Sweet Peas

Cayce's Birth Story

2010-11-21T18:32:00.000-08:00

Cayce Williams was born in the late afternoon of March 2, 2010. She weighed nearly eight pounds and was perfect in every way. Immediately after birth she was placed on her mother’s stomach, eyes wide open, taking in the world around her. Her parents were able to look at her, hold her, and enjoy those first moments as a family together. Her mother had worked so hard for many hours in order to finally enjoy this moment.

Labor began early in the morning the day before. Contractions were tolerable and sporadic for most of the day, but Jenifer knew that her baby would be coming soon, so she spent the day in preparation for what was ahead, by packing and making food. Jenifer called her family, and they were soon on their way to witness this birth experience. She wondered if her water had broken, and contemplated going to the hospital to have things checked out.

Towards evening, Jenifer’s contractions became stronger and more regular. She decided to get into the bathtub to relax and to help her manage the stronger contractions. It was at this point, Sam’s mother came over to join them and that the doula was called. After a couple of hours in the tub, and many very strong contractions that Jenifer managed so well, she decided to move into the bed. Getting out of the tub was difficult, and Jenifer experienced some very strong contractions and nausea. Everyone wondered if she might be close to giving birth, and it was decided to head over to the hospital in Salem. Jenifer was not ready to get out of bed, though, so everyone waited for her and then supported her out to the car.

At the hospital Jenifer was found to be 2.5 centimeters dilated. Her contractions continued on regularly and intensely, and the hospital staff realized that she might be farther along than she was measuring because of a bit of scar tissue that was probably restricting dilation. The nurses opened up a room for her so that she could labor in the bathtub for a while. She was checked every hour for four hours, while having contractions about three minutes apart, and continued to remain at 2.5 centimeters dilated. To carry on without having progress was so difficult, but Jenifer continued to work so hard. She amazed everyone around her, including the staff at the hospital.

Towards five in the morning, Jenifer was checked again and was found to be closer to four centimeters dilated! Jenifer decided that at this point she would like to have IV medications to help make contractions more manageable. She had not slept in a very long time, and hoped that the medication would help her rest between contractions. She now labored in the hospital bed, on her side. She liked having her back and feet massaged, her head stroked, and maintaining eye contact with Sam, who never left her side. So many people remarked at what a close couple they were, how strong Jenifer was, and what an amazing support that Sam was to her.

By 10 o’clock, the IV medications were not as effective as they once were, and Jenifer felt like she needed more to get through. She was now seven centimeters dilated. Her back was hurting so much and she was very tired. The nurse and her doula suggested that she go to the bathroom and spend some time leaning forward, as that might help her baby to rotate and come down farther. This was, by far, the most intense part of Jenifer’s labor. She worked so hard, and everyone so admired her strength and determination!

After some time on her feet, Jenifer decided to get an epidural. Everyone around her supported this decision, wanting her to get some relief from her contractions. It took some time for the epidural to fully take effect, but it finally did and everyone was relieved that Jenifer could finally have some respite from the pain she was experiencing. Family members took turns resting, quietly visiting, and supporting the expectant couple.

At three o’clock, the nurse felt just a small lip of cervix over the baby’s head that she was able to push back as Jenifer pushed. It was time to start pushing! Although Jenifer was told that the first pushes were for practice, she did awesome right from the start. She pushed at the peak of the contractions, with Sam and her doula supporting her legs, and it wasn’t long before the top of her baby’s head was visible. By the time the doctor came into the room, Jenifer was nearly crowing. During the final pushes, all of Jenifer’s family came close so that they could see baby Cayce be born. It was an amazing sight! She came out with her hand by her face, surrounded by so many people who marveled at her and loved her.

It is always such an honor to be present during a labor and birth. It is such an intimate time for a couple and for a family, and I can’t help but be amazed every time at the miracle of it all. Sam and Jenifer were a very special partnership, and it was very evident to all that saw them together that they have an extraordinary relationship. I saw in Jenifer such a strong, strong woman. She truly amazed me, and I will always remember the grace and strength that she possessed during this time of her life.

Sylvia's Birth Story

2010-11-14T18:57:00.000-08:00

This is the story of a birth that I attended last Spring -- an amazingly peaceful experience. I am always so grateful to families that allow me to be a part of such an important time in their lives.

