When's Your Due Month?

So often we hear the words, "When's your due date?" Very common is the desire to know when a woman will birth her baby. It is also general knowledge that babies don't always come on their due dates. Although most people know this, they doubtfully know the actual physiology behind when and why a woman begins labor. I read a fantastic short article today on Pushed Birth's website from Jennifer Block. She wrote the fantastic book "Pushed" that candidly explains what is most likely to happen to the average woman when she enters a US hospital to give birth.

I feel like we live in a society where everyone wants to know exactly when things are going to happen because there's not enough time in the day for wasting. The problem is that birth, by no means, is something to be determined exactly. Birth in normal, healthy women and babies is supposed to happen on its own without intervention. But that hardly happens anymore. We talk (and are talked to) about our due date or our friend's due date or whoever's due date. If the baby comes at 38 weeks it's considered early. If the baby comes at 41 weeks it's considered late. The reality, physiologically, is that babies are full term at 37 weeks and are usually born somewhere between 37 and 42 weeks. Someone decided (and I want to know who) that a woman's due date is 40 weeks from the first day of her last period. But that date, by no means, circumstances, common sense or understanding of the human body should determine the readiness of the baby to be born. Sure, the baby has developed and will survive outside the womb. But more importantly, your body and your baby are in sync and they both know when it's time for labor to begin. This is the reason why all babies are not born on exactly the first day of the 40th week!

Many OBs start pushing women after they hit 40 weeks to induce labor. It is true that certain risks increase after 40 weeks, but there are so many variables to consider in the equation of when a baby is overdue and will not be safely born. In the heat of the pregnancy-almost-being-over moment, women succumb to the temptations of these magical baby removers and go ahead with inductions. The facts are that babies who haven't come out at 40 weeks probably AREN'T READY TO COME OUT YET. Am I one of the few people who understands this concept? I ask this jokingly but I also believe that there is a strong correlation between inductions from 40 to 42 weeks and instances of emergency cesareans or other interventions like episiotomies or forceps delivery. In fact, there is numerous data to prove this correlation.

Fortunately for me, I was never force into an induction, even though my due date came and went. I was just so unhappy, emotionally spent, and physically exhausted to go on much longer. I asked my midwife to do one of the least invasive procedures to possibly jumpstart my labor; a membrane sweep. Basically she just took two fingers, inserted them into my cervix, swept the inner layer of my cervix, separating the amniotic membrane from my uterus near the cervical opening. It does not rupture the actual amniotic sac that the baby is in; it merely loosens up that small area enough to possibly signal the uterus to lightly contract. These light contractions can then signal the body to begin labor. If a membrane sweep is done and the woman does not go into labor within 24-48 hours, then her body is probably not ready to have the baby yet and it will still be (many) days away. Arguably membrane sweeping is an induction method since it helps a woman go into labor a short time before she would naturally, but when done properly it only reduces time before labor by a day or so. "So why do it if labor is coming anyway?" I asked that question myself. It almost seemed silly to have Nancy do the sweep, but I needed to do at least one thing to help bring Evelyn out. When Nancy said I had dilated more and there was blood on her glove, she said it was a sure sign that I would be going into labor very soon anyway. Sure enough, our kitten busted her leg on the broken plate and Evelyn decided it was time to be born.

So even though I knew that there was such a big time frame in which Evelyn could be born, I was still a nervous wreck and could not affirm myself enough to wait it out without trying to help her along. I am ok with that, strangely. I certainly didn't bring my 40 week, 2 day pregnant belly into the hospital and demand a c-section, and maybe I feel like what I did was so minor compared to what other women are pressured to do or elect to have done. Coming from an educated, thoughtful place helped me trust my decision. Having a loving, supportive care provider also helped me trust in this path I was taking. For most women, sadly, this is not the case. I ask all my friends, family, and readers to try to have faith in your body to give birth to your baby when the time is right. If you are a healthy, low-risk woman, you do not have to be induced before 42 weeks. It is your choice to allow your baby enough time to grow and wait until the exactly right moment to signal your body for birth. Tell you friends and family your "due month" ...Early March, mid-July, late August/early September. Trust your body to grow and nurture your baby until the time is right :)

I would love to hear thoughts on this topic!

