Pregnancy, Birth and Beyond: My advice to new moms PART 1

Pregnancy and birth is a subject that is near and dear to my heart.  Having children has profoundly changed me in so many ways.  I have also learned so much (the hard way) since I've become a mother.  I could elaborate all day but most people aren't going to read it so instead, here's a short list I've compiled of things I wish I had known so maybe you can avoid some common pitfalls.  The first three are general rules of thumb to set the framework for a healthy experience and the remaining are more specific.

*Disclaimer - I have had a hospital birth with an OB that included induction and epidural and a natural birth at home with a midwife.  I do not advocate that my way is the only right way.  I want women to make informed decisions and give birth where and with whom they feel safe. The views below are my own with resources are below.*

1. Consider the source - When someone gives you advice they are usually well meaning but not always qualified to dispense the advice. Trust the experts but not blindly.  Do the research and consider your instincts and your child. 

2. Pick your care provider carefully - Find a Dr or midwife you can connect with and trust.  Really research the statistics of safety and interventions for that care provider.  A midwife (in TX) is required to provide those statistics up front.  If your instincts are telling you your provider is not a good fit, do both of you a favor and switch.

3.  Accept responsibility - As tempting as it may be to relinquish your care into the hands of "the experts" you need to be responsible for your own health.  You can get opinions from others but ultimately you must decide what to do.  Its easier to live with the choices you make than the choices you let others make for you especially if things don't go well.  Put on your big girl panties and get the information you need to make the right decisions for you and your baby.

3. Do the research - Experts are people too and can and do make mistakes.  Do not assume any procedure done on you is in your best interest.  Do not assume that your Dr knows what you want without first discussing it. For example, two common procedures that cause more harm than good are immediate cord clamping and episiotomy (1).  Both of these are still routinely done on women and infants without scientific evidence and without consent. These are not the only procedures in this category nor are they the most dangerous or damaging.  A good place to start your research is Henci Goer's book, The Thinking Woman's Guide to a Better Birth

4. What you eat matters - What you eat when pregnant really matters and has far reaching health consequences for you and your baby.  Many pregnancy complications can be prevented by careful attention to diet yet most women under OB care are never counseled or referred to a nutritionist.  My personal pregnancy experiences and birth were vastly different when I became aware of this.  A good place to start is, Dr. Brewer's Pregnancy Diet

5. Exercise -  Labor is usually physically exhausting, but it will be smoother if you train for it.  Do as much physical activity as you can during pregnancy.  You will feel better and you won't swell as much.  Do specific exercises like pelvic rocks, squats and tailor sitting to prepare your body for labor and proactively move the baby into optimal position for late pregnancy.
 
6. Nap - Sleep as much as you can when you can and don't feel guilty for it.  Manufacturing a human is hard work!

7. Know your baby - Take the time to ask your care provider how to tell what position your baby is in.  You should be able to tell what your baby is doing with a little practice.  Once you have this mastered you can do exercises to ensure your baby will stay in a position that will make labor easier. (6)  Talk daily and connect with your baby.  You will be working as a team when the big day gets here.

8.  Natural childbirth - You may be under the impression that women who chose to have a baby naturally are macho masochists.  I know I thought that at one time.  What is the big deal?  What so wrong with an epidural?  Once again I found out the hard way.  It turns out the epidural has side effects that nobody told me about! (2)  After having a baby naturally I would never again chose an epidural.  Most women who have had both kinds of birth also prefer natural.  Does that surprise you?

9. Be prepared - If you do chose to go natural, don't assume it will just happen.  The hospital system is not set up to support a natural birth.  You must be determined and prepared.  I would recommend a Bradley Class(3) or Hypnobabies(4) class.  If you are planning on an epidural, remember that they do not always work or you may have a precipitous labor and not be able to have one.  I would prepare for a natural birth/unassisted childbirth in either case.

10.  Consider a Doula - A doula?  Seriously?  That is what my husband is for!  Ok, well that is what the Dr and nurses are for then.  What came a a shock to me was that my Dr was NOT there until the last 20 minutes of the birth and the nurses were busy and also NOT there for me.  It was just me and my husband all alone without knowing what to do.  Turns out expecting a husband to know when/how to support you is asking too much of someone who is probably just as inexperienced as you are.  A doula will take the pressure off of your husband and will bring knowledge that will make your birth go better.  Studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and requests for an epidural by 60% (5).  Don't leave it to chance that you will have a good nurse who will support and spend time with you.  The nurses work for the hospital, not you. 

11. Eat - If you have a long labor you will probably get hungry.  You can eat if you need to and you don't need permission.