Contractions began for Melanie on the evening of April 16^th, after her baby shower. She tried to go to sleep for the night, knowing that her baby would be coming soon, but she was too excited, and didn’t sleep until very early in the morning. Her contractions were strong, but remained spaced apart.

Throughout the next day she continued to have regular, strong contractions. She and her doula went on a walk, enjoying a very beautiful morning with many flowers in bloom. Melanie, her husband and their doula went to the Farmer’s Market to pass the time, all while she was having contractions. She found some soap she really liked and ate a bit of bread. She ran into several people that she knows, and all were amazed that she could actually be in labor. Melanie had such a big smile on her face, she was so excited, and no one expected to see such a happy laboring woman.

Early in the afternoon Melanie’s doula left Melanie and Kuno alone in the house for a couple of hours so that they could rest. Everyone hoped that by resting and being in a quiet house that Melanie’s contractions would intensify and become closer together. Alone time worked, and three hours later (around 4 pm) Melanie was ready to go to the hospital.

Melanie’s contractions were much more intense, but she continued to have a smile on her face. All of the people who saw her commented on her happy attitude and told her how amazing she was. When she was checked in, her cervix was checked and found to be 2.5 centimeters. The hospital staff wanted her to spend time walking around because they did not want to admit her until she was 3 centimeters. So everyone did a bit of walking the halls. Melanie relied on her husband for support while she was standing. After a couple of contractions in the hall, Melanie asked to go back to the room to sit on the ball for a while. She felt a lot of back pressure, so she liked to have someone push on her back during a contraction.

After 90 minutes in triage, Melanie was found to be nearly 4 centimeters dilated and was taken to a room to have her IVs inserted and antibiotics administered. Melanie was eager to get into the Jacuzzi tub, so it was a long wait to have everything done, but Melanie continued to smile through it all.

Finally she was able to get in the tub, and it was such a relief. It was as good as she imagined it would be. Kuno stayed with Melanie in the bathroom, supporting her through her contractions. After about 45 minutes in the tub, Melanie wondered if she might be pushing. Her nurse helped her out of the tub and onto the bed so that she could be checked again. She was 8 centimeters! Everyone knew the baby was coming soon, and within three contractions, and after a couple of kisses from her husband, Melanie was actually pushing (still smiling). No one needed to tell her how to do it, she just knew exactly how!

Sylvia was born before 8 pm and was perfect in every way. Her mother and father were so excited to meet her and to introduce her to Big Sister. Sylvia nursed right away, showing everyone how healthy and strong she was.

Has Hospital Birth Lost Its Way?

2010-11-12T15:32:00.000-08:00

Me, with a very cheesy grin, about two hours from birthing Charlie.

The last several births I have been to in hospitals have been awesome, and I have seen the nurses treating laboring mothers with so much respect and care. I was interested to read this article in the Huffington Post today. I do think it is important to remember that hospitals are like a giant machine, and it is easy for things to start getting rushed and out-of-control. Having extra support is so important, in my opinion.

A quote I liked from the article:

"We need to make sure that we reduce the overuse of interventions that are not always necessary, like C-sections, and increase access to the care that we know is good for mothers and babies, like labor support." -- Maureen Corry, executive director of Childbirth Connection.