~Christine

Birth Reflections (and some repeats)

Oh man, where to start.. I think the first thing that comes to mind when I reflect on Evelyn's birth is how grateful I am that I had a very positive birth experience overall. I am so glad we had Nancy as our midwife.  I am so glad I became aware of midwives and the midwifery model of care. I will never choose to have an obstetrician assist me in birthing my babies. Not because I don't trust my OB, but because I trust my midwife more. I trusted Nancy to know how I was doing and how Evelyn was tolerating the birth. I trusted Nancy to know how to care for me during my pregnancy and to respect my beliefs and desires about how I wanted this baby's birth to be. 


I wrote in my birth story about how hard the first part of my labor was. I still don't know why I became so sick during labor. Up until that point I had felt that I wouldn't get hyperemesis of labor. I thought that my pregnancy had been hard enough and to be sick during labor was just wrong and shouldn't happen to me. But it did and we dealt with it. I dealt with it. I had to dry-heave with each contraction, causing immense pain and  making me dry-heave even more. It was awful. But when Nancy told me while I was in the tub that it was making her ill watching me go through that, I felt relieved. There was a part of me that was hanging on to having a homebirth. A big part. And part of trusting my body was knowing that this just wasn't going to work out at home. 


Making the decision to get an epidural was not something I spent much time on. It was like the dots connected almost instantly in my head. I had done so much research about epidurals that I knew why it was a good idea for me to get one. I felt so much relief and confidence that I had made the right decision. There was no worry in my mind about a possible c-section. It was weird, actually, looking around and really taking in how not only was in a hospital, but I was hooked up to an IV, had an external fetal monitor, an epidural and was getting a small amount of pitocin. So many interventions! That was not what I thought this birth would be like at all! 


So even though I had the interventions, I was in charge of my birth from the beginning. I did not choose to do these things from the start. I chose a midwife and planned a home birth. I did my research, became very involved, asked questions, and made informed decisions. For me, it wasn't like I was being manipulated and I just ended up like any other woman going into the hospital to have her baby. It was all necessary. Weeks after the birth Nancy told me that a century ago I probably wouldn't have survived the pregnancy, and if I did, I would have died in childbirth. This coming from a midwife who has helped birth thousands of babies really *really* took any guilt I had and flushed it straight down the toilet. 


One thing I want to mention is how my views on birth have changed since I've had my own baby. I am still in fierce support of natural, home birth, but I appreciate the medical side of birth more. I still don't encourage moms to plan on choosing interventions because I think *most* of the time it damages the labor process. But not all babies born to mothers with epidurals are doped up at birth, either. It depends on how much of the pain medication is injected through the epidural into the mother throughout labor. I only had one dose of actual pain medication during the insertion and never took more. I did start to feel pain while Evelyn was crowning and being born, but it was good thing because I wasn't numb. I felt my baby being born and that was a magnificent experience.


I have wondered or asked myself if there was anything I would have done differently. I don't think so. I know what to do differently now that I've been through it all, and that's what's important to me for the next baby. I know that probiotics earlier in my pregnancy will probably help my hyperemesis. I have learned that I need fluids more often during pregnancy, along with more vitamins and acid-reflux medication from the start. If I had taken prevacid earlier, I probably would not have been sick for so long. These are all things I have learned through experience; there was no way for me to know ahead of time. I am really hoping that if we have another baby in 3-4 years my hyperemesis won't be as bad and I will be able to have my beautiful home birth. Nancy seems to think that next time around labor will be much faster and if we can just get the nausea under control, I will do really well. ::fingers crossed::


Evelyn's birth was still very beautiful to me and I love sharing my story. As soon as I can figure out how to get video off my camera, I will post a link to my birth video on youtube. Yes, I'm putting it up there in all it's glory. If it wasn't for all the birth videos that other moms have posted, I would not be as confident as I am about being a doula and understanding birth. It is different for all women and I think it's important that I give my story back to the community. 


Please ask away if you have questions or comments.