12.  Let go - There are many things in labor you cannot control. If you've done your homework, taken care of yourself and prepared as diligently as you can then it is time to surrender to the process and ride it out.  Labor is not the place for fear and anxiety - this is why I'm stressing mental and physical preparation before D-day.  Birth is as safe as life is. Women were made to give birth and you can do it.  Pray for peace and guidance from God and he will be there to help you out.  Enjoy your birth!

Stay tuned for PART 2 - Breastfeeding

Resources:
1. http://pregnancy.cochrane.org/
2. http://www.natural-pregnancy-mentor.com/epidural-side-effects.html
3. http://www.bradleybirth.com/
4. www.hypnobabies.com
5. http://www.americanpregnancy.org/labornbirth/havingadoula.html
6. http://www.spinningbabies.com/

Happy First Birthday Ehren!

One year ago today at 2:17 in the afternoon we welcomed our son Ehren into the world. He has grown into a joyful, sweet baby. Always giving out a smile and a hug and sometimes an open mouth kiss. He's known in our family as "the hugger." I've enjoyed waking up each morning to his smiles and giggles and can"t imagine life without him.

Ehren at 1 month old - Lily put his hat on (doesn't he look thrilled!)

I'd like to thank our family for your unwavering support (even when it scared you.) Thanks especially to my Mom who can sense when I feel overwhelmed and drive all the way from Dallas to take care of me and take Lily home with her for a week. I feel inexpressible gratitude to our midwife Toni, who caught Ehren with gentle, patient and loving hands. I also want to thank the many mothers I have met along the way who by their example showed me how to parent gently. Elaine P., Andrea H., Cori L., and Rachel S. for sharing their home birth experiences and giving me living examples of strong women who have brought their children into the world without fear. Thanks to Kimberly R. and Natalie H, who helped me embark with confidence and discover the joy of exclusive breastfeeding. Thanks to my dear sweet Lily who has learned to share Mommy's attention with grace above her years. Thanks to all of the people who offered kind words when we needed it. This year has been the hardest of my life but also the most rewarding!

Here's a collection of photos from Ehren's first year you might not have seen.

Ehren at 1 week old

Cuddles with daddy - He's about 1 month old here

4 months - the chunky phase

Future Starbucks addict (Won't Aunty be proud!)

Loving on the dog

Have toy - will hug

Welcome home Daddy - I love you!

The hugger in action - he loves the cat

Ehren's Birth Story

This is the story about the birth that changed my life - for the better and helped me learn what birth could be like and why we NEED natural birth.  Some day I will write Lily's birth story.  Still processing how I want to share it. 

When Lily was about 18 months old Brandon said that she needed a playmate.  Until then it really did not occur to me that we might get started on #2.  I was just so busy with Lily at the time.  So we started TTC.  After it didn't work the first month I started researching....  I became obsessed with learning as much as I could!  I wish I had read Taking Charge of Your Fertility at the time.  After 7 frustrating months we had a faint little positive line on the pregnancy test!

Now on to step two - have a better pregnancy and birth!

32 Weeks

I talked to other home birth mamas and did hours and hours of research.  After the impersonal at best and negligent at worst OB care I received I decided to see a midwife and have a home birth.

My second pregnancy went much better than the first one.  I ate healthier, exercised and didn't gain as much weight.  I got plenty of rest and relaxation and didn't have any problems.  No diabetes, no toxemia, no swelling.  I looked and felt so much better this time.  We took a Bradley class which was great.  We met nice people and learned a lot of good information about staying healthy and gained confidence through knowledge.

37 weeks

Ehren was due December 7th by traditional due date calculations, but really due on the 12th if you use NFP calculations. Ehren gave us a practice run the day before his due date.  I woke up in the middle of the night with contractions.  I tried to go back to sleep but couldn't and they kept getting closer.  From 6:00 to 8:00 they were 10 minutes apart.  When I got up to make breakfast they went away. We were a little disappointed but decided to make the best of it.  We went for a walk around the neighborhood and for a lunch date at Ninfas.  It was sunny and beautiful and Brandon and I enjoyed spending time together.

I didn't have any more contractions until the day after his due date, December 8th.  I woke up at 6:30 with contractions 2-4 minutes apart, but they were still rather mild.  When they didn't go away after we ate, I called the midwife and let her know what was going on and that I probably wouldn't make it to my appointment we had at 11.

I labored pretty calmly without much fuss.  Brandon would support me and remind me to relax and he made them so much better when I could lean on him.  At 10:45 he called my midwife and asked her to come over because the contractions were getting much more intense.  She came over and checked me at 11:30.  To our surprise, I was already 9 cm dilated.  Wow.  I thought to myself.  This is going to be a piece of cake! With the ok from the midwife (Toni) I hopped in the bathtub and Toni called her assistant Liz (whom I had by chance met at the grocery store the week before) and they set up the room with plastic and equipment while I labored in the tub.  The bathtub made the contractions feel better and I laughed and joked around between them.