Birth is Best

2009-08-26T09:18:00.000-07:00

One week ago today, I had the privilege of being at the birth of a good friend. It is the only home birth that I have witnessed, besides my own, and it just really touched me. The mama was such a strong and powerful woman during her labor and her midwives remained totally in the background until they were needed. Baby was born into warm water, with his family around him, to dim lights and quiet voices. It was a special experience. I wanted to just write a few things down while they are fresh in my mind.
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Birth is best when we stop focusing on due dates. The pressure of going overdue in our society is HUGE. Before most women have reached their due date they are being hounded by friends and family to find out why that baby hasn't been born yet. Science has yet to discover why babies come when they do, and I think it is best to assume that there is a very good reason that baby chooses the day he is born. Any woman who has been pregnant knows all too well the physical and emotional discomfort that the last weeks of pregnancy can bring, so it very important to honor pregnant mothers with support and love, not questions and comments about how the baby is getting too big or that something must be wrong. Baby will come at just the right time if we allow him to.
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Birth is best when moms have choices. Choices about where to birth -- home or hospital, when to give birth -- no pressure of inductions, how to give birth and choices about who will be in attendance. Did you know that homebirth and even a birth attended by a midwife (in a hospital or birth center) is illegal in some states? This means that in this country women have more choices and options when it comes to terminating a pregnancy than they do when it comes to making choices about their maternity care and how/where they want to give birth? A woman should also have the choice, after making an informed decision, to give birth vaginally after having a c-section if that is her desire.
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Birth is best when we stop looking at the clock. One of the main differences you will notice if you get to witness a homebirth with awesome midwives, is that no one is going to stick their hand in a vagina and check dilation (even if you beg them to), unless there is a pretty good reason. Smart midwives understand that how far dilated someone is is not really an indication of much. We've all heard of that woman who walked around dilated to six centimeters for days before her baby was born, or the woman dilated from zero to 10 in the space of an hour and nearly had her baby in the car. Every labor is different, just as every baby is different. When we get stuck on the numbers it can be so disheartening to hear something that we didn't want to hear or give false hope when we still have hours of laboring ahead. The process of birth is a journey towards surrender, giving in to the process, letting our body just do its job as it is designed to do, without getting hung up on how you think it is supposed to happen.
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Birth is best when we center on the mother and honor her. Pregnant women are more than cute bumps and adorable maternity clothes and accessories. While it can be fun to open a million presents and play silly games about guessing which chocolate bar has been smeared in which diaper, an event that honors the pregnant mother, and her journey towards birth and motherhood are seriously lacking in our society. If you ever have the chance to attend (or better yet, plan or be the recipient of) a mother's blessing, I encourage you to do so. Gathering women together to send love and best wishes to the expectant mother is so special and deserved. I was very interested to learn recently that these types of events were very common during the early years of my own personal religious culture.
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Birth is best when we trust that mom (and dad) know best. I guess this is all the stuff that happens after the birth, all of the decisions that come when little baby is here. What baby will eat, where baby will sleep, shots, circumcision, discipline, etc. Everyone will have an opinion that they want to share, but it is important to remember that mom knows what is best for her child, and we don't want to do anything that will damper the natural instinct that she has to care for her children. I can be guilty of this, so I think it is a good reminder.
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I have a friend who told me that birth is like a wedding -- it should happen exactly how the mother (bride) wants it to. And this is so true...weddings take much preparation and planning, there is excitement and stress, we invite who we want to be there (no one would dream of crashing in on a wedding uninvited), we choose our location and attendant carefully, and through it all the bride is center stage, the one given the most consideration, the most honor. Birth can and should be the exact same way. Birth is best if it is.

Do You Doula?

2009-05-23T13:40:00.000-07:00

Why the Fuss?

2009-05-12T22:13:00.000-07:00

I've had to delete this post because it has caused some unwelcome traffic. I'll try and find a link to another one so you can find it if you need to.

Two Births, One Doula

2009-04-25T21:09:00.001-07:00

As soon as we saw the plus on the stick, my husband looked at me and said, "Are you going to call Stacey?" So before I called a midwife and before I even told my mother about my third pregnancy, I called my doula to make sure she was available to support me at this birth. There was such peace knowing that she would be there with us again.

My doula left such an impression with me after my second birth. When she came into our hospital room she brought with her so much confidence -- confidence that I could birth my baby MY way. Confidence that I could get through it and that all things would play out exactly as they should. She breathed with me through ever contraction, shushed my husband and mother when I asked her to, knelt by my feet while I rocked in a chair, sat next to the tub while I moaned, whispered over and over that I could do this, that my baby would be here soon. She prepared me for some serious pain, dried my naked body with warm towels and helped me dress. She helped me walk, make the arduous climb onto the too tall hospital bed. She was unfazed and matter-of-fact. She was my lifeline and connection to Earth. And when baby came, when I finally got to hold him in my arms, she faded into the walls, guarding my space, so that I could marvel at my newborn with his daddy.

You understand now why I couldn't imagine giving birth again without her there.

It was awesome having her at my home as my doula the second time around, but just as each birth is never the same, our doula/client relationship was different this time also. Here is an excerpt from an email I sent Stacey just a couple of weeks after the birth of our third son, Sam.