~Christine

My Super Long Birth Story

Due Date: 

So it was Wednesday, March 10th, 2010. The great anticipated date of Evelyn's birth. I had been so dilated, effaced, and with baby at low station for many weeks and I was sure we would be having this little one before that day. When 3-10 came, we had an appointment with Nancy, our beloved midwife. It was around 10AM. I went into her house thinking that I might ask her to strip my membranes, but I was very willing to have her tell me that it wasn't a good idea. She checked me after talking at length (1 hour) about the birth process and how it might be for me. We talked about how since the baby was so far down already, I would most likely skip that early phase of labor where it takes about 12 hours to go from 0 cm dilated to 3-4. This is called early labor. I caved and told Nancy that I was anxious for the first time, regarding Evelyn's impending arrival. I told her in all honesty that I was thinking about her stripping me. She said she wanted me to be patient, but she saw the exhaustion in my eyes, I suppose. She said that if she stripped me, I would either go into labor within 48 hours or nothing would happen. Stripping only "works" if you are going to go into labor within the next few days anyway, she said. If the baby is not ready to come out, stripping the membranes won't do a darn thing besides make me cramp for a few hours. I was laying on the bed with my legs open, while she was checking and she said she could get about two fingers in my cervix. She then asked me, point blank, if I wanted her to "talk to my cervix"... it's Nancy's way of putting it. I said yes immediately so she did. It was relatively painless until the stretching caused me to have a few contractions. When she was done, there was a bit of blood, which Nancy said was a good sign that my body was getting ready to go into labor soon. Dave and I went home, excited and hopeful that this would be it. That night I finished getting the bedroom ready so Evelyn, Dave and I could all coexist in that space together. 

Early Labor: 

That night I continued cramping. The next morning, I was very groggy from not sleeping and I had just dreamed that Nala, our kitten, had knocked over a glass in the kitchen and cut herself. I'm not sure what the heck that was all about, but then I woke just in time to hear the big thud and unmistakeable sound of glass breaking. I quickly sat up and cried to Dave that I had just dreamt that Nala was hurt. Sure enough, she and Baloo had been rough-housing up on the counter. Nala had sprung up onto the breakfast bar, into the sink, knocking out many dishes, and then leaped to the floor, cutting her leg open on the broken plates. She had a big gash on her back leg. I immediately called the vet to tell them we were coming in for an emergency. When I went to the bathroom to pee, I wiped and a huge chunk of my mucus plug had come out. I immediately started having some mild contractions. I thought to myself, OH CRAP. I was beginning to go into labor and our kitten was just hurt. Off to the vet we go!! The vet wanted to keep Nala for us, but we had to explain that I was in labor, and that my parents could keep her at their house while I was giving birth and recovering. The vet quickly stitched Nala up; she was totally fine and they said it would heal fabulously in a week or so). After paying about $300 for an hour visit (I was contracting in the waiting room the entire time) we decided to go home where I would labor until I wanted to go to my parents' house. 

Active Labor at Home: 

When we got home, I opened up the contraction master app on my iPhone and started timing. I actually saved the sheet of contractions in my email! Time was fuzzy from that point on. Once we got settled and I was no longer panicked about Nala, things picked up with my labor. This was at about 6:15 pm, and my contractions were on average 4-5 mins apart. I called Nancy to tell her that I was in labor and how far apart the contractions were. I wanted to wait until they were somewhere between 2-4 to go to my parents' house and Nancy thought that I should go when I feel like things are getting a little difficult. Well, I made the smooth move of attempting to take a shower to ease my labor pains. The shower felt amazing with the intensely hot water on my back, but my contractions picked up quickly!!! Around 7:30 pm I was having contractions every 2-3 minutes. I called Nancy right back and told her that they were 2-3 now. She said to get in the car ASAP and get down to the house. We finished getting packed within 20 mins and were off to mom and dad's house. 

The car ride was horrible and by the time we got there, I was already groaning in a low tone. I went straight to the bedroom and leaned over the bed, waving my hips side to side. I then went into the bathroom and got on all fours in front of the tub. Nancy and Therese arrived minutes after us. Nancy came in, greeted me, and had me lay back so she could check me. I was about 3cm dilated and more than 50% effaced. I kept laboring on all fours in the bathroom, then decided to go lay down on the bed and save some strength since I knew Evelyn's birth would be many hours away still. 

