky in my urine, but both midwives #2 and #3 said that because I had just eaten a bagel and had some juice for my Floradix, it wasn’t outside the norm.  It was just my body processing the sugars and carbs from the bagel and juice.  Midwife #2, who is an HG survivor, said that her numbers were strange her entire pregnancy.  The HG just messes up your body for a long time.

Then midwife #3 measured me and listened to the baby’s heartbeat.  Everything is measuring right on target for 30 weeks.  She also felt around on my belly to see if she could tell how the baby is positioned in there.  As it turns out, she’s currently laying sideways.  This would account for the increased pain I’m having in my pelvic bones and sciatic nerve.  Her feet are sticking out to my right, and her head is over on my left.  Midwife #3 explained that she is probably in the process of turning herself head down, and while there is plenty of room and time for her to go back and forth a few times, it’s likely that she’ll settle in head down and just stay that way.

I hope she finishes her acrobatics soon!  I am not living this side-lying position!  I swear I can feel her pointy little toes and toenails digging into the side of my uterus!  Ouch!

The pain in my pelvis really is pretty bad.  It’s bad enough that it’s been keeping me up at night.  It hurts to lift my legs and put my pants on.  Most of the pain is right where the pubic bones meet in front, but last night my whole sciatic nerve was aching and burning.  I asked for a referral to a chiropractor, so I’m going in to get adjusted and massaged this afternoon.  I’m hoping that will help.  Midwife #3 also suggested just a few cat/cow or pelvic rocks before bed.  That should move the baby up off of my bones and help through the night.

Since I am nicely into my third trimester, we briefly took the opportunity to talk about birthing options.  It’s so strange and refreshing to think that I don’t need to worry much about telling a nurse in the hospital what not to do to me or my child!  I don’t need to gear up for any strong advocacy.  Most of the things I want, like delayed cord clamping, are things that they do just as a part of their every day procedure.

I plan to do a full post on my birthing preferences to help readers who might be interested see the reasoning behind them, but for now, here are a couple of things that I mentioned to midwife #3:

  • Delayed cord clamping
  • No internal checks until I express a desire to push
  • Allow me to birth the placenta on my own without assistance
  • Low lights and quiet voices so I can focus on my hypnobabies techniques
  • Prefer, when possible, for everyone to use the hypnobabies terminology to refer to my pressure waves, birthing time, etc

She was great about it.  She listened, took notes, and generally did not make me feel silly for asking about this stuff.  It’s just really cool that I don’t have to put in big bold letters anywhere NO EPISIOTOMIES!!! and just hope and pray that the doctor on call remembers to look at my birth plan.

It’s just so much more… peaceful with these midwives.

I’m not saying that to knock doctors.  Not at all.  My OB with Gabi was wonderful!  It was a great birth experience and he could not have been more supportive.  And of course, Dr. Awesome is, well… she’s awesome!  The birth center and midwifery practice just has such a calm, quiet vibe.  No beeping machines, no harsh lights, no weird smells, no people barging in and out.  It’s just a completely peaceful and nurturing environment.

We also talked about birth kits and what to bring to the birth center.  She gave me an order form for the birth kit (pads, some herbs, gloves, etc) and a list of other things to pack to bring with us.  The birth kid needs to be ordered and in hand by 37 weeks, which is right around the corner.  Pretty exciting!

And as a bonus, as I was making my next appointment, a brand new mom came out with her baby girl who was born just today in the very wee hours of the morning!  She had wanted to lay still and sleep for a while there at the birth center, so instead of driving home in the middle of the night, they stayed.  It was amazing to see how tiny and perfect that brand new baby was!  I forgot just how small they actually are!

All in all, it was a great appointment.  We’ve gotten past the anemia scare with the Floradix doing a wonderful job at bringing up my iron, and I’m doing great!  You know.  Aside from the HG.  And today has been a 2 Zofran day.  One before bed and one after breakfast.  10 more weeks.  10 more weeks.