I have wanted to tell you that I feel like I learned more about being a doula after Sam’s birth then I thought I could. Even though you did more physically when I was birthing Charlie, you were there for me more emotionally for Sam. It felt very nurturing, maybe because I trusted/knew you more. It was a beautiful experience to have you there. I feel even more inspired and more equipped to work with women.

My third labor, once active, was a collision course towards pushing and birth. I was so in the zone ("labor land", as some people call it), I barely noticed the presence of anyone. I needed to totally go inside of myself in order to manage the pain and maintain some control over my body. This time I didn't need my doula right by my side assisting me through every contraction, talking me through it all, encouraging me with her words. Instead what I needed was just...HER. Her presence, her energy, and her nurturing spirit.

After Sam was born, and I was all cleaned up and snuggling my baby in bed with me, my doula came into the room to say good-bye. It was time for her to go home. She brought me a drink and then smoothed my damp hair off of my face, and told me that I had done such an amazing job and that she was so glad that she got to be there. Her words and touch soothed me more than anything else I had experienced that night, because she made me feel honored and special, that my birth wasn't just all about getting a "healthy baby".

Being a doula is more than just the physical services that we have to offer. Labor positioning, massage, coaching, praising, counting and hand holding are all very important, and each birth demands its own type of support, but being a good doula is more than just being good at these things. Being a good doula is about embodying the entire definition of the word doula, to provide physical and emotional support for the pregnant and birthing woman. And, in my opinion, none of that physical stuff will work without an emotional connection. It is that critical.

Emerging

2009-04-21T19:23:00.000-07:00

Hi! Remember me? I think there are a couple of you that check in here.

It has been too long since I have posted to this blog, and I am back to remedy my ways. Over the past few months I have had several posts nearly completely written in my head, and then didn't have the guts (or the time) to fully translate it to type. I have missed this place, and plan on renewing my commitment to take the time to express my thoughts on pregnancy, birth, mothering and breastfeeding. This is an exciting time in the birth world.

The summer is fast approaching and my baby is nearly one. I am amazed at all that has happened this past year -- it has been a good one. I love being a doula! It is an honor to be a part of such an important time in a couple's life, and I look forward to supporting more mothers this year on their childbirth journey.

Cost Versus Benefit

2008-10-17T19:28:00.000-07:00

From a recent article in USA Today:

"Childbirth is the leading reason for hospitalization in the USA and one of the top reasons for outpatient visits, yet much maternity care consists of high-tech procedures that lack scientific evidence of benefit for most women, a report says today."

Currently, one-third of births in the United States is a c-section (the cesarean rate at our local hospital is currently just over 40%), and I would venture to say that nearly 50% of hospital births are started by induction. Interventions in childbirth seem to increase every year, and it is important to ask -- Are births getting safer?

To read the full text of the quoted article, follow this link.

The Winner Is...

2008-10-05T21:53:00.000-07:00

Team Hanni, commenter #6. Please email me with your info, and I should have that to you in a week.

Ring Sling Giveaway

2008-09-30T09:13:00.000-07:00

I recently purchased some beautiful, natural colored, linen/rayon fabric with the intention of sewing myself a sling. Since I can easily make two slings with the fabric I have (each will be 30 inches wide), I thought it would be fun to make another to give away.

Leave me a comment to enter yourself into this giveaway, and I will randomly select the winner next Sunday evening.

The winner will get to choose the color of the rings and thread (the fabric is a neutral light tan/khaki color), and should receive their sling within a week of being chosen. You also don't have to live locally to enter -- I'll just put it in the mail.

Good luck!

PS: This type of sling could be used with a child up to about 35 pounds, so you don't have to have a tiny baby to enter.

Things to Ponder

2008-09-17T21:48:00.000-07:00

I just got done watching the trailer for The Other Side of the Glass, a movie that is geared towards empowering fathers to preserve their baby's space after birth. It was pretty mind blowing.

I think sometimes we are geared to think that things are a certain way, just because that is how it has always been. If we have a baby in the hospital, such and such will happen. If we have a baby at home, so and so will happen. We forget, sometimes, that just as we have rights that should be honored, our newborn babies also deserve those same protections.