Somewhere between the bathroom and the bed, I became super nauseated and threw up. I tried to get comfy on the bed, but I was getting nauseous with each contraction. When the contraction would start to come, I would try to relax. Instantly my body would dry-heave. The only way for me to not dry-heave was to tense my stomach muscles a bit, which made the contractions even more painful. It was so awful! I tried to eat applesauce, which I threw up. I tried to eat some sherbert, but that came up, too. Peanut butter, crackers, even water would make me more nauseous. After laying in bed with some killer contractions, I asked if I could try the tub, or Nancy suggested it. I don't remember. I do remember walking into the bathroom while the tub was filling and anxiously getting in there, hoping for some pain relief and a break from the dry-heaving. My body was calm for about 5 minutes, then the nausea swept over me again. We had to have a bucket in the tub and every time I had a contraction, I would have to sit up and throw up in the bucket that was floating on the water. About 20-30 minutes into this tub time, and with Nancy sitting and supporting me next to the tub, she said "Honey, I hate to see you so sick like this." She said she was thinking that I was starting to get dehydrated and we would see how things go for a little bit longer. I had about 3 more contractions and between them I was telling Nancy how I was prepared to go to the hospital. We had talked at length about the possibility of me having hyperemesis of labor, since I had had it for almost 7 months for the pregnancy. There was no admitting defeat if I had to relocate to the hospital, and I felt strongly that I was not going to torture myself at home when it was crystal clear that I would literally not survive this birth if we stayed home. Yes, that sounds very dramatic, but it was very true. Many women can go hours being in labor without hydrating, but when you are throwing up bile, it's not a healthy situation for the mother or the baby. Eventually my muscles would not have enough strength to actually contract and help the baby down the birth canal. I don't like to think about what could have happened. Nancy sympathetically said that it was making her sick seeing me so sick and that it really was time to get proper help. She never talked me into anything. I said we should go and she agreed, very happy that I was thinking rationally. As we were getting ready to go, I took a shower to help relieve some pain. I even threw up in the shower. Dave came in to tell me that Nancy mentioned the possibility of trying an epidural to help my body relax. I knew right away that Nancy was not pushing intervention on me and what she was thinking made complete sense. I had also done a lot of research on epidurals and when it is a good idea to use one. This was one of them. I got out of the shower and told Dave to tell Nancy that I wanted an epidural as soon as we got to the hospital. 

Active Labor at Hospital:

So off to the hospital we went. Nancy had already called Dr. Fitzhugh (her back-up OB) and he would meet us there. I walked through the parking lot, through my contractions, and straight into my labor and delivery room. A nurse came in minutes later, hooked me up to a saline drip, and they gave me IV zofran to try and knock out the nausea. It worked for a short while, but I kept dry-heaving. The thing about zofran is that it will work better if you can get it in your system before you start throwing up. Once you start throwing up, it's a toss up as to whether it will actually stop the heaving. I toughened up, knowing that it would take about 20 minutes to get the epidural. It took almost every ounce of my strength to breathe slowly and stay loose. Those were the most difficult 20 minutes of my labor. I wanted so badly to throw up, and it took some incredibly focus to manage each contraction along with each wave of nausea. I will never forget that sensation of immense pain and nausea at the same time. The sounds of the anesthesia cart was like instant relief and the anxiety momentarily stopped my contractions. Dave was able to stay with me as she put the needle in my back. I have two tattoos on my back, so the pain of the needle insertion was cake! I felt almost delirious from all the pain and nausea at that point. I was about ready to pass out and I had only been laboring for about 4 hours.

The epidural started working immediately and I finally had relief. I didn't mind the pain as much as I minded the nausea. I could have dealt with the pain very well if I hadn't felt the need to throw up. Oh my gosh it was so bad. After the epidural had fully kicked in, I took a much needed rest. I don't remember much about falling asleep and waking up. I needed rest badly. I know I made small talk with Nancy and everyone else in the room for about a half hour until I went to sleep. The relief I felt from not having to throw up was so incredible. It was like waking back up again from the nightmare that was the hyperemesis I had for so many months during my pregnancy. I knew the hard part was over and I could ENJOY this birth. 

Since I had decided to have the epidural put in, I was going to need a tiny bit of pitocin to keep my labor going while I was resting. As most people know, pitocin is a synthetic form of oxytocin, the hormone that during birth, makes the uterus contract and push the baby down. Oxytocin also helps relieve pain, as long as the mother can stay relatively relaxed. When administered in a hospital, the range of pitocin goes from 1-20. Nancy said they would start me on two, then go up every 15 minutes as needed. I vocalized that I wanted the lowest dose possible, and then have it turned down to see if my labor would continue on its own. Nancy already knew that I wanted the least amount of intervention, so she reassured me that they would only give me enough to keep my contractions coming and not blow the baby out. After 15 minutes, I was bumped up to four, where I stayed for about 2-3 hours during my resting period. 