When I started to feel shaky and queezy I decided that it was time to get out of the bathtub.  When I looked around my bedroom it was an amazing transformation!  Everything was set up and ready with supplies and the bed had plastic under the sheets.  The pillows were even encased in plastic with the pillow cases over them.  They were super efficient.  The contractions were much more intense after I was out of the tub.  Toni checked me and said I still had a lip of cervix that needed to get out of the way.  She gave me some options, wait, stand up during contractions, break water.  I said I wanted all three because it was getting quite painful and I was having a hard time relaxing.  When the cervix lip was finally gone, they told me that I could start pushing, but I did not like that at all!  I screamed so loud the windows shook and jumped up mid contraction.  Toni almost got kicked in the head (sorry!) I didn't feel stable on the birth stool, the bed was much too painful, pushing hurt more than not pushing so I breathed through some of the contractions.  I was getting very panicky by this time and Toni, Liz and Brandon were all working together to help calm me down. In my head what they were saying made sense, but my body just wanted to say NO, GO AWAY, and RUN myself out of there.

Toni suggested I go to the shower again and have a couple of contractions so we tried that and then I sat on the toilet.  I finally got the real urge to push when I was on the toilet and he dropped down almost immediately.  They hauled me off the toilet and back to the birth stool.  Brandon figured out the best way to support me, with his arms supporting me under my arms and I pushed!  Because he was behind me he didn't get to see Ehren coming out but I really needed him there to use as leverage.

As I was pushing I closed my eyes it seemed like I was no longer in my own body, I could vaguely hear what was going on but it didn't feel like it was me there.  Toni told Liz to get me some oxygen and that gave me strength (perhaps only in my head like Dumbo's magic feather).  I felt a ring of fire which was worse during the break between contractions and then after two contractions they told me his head was out. I figured the rest of him would slide out like the other babies I had seen, but no such luck.  I had to keep pushing and felt a ring of fire again (what?  Nobody told me about that!) and finally I felt the little legs slither out and a giant blue baby was put on my chest.  Liz gave him some oxygen and he turned pink and cried immediately.  Toni immediately thanked God for the safe delivery of Ehren.  (I'm so glad the spiritualism of Ehren's birth was honored by my midwife!)

He was born at 2:17 in the afternoon after a labor that lasted less than 8 hours.

Minutes old!

 He laid on my chest until the cord stopped pulsing and then Toni clamped it and Brandon cut it.  My mom and Lily came into the room as soon as they heard him cry and I was so happy to see them!

Ehren was cleaned with a towel and wrapped in a blanket while I moved to the bed to deliver the placenta.  One little push and it was out (much easier!)  I got to hold Ehren and look at him and nobody took him away.

After a while, Toni checked me and found a superficial but long tear along my (unnecessary) episiotomy scar that I got with my first baby.  She gave me two stitches which didn't hurt much at all.  She had been supporting me with warm washcloths and olive oil while I pushed (which felt much better).

I felt like quite a wuss about the whole transition and pushing and all the whining and complaining I put everyone through, but when they weighted and measured Ehren he was 10 pounds 1/2 oz and had a 13 3/4 inch head (moulded) and a 15 inch chest.  OH.  Ok, well I didn't feel quite as wussy when I found that out.  Toni also said that the giant baby head might have been dragging my cervix down instead of the cervix moving out of the way for it so that would have contributed to the difficult transition and me not wanting to push.

Recovery has been great!  I feel good emotionally and physically.  Didn't have very much soreness like with Lily with the exception of my back and arm muscles. 

My father and Ehren on his birthday

I am very grateful to my midwife Toni and assistant Liz for all their skills and the faith they had in me when I didn't think I could do it.  They made Ehren's entrance into the world as safe, gentle, natural and wonderful as it could have been.

Looking back I'm so glad we had a home birth.  Ehren was born so healthy and perfect with nobody tugging on him with forceps or trying to section me for a "big baby".  It is frightening to me to think about what could have happened at the hospital with the tendency of the Dr.s to overreact and the position I would have been forced to push in.  Article about lithotomy position

Ehren at 6 months old

I have grown so much from that experience.  I used to think in my head that I was in control of my life and circumstances, but labor showed me that GOD is in control.  I could not escape the feeling and had to surrender to it and ride it out.  It was a hard lesson for me to learn, but a valuable one for a mother.

P.S.  My home birth cost 1/5 the price of the hospital birth and my midwife must have spent about 10X more time with me.  She actually stayed with me and cleaned up afterwards.  I was treated like royalty instead of just another patient.  It felt nice to be mothered. :-)