It is difficult at the very end of birth for the mother to be able to totally advocate for herself and her child. Sometimes she is experiencing her own interventions that can take away her ability to totally focus on her baby (placental delivery, stitches, c-section, anesthesia, etc.), and this is why she totally and completely depends on her birth partner to watch over her newborn's safe-keeping. I don't think that most fathers are equipped to advocate for their child. It can be intimidating to stand up to or question those we consider professionals.

I know some people will watch the trailer and think of their own birth experiences (I know I did). You may feel that the interventions that your baby experienced after birth were necessary or that they caused no ill effects. Watching the video may cause you to relive your own and your baby's birth trauma. For me, the trailer reminded me that babies, in utero and freshly birthed, are sentient. They are individuals with a brain and a heart and a soul. They have awareness and memory. They should be treated with tender hands, soft voices, and with respect.

Now go watch the trailer and tell me what you think.

Due Before December?

2008-09-01T14:43:00.000-07:00

I am trying to achieve DONA certification before the beginning of the year and would love to attend two births in November/December. If you are due during that time, and would like to have support of a doula, please email me for information. I am offering my services for FREE!

Worried About a Big Baby?

2008-08-29T09:11:00.001-07:00

Like many women, I've watched my share of pregnancy/birth shows (like A Baby Story), and recently I've noticed that many of the moms are told at some point towards the end of their pregnancy that they could possibly have a "big" baby and should consider induction. Having a larger than normal baby can be some women's biggest fears when it comes to childbirth.

The difficulty lies in the idea that there is no way of truly knowing how big a baby will be at birth. Fundal height measurements are affected by amniotic fluid levels, baby's position and mother's body. Ultrasounds have not proven completely accurate in measuring how big a baby actually is. Even a skilled practitioner cannot be totally sure of a baby's size by palpitation (although some really like to try and guess).

I think the key to a healthy and happy birth is truly accepting the idea that women's bodies are designed to give birth. We will grow a baby that is the perfect size for us. The greatest majority of the time, all will be well with our labor and delivery if we trust our bodies to do what they are made to do without interference.

If you would like to do further reading on the subject, check out this wonderful article by a very experienced birth doula.

Sam's Homebirth

2008-07-02T23:11:00.001-07:00

Make an on-line slide show at www.OneTrueMedia.com

Sam's Birth Story, Part V -- Birth

2008-07-02T23:02:00.000-07:00

When Pam told me she was concerned about the blood she was seeing and that she wanted me to get serious about pushing, I wasn't concerned. I was so inside of myself, overwhelmed with the intensity of what I was feeling, that what she said didn't worry me. I knew that everything was going to be okay.

As the next contraction started to build, I started to push. Hard. It was the strangest feeling -- almost like I was pushing against a brick wall. It felt like this baby wasn't budging a bit, and remembering that no one had checked my cervix to tell me that I was fully dilated (I was operating on instinct), I wondered if my sense was correct. Maybe my body wasn't ready yet. No sooner had that thought crossed my mind, then I felt an explosion. I had pushed the baby's head out without even realizing that I was crowning. I wouldn't have even known that the head was out if somebody (I don't know who) hadn't said something. Being in the water took away all of those "ring of fire" sensations that I was expecting. It was amazing.

Pamela and Lennon reached across to unloop the cord from around the baby's neck. This is the part that I wasn't aware of until I saw pictures. My back was to everyone and I had no idea anyone even came near me (shows how good they are at their job). With another small push, the baby shot out towards the other end of the pool, totally under the water, and Lennon reached in and "swooshed" the baby back through my legs so I could pick him up.I reached down and pulled him up by the armpits, and held him to my chest. I was in awe. I was finally able to open my eyes to look up and see my family gathered on my bed. Mike and John were smiling; my mom was crying; Stacey, Lennon and Pamela looked so supportive. I was filled with love. Love for this new little boy I was holding against me, and love for my family and friends that were able to share the experience with me. I don't really think I can find the right words to describe that moment with any accuracy. Just filled with joy.

Cradling him in my hands, I held him out so I could have a look at him. He wasn't moving at all or making any noises. For a moment I was worried something was wrong, but right then he brought his arm to his face and let out a little coo. He never cried. He kept his eyes closed, and to me it seemed like he must have slept through most of labor because he really acted like he was asleep. I studied his faced wondering who he looked like, and noticing his nose first, I announced that he looked like Charlie. He was perfect.