It was ether the nurse or Dr. Fitzhugh that came in to wake me and see if I had progressed. Sure enough, I was at about 9 cm with a tiny bit of cervix left. They immediately turned off the pitocin and started prepping for the actual birth. Throughout the time I had the epidural in, I never once pushed more pain medication via the clicker thingie. In fact, I didn't know it was even there, no one told me! Because I had rested and some of the medication had worn off, I could feel a lot of vaginal pressure as I was waking up. That got me really excited about starting to push. I could feel my left side and could actually move my leg around, but my right side was completely numb. It was a strange feeling, but I was thrilled that I could feel the baby in the birth canal. I remember telling Nancy that I could feel the baby coming down. I was happy that I had sensation but no pain. My left rib cage did hurt a bit, though, from all the vomiting and dry-heaving prior to the hospital. 

The Birth: 

As the nurses were prepping for delivery, I was unaware that the bag of waters had started bulging outside my body! Dave was saying how neat it looked and I reached down to feel it. It was super smooth and felt like a slippery water balloon. We got the mirror and it indeed looked exactly like a balloon coming out of me - so weird, but so fascinating! Nancy said that Dr. Fitzhugh might not make it to the baby's birth because I could have her any minute. Her head was right behind my bag of waters, and she was moving down pretty fast. Somewhere during this time, I started pushing a bit because I could feel the tightening sensation of my contractions. I was sort of experimenting with the feeling of trying to push without knowing if it was working or not. Dr. Fitzhugh made his appearance and I remember telling him how amazed I was at my baby balloon. I was relieved that he was there, but I knew that Nancy could have helped me birth the baby safely without him. 

(Mother-led pushing): 

After a few minutes of getting the hang of the pushing sensations, my bag of waters slowly leaked open and formed a small little pool right on the bed next to the baby's head. I made a joke about her being a true water baby and having a nice little pool to be born into. In some strange way, it felt symbolic of the water birth I had hoped for at home. We got the mirror out and I began to watch as I slowly inched baby's head out with each contraction. I am still very thankful that Nancy and Dr. Fitzhugh recognized that I was doing a great job pushing on my own. It was a very intuitive experience for me. Nancy picked up on my effective pushing, and when Dr. Fitzhugh got there, he really just sat at the end of the bed in silence. Everyone was barely whispering. I would vocalize that I was having a contraction and Nancy would encourage me through it, telling me to go nice and slow and how I was doing a great job. I could see the baby's head in the mirror, so I had a good idea of how hard or soft I had to push. Dr. Fitzhugh rubbed some lubricating gel around my vaginal opening to help glide the baby's head out and stretch the skin a bit. With each contraction, I pushed at a consistent pace, even holding the push between contractions. I was determined to get her out and not tear! So eventually her head came out and I saw her sweet little face as it turned towards the side. Nancy did encourage me to continue pushing, I think, so I could birth the rest of her body. I pushed as Dr. Fitzhugh supported her body. 

(This is my favorite part of the entire birth!!) Then Nancy told me to reach down and pick up my baby. I said "I can't!" and she said "Yes you can, just reach down!" So I reached down, hooked my hands under her armpits, pushed the rest of her body out, and lifted Evelyn Isabel to my chest at 10:38 AM. It was so unbelievably amazing. I actually birthed my own baby, even in the hospital with an epidural!! Of course, Dr. Fitzhugh did help make sure I didn't drop this super slippery baby, but I was so proud that I was able to bring her to me. I did not tear at all and had no abrasions. Yay! 

Evelyn pinked up and was gently crying as we rubbed her back to loosen up the mucus. She was never suctioned. After a few minutes of bonding, Dave cut the cord (which had stopped pulsing). We attempted to nurse for about a half hour, then the nurses quickly weighed her, swaddled her, and gave her back to me. Dave got to hold her at some point and I was in total awe of what had just happened. We were one happy lil' family!

My grandma, mom, and sister were also present at the birth and I'm glad they were able to be there. My friend Courtney was also there for a good portion of my labor to help and let my sister, Kelly, come in towards the end to hold the camera and witness the birth. Kelly had just driven 8 hours from Georgia, straight to the hospital, and into the birthing room in time to see Evelyn be born. 

I will be forever thankful for my labor support team, especially Dave, Nancy, and Dr. Fitzhugh. I feel so blessed that I was in the company of such wonderful people who supported, trusted, and cared for me during Evelyn's birth. Stay tuned for my reflection post!