Pretty quickly Lennon had me get out of the pool to sit on the birth stool to await the delivery of my placenta. She wanted to better be able to monitor my blood loss. Even though labor was over, I was continuing to have contractions and cramping, as my uterus was clamping down, trying to do the last of its work. This was not fun. I wanted to just hop in bed and cuddle with my baby, but instead I was squatting on a very low stool that resembled a toilet seat while holding my baby. Someone helped me take of my swimsuit top and wrapped me in a towel so I could keep Sam warm. After a half-hour of waiting, I got impatient, and Lennon did a little cord traction to see if the placenta was sitting right there, but it stayed put for the time being. Finally, after another fifteen minutes (45 minutes total), the placenta plopped out into a metal bowl after a little push from me. My pesky placenta and I were finally face to face, and I could care less. I was ready to get cleaned up and get into bed.

Stacey and Lennon washed me from the waist down and checked for tears, all while little Sam was in bed with me. After pushing so hard, and not very carefully, I fully expected to need some stitches. Amazingly, I only had a very superficial first-degree tear that did not require stitching. As they were working on me, I was able to put Sam to my breast and he latched right on. His eyes were open wide and he just stared at me while he nursed. It is my favorite memory of the birth. I felt so bonded to him. While he was nursing I could hear that Charlie was up too, and I could hear him laughing and playing with Mike and John.

Lennon weighed Sam right next to me on the bed. He was seven pounds, two ounces -- my smallest baby by nearly a pound. After he was weighed Lennon asked me if I would like to dress Sam, but I was too tired so I asked her if she would do it. She dressed him in a little nightgown that I had picked out and set aside several weeks before he was born. Pamela came in and washed my face with a cool washcloth, and it felt like heaven. I was so hot. I got up and put on a clean t-shirt and climbed back into bed.

Soon, Stacey, Lennon and Pamela made their way home. They would be back the next day to check on me. My mom and Mike settled down the kids and got them ready for bed. Slowly, the house became quiet and dark and Sam and I snuggled into my bed together, mother and baby son. It took me a long time to fall asleep. My mind was full of memories of the last 48 hours, amazed at how perfectly things had turned out despite my worries and fears. Looking down at this new little boy, I felt a strong sense of completion. We had our three boys: John, Charlie, and Sam, the children I felt that we were meant to have.

Finally, as the night sky started to glow with the sun's first light, I fell into an exhausted (and sweaty) sleep, holding the sweetest smelling baby in my arms.

Sam's Birth Story, Part IV -- This is It!

2008-07-01T23:05:00.000-07:00

I've read several birth stories lately where the author has used their midwife's notes to write everything out. This makes sense, because when in the throes of labor, it can be very difficult to be aware of everything that is going on. Everyone at a birth has their own experiences and perceptions, and I've done the best I can to be as accurate as possible, while sharing my own perspective of the birth. Interestingly, I got some pictures back from my doula the other day of the birth. She had captured a picture of something that I had absolutely no idea had occurred (I'll share more about this later). I don't know where I'm going with this, other than to say that the facts presented are my own thoughts of how everything occurred, and maybe I'm not totally accurate, but I think I'm pretty close.Back to the story...

Stacey, my doula, was first to arrive. It was about one o'clock in the morning. I had been in the water for less than five minutes, and I really had a hard time finding a comfortable position. I tried sitting cross-legged, leaning back against the walls of the tub, floating on my stomach, and kneeling, but as soon as a contraction hit my whole bottom would hurt so bad that I just didn't know where to situate myself. I started yelling, "No, no, no, no, no" over and over during contractions. Stacey encouraged me to relax my face and that I could definitely do this.

Lennon came in soon after to listen to the baby's heart rate during a contraction. She didn't make me move at all, and just stuck the doppler into the water and listened. The baby had gotten a lot lower so it was difficult to find his heartbeat, but she did after several tries, and it was a wonderful sound.

Within minutes, the contractions were right on top of each other. I was yelling my way through them. I was yelling so loud that I was sure I would wake up the kids and my neighbors. Later, my midwives told me that I wasn't yelling all that loud, but, in the moment, I felt like I was loud enough to bring down the roof. It was the only way I could manage the pain. I never would have felt comfortable yelling like that in the hospital, but it really helped me to feel better.