~Christine

 

It's our due date!!

No baby yet, but I think it's going to be very soon, possibly tonight. My midwife stripped my membranes (I will explain this when I'm not exhausted and about to sleep) and I have been cramping and contracting since we left. After going to lunch with Dave and my mom, I have started to have more contractions and I kind of feel like this is pre-labor, but only time will tell.. I'd really love to wake up and go into labor tonight, but I don't want to get my hopes up just yet. (Who am I kidding, I'm excited and I really want to have this baby!!)


So please send me good labor vibes and pray that this baby girl is ready to come out.. If she doesn't show up in the next day or so; that's ok.. I just want her to come when she's ready but I'd prefer that she's ready NOW.. hehe.


Patience and calm is my motto for this evening so I'm going to sleep for a while and see how I feel when I wake up.


~Christine

37 weeks and more..

What a busy 2 weeks!! It feels like we just got back from Katsucon, but we really got back Monday night. Tuesday was spent sleeping and trying to get rid of a headache, Wednesday we met with the pediatrician and ran some errands, and today we had another great appointment with Nancy, our midwife, where we talked at length about my unfortunate test results.. I am GBS positive. 


GBS (group B strep) is a bacteria that can live in the intestines, vagina and rectum. I'm not sure I understand this statistic, but apparently 15-40% (?) of women carry GBS. Nancy says that really about 40% of women carry it, but it is not always detectable throughout their life-span. You could also be more heavily colonized at different times in your life. Either way, it is not a good idea to go untreated during labor, especially for vaginal deliveries because you can pass GBS onto your baby and the side effects can be severe. Whereas carriers of GBS do not have any symptoms, babies can have breathing, intestinal, and kidney problems, as well as develop meningitis. These are not good things! 


So how is GBS treated? In the hospital, women have IV antibiotics during labor that get into the baby's system to protect them from getting it if they're exposed. The risk of transferring GBS to your baby is very rare if you receive these IV antibiotics during labor with enough time to get into your system before the baby is actually born. Women with short labors in the hospital might not get enough dosage of antibiotics, but if their babies are born quickly, there is much less exposure to GBS. 


At home you treat it a little differently. Dave and I do have the option to go to the hospital as a precaution, but we have decided instead to go a very common midwifery route and take oral antibiotics during labor. Because we have an idea of when the baby might be born, I am going to take a 5 day round of antibiotics about 10 days prior to my due date and it will protect the baby for 2 weeks after my last dose. Nancy does not expect me to go late at all, so this plan should work well. If I go into labor before I have taken the original antibiotics (say before Feb 28th), I will switch to another antibiotic during labor that will get into my system faster and protect the baby against GBS as long as I can take it about 4 hours prior to delivery. If I go into labor and have the baby without time to get antibiotics, I would be in the same position as a woman who showed up at the hospital and delivered her baby too quickly to get the antibiotics. Me being at home does not change the time frame in which to receive antibiotics whatsoever.


Some doctors say that oral antibiotics don't work as well as IV antibiotics, but Nancy has seen the exact same results with both - healthy babies who don't get GBS whether their moms take it through IV or orally. After 30 years and ~1000 babies, I trust that Nancy knows what she's talking about. I don't feed into the scare tactics about my baby dying - it's just ridiculous. Only 1 in 200 babies get GBS if it goes completely untreated, too. I'd say my chances of anything happening are so extremely slim with the antibiotics and I feel confident about our decision :)


Now that we have reached the 37 week mark (YAY!) we can safely deliver the baby at home. No hospitals, IVs, people yelling at me to push, nurses telling me I need to stay on the monitor, etc. etc. Baby E is full term and any growth she does from here on out is general growth and will not affect her chances of survival outside the womb. It would be nice to deliver sooner rather than later - less baby to push out - but I am ready to let go of the worries and frustrations about when she's coming and how that will fit into everyone else's plans. She is going to come when she's ready and all I can do is try to stay nice and relaxed, take my fish oil and probiotics, and get the freaking room ready!!!! I desperately need to finish prepping our bedroom for this baby but as the days pass, I am SO exhausted. My list right now consists of:


~ buying the final birth supplies
~ taking them to my mom's house to organize and label it all
~ washing the newborn diapers (boiling and washing a few times to quilt and increase absorbency)
~ hanging up the rods in the extra closet for her clothes, then hanging clothes
~ organizing the rest of her stuff in the closet to be easily accessible
~ moving the bedroom furniture to accommodate the co-sleeper (and possibly move the bookshelf?)
~ acquiring nursing bras and packing enough clothes and such for post-partum at the rents' house
~ packing the baby bag for post-partum at the rents'
~ getting new tubing and shells for the borrowed breastpump
~ making a mini birth plan/guide for the people who will be attending the birth
~ making a playlist of music and birth affirmations for labor
~ buying film and extra tapes for the camcorder (yes, we're filming the birth)
~ making copies of the emergency back-up plan for my parents
~ remembering to take my probiotics and fish oil every single day


That's all I can think of right now... there's a lot more things I need to do unrelated to baby, but they need to get done and I am procrastinating.


I will try to post more often now that we're home and there aren't any conventions for a while. We are having Baby Shower 2.0 this weekend after the storm hit 2 weeks ago and made it pretty much impossible for our friends to get down to Richmond. Let's hope it all goes well and that everyone has a good time!


~Christine

21 weeks 2 days and home birth

This is a long post. People have a lot of strong feelings about home birth and I think the majority of the American population does not support it, especially obstetricians. Nonetheless, I have done my research. I have been in the natural/home birth community for a while now. I can say that it is truly a beautiful and safe practice, and women who do it will tell you that they’ll never walk into a hospital for a birth if they can help it.


What I’ve been hearing from a lot of people recently, upon discovering that we are planning a home birth, is how “brave” I must be for doing this. I don’t think of myself as brave at all. Rather, I would consider myself brave for going into a hospital. I used to think all babies were born in a hospital and for those women who didn’t have hospitals.. well, they managed somehow but I had no clue. I actually remember thinking that before hospitals, babies had to survive otherwise we would not have a world full of people today. The truth is, most women don’t need hospitals in the world. The female body was made to birth babies, along with processing all the complex hormonal changes that occur when a woman is in labor.


You might read a statistic that says 1 in 4 babies are born via c-section. The most recent statistic, however, is that 1 in 3 babies are born via c-section. 33% of babies. Among the 4 women I know besides myself who are pregnant, the chances are that at least one of us will deliver by c-section. I am definitely terrified of having a c-section. It is major surgery, and although doctors do it all the time, it is not without major consequences. One of my reasons for wanting a home birth is so that I am able to labor in the water, move around, and receive constant support and medical expertise from my midwife, who will be there by my side 100% of the time. This reduces the need for intervention and decreases the chance that I will need a transfer or emergency c-section. If I do have to have a c-section, I’ll probably cry, but I’ll get over it. What’s important is the safety of me and my little girl.


The medical community can easily scare us into thinking that birth is so dangerous. There are so many “what ifs” that you can be easily overwhelmed into thinking that a hospital is the only safe place to have a baby. Well, statistically for healthy mothers and babies, that is plain wrong. If you choose to have your baby in a birth center or at home you are a bad mother and risking your baby’s life, according to some people. Plain and simple, most hospital staff like to control your labor and birth. They like to put you on a clock and get you out, so the next mom can get in. The more babies delivered in one day means more money and more surgeries. Hospitals make more money off c-sections than any other procedure. And due to the fact that families will quickly sue a doctor if there is a bad outcome, too many doctors now believe that the safest way to take care of any problem is to cut the baby out of the mother’s womb. They can’t get sued if they “did everything they could.” What is REALLY in question here is whether or not they did the right things to begin with. Did they start pain medications too early and it stressed the baby out? Did they not allow the mother to move around, so she experienced extreme pain while having to just lay in bed? Gravity makes babies come out. Did they prevent the woman from feeling like she was the one who could make decisions, or did they guilt her into taking medications that would make for a faster labor, not a necessarily safer one? Did they break her water too early and now she is at a high risk of infection? There are so many possible outcomes when you go into the hospital, and I’m trying to avoid unnecessary intervention more than anything.


Yes, you can have a natural, non-intervention birth in the hospital, it is just very difficult unless you have spoken with your doctor at great length. Seeing a midwife in the hospital, which Dave and I already considered, is also a great option. A free-standing birth center detached from a hospital might be a great place for you to have a calm and relaxing birth, as well. It has all the comforts of home with medical technology available, although they have all the supplies that a midwife would bring to a home birth, as well. A birth center might be a better option if your home is far away from a hospital, since many birth centers are a short distance from a hospital.