Stacey mentioned that she would like to try and take off my swimsuit bottoms in between a contraction (unlike me, she actually thought I might have a baby sometime soon). I agreed with her, but the contractions weren't really having a breaking point, and the baby was just pushing down so hard. Every time he moved it was excruciating and the most difficult part of labor. I had never experienced that sensation before. It was almost more than I could handle. I kept saying, "don't move baby, please don't move". At some point, Stacey came over and yanked off my underwear. It was quite an ordeal, and one of my funniest memories of the birth. Me squirming around, trying to lift my hips and her pulling off my very wet, and difficult to maneuver, bottoms off.

I wish I could share some amazing technique that I used to get through those contractions, but I don't. This was such a different labor for me, and it was all I could do to get through it. I was yelling, saying I couldn't do it, crying. I didn't visualize a bud opening up to the flower. I didn't have a mantra. I felt like I was on a runaway train, and was just hanging on for dear life.

A little before 2:00 AM I switched positions to lean over the side of the pool. My back was towards everyone. Lennon came over to listen to the baby again. I had another contraction, but it felt different this time. It felt good. It wasn't painful. I was able to just breathe through it and didn't feel the need to yell. At the peak of it I wondered if my body was starting to push. I told Mike that I thought it was time to go and wake up John. I waited for the next contraction to actually try pushing. The contraction came and as it peaked I pushed a little bit. I could feel my water breaking and said so out loud.

From behind me I heard Pamela's voice. I hadn't even realized she was in the room. Quietly she told me that she was seeing a little more blood than she likes to see (I hadn't noticed that the clear water of the birth pool was slowly turning red) and that she would like me to push really hard during the next contraction and get my baby out.

I grumbled something about already pushing hard, and started to bear down.

Sam's Birth Story, Part III

2008-06-23T11:14:00.000-07:00

Since completing my doula training, and immersing myself in birth culture, one of the things that really interested me was fetal positioning. Although I had never experienced it myself, I had heard many stories of friends who had had excruciating back labor, indicating that the baby was posterior (facing forward). I also had read about ascynclitic (baby's head cocked or angled to the side) births, where labor and delivery lasted forever because baby was not in an optimal position. Probably due to all of this exposure to alternative positioning, I had a lot of concerns about how I might handle this if it happened to me. My midwives can attest to me bringing it up often during our visits, asking them what we would do if I experienced back labor or a different "malpresentation". I read books about optimal fetal positioning, slept on my side, didn't recline backwards, sat forward on my birth ball, spent a lot of time on my hands and knees, and even visited a doula friend in another town so she could rebozo me, encouraging baby into a good position.

Prodromal labor is sometimes referred to as "false labor". There is nothing "false" about it, however, as it really does serve a purpose. Prodromal labor are contractions that are irregular, that do not get closer together or more intense, leading up to birth. Prodromal labor can dilate and efface. Prodromal labor can be painful and intense. It can last for hours or days. The main purpose of prodromal, or pre-labor, is to get your body and baby ready for delivery. The contractions can help baby move into a better position. Women who experience prodromal labor can also have shorter periods of active labor.

None of these rational thoughts were running through my mind on Friday evening. I had burst into tears off and on all day in frustration and fear. By 7:00 pm I was completing 16 hours of contractions that were hurting and exhausting me. I hadn't slept more than an hour in the past two days and I could sense that I was reaching my limit. In desperation, Mike and I took a walk around our neighborhood. It was the same route that we took the afternoon before Charlie was born, and maybe I was hoping for similar results. On our walk, Mike reassured me that everything was going to be just fine, and that he trusted what our midwives had told us -- that labor would start that night. I tried to share his optimism, but thought to myself that he wasn't the one enduring contractions every five to 15 minutes.

Shortly after getting home, we all decided to go to bed. My mother had decided not to go home that morning and was going to stay the night. I actually encouraged her to go home because I was sure that as long as she was there I wouldn't go into labor (for some reason). My mom slept in with John and Mike slept out on the sofa, knowing that I probably wouldn't be doing much sleeping once I got into bed. I laid