Yes, there are emergencies. True high risk women should be in a hospital. Sometimes there is a problem and the best thing to do is a c-section. Not all nurses and obstetricians are bad. Something that is so alarming to me is how the higher the cesarean rate goes, the higher the infant mortality goes. That means that the more c-sections we perform, the more babies die between birth and one year. Granted c-sections do not cause infant death directly, there are many problems associated with c-sections that can contribute to poorer infant health, like longer times in the NICU therefore less contact with mom, and lower rate of breastfeeding success due to the difficulty and pain in recovering from a c-section.


I am happy to be giving birth at home. I will be around supportive people, I will have almost complete attention from my midwife who is not only a nurse, but has received special training in birth. She has been doing home birth for over 20 years and has seen just about every scenario. I trust her completely and I know that if there is a problem, she will be able to assess it ahead of time and decide how to proceed. Something that is important to remember is that just because I’m at home does not mean that if there is an emergency I won’t go to the hospital. The hospital is less than 10 minutes away and my midwife or I will decide if I need to transfer.


Midwives don’t show up to a birth with a towel and scissors. My midwife is a Certified Nurse Midwife. She brings with her many of the tools they would use in a hospital, besides an operating room. She has oxygen for me or the baby if we need it. She has IV fluids in case I get dehydrated. She has tools to cut the umbilical cord and knows how to properly stitch tears. She knows how to perform CPR on an infant. She knows how to diagnose hemorrhaging and can give me pitocin to stop it entirely or until an ambulance arrives. Basically, she knows what she’s doing and is prepared for emergencies. The emergencies that could arise without us knowing are real, but occur rarely in healthy women and babies. She has been a midwife for so long that she can catch on early to problems that need attention or would require a transfer to a hospital. She is not just there to catch a baby. A huge part of her life has been dedicated to the safe passage of babies into the world and she would not be doing midwifery today if she wasn’t good at it.


I have an idea of what I’d like my birth to be like. I’m at home. I call my midwife and she comes over. I try to rest in whatever position feels best for me. The midwife checks my blood pressure every half hour or so, maybe takes my temperature, and uses the doppler to check the baby’s heart beat. I am then free to lay down on my own bed, kneel on my own couch, and take a shower or bath without having to detach 4 cords and try to keep my IV site from getting wet like I would in a hospital. My midwife is there the entire time so when I are scared or in pain I can talk to her and she will comfort me, along with Dave and the other women at my birth. I can listen to my own music, adjust the temperature in the room, drink water or juice, eat food. I can wear my own clothes. I can get into the birth tub when my pain is intense and I need the relief. When I am ready to push the baby out, no one is grabbing my legs and counting to 10, making me hold my breath and strain my body. I am in less pain because I’m not on my back, which is the worst position to give birth in. Being on your back requires pushing the baby sort of uphill, whereas being upright greatly assists the baby in moving down and coming out easier. I am weightless in the water and I feel more relaxed. The water helps loosen my birth canal to make an easier path for the baby. When the baby is born I get to bring her immediately to my chest and hold her in a towel, while allowing the placenta to continue delivering oxygen as she is transitioning to the outside world. After cleaning her up and somewhat getting over the shock of having my first baby, we can do what feels natural and relax.


Birth is normal. Women have been doing it since the beginning of human existence. Having your baby at home is not something that is horrible and dangerous, as long as you and your health provider determine that you are at a low risk of complications and someone is there to assist if there is a problem. If we always focus on what can go wrong, women will lose more trust than they have already lost in their body’s ability to birth a baby. I trust my body and my mind to go through this experience. I know just believing in my body and birth won’t magically make my birth happen without any problems, but I at least know that our baby girl is in perfect health so far, and to bring her gently and safely into this would is to birth her at home.


Here are various links to give you more info:


http://www.americanpregnancy.org/labornbirth/homebirth.html
http://www.midwiferytoday.com/articles/homebirthissues.asp (cites specific research studies)
http://www.midwiferytoday.com/articles/technologyinbirth.asp
http://www.midwiferytoday.com/articles/whyhomebirth.asp
http://www.changesurfer.com/Hlth/homebirth.html (a huge list of journal article abstracts listing the method and results)


~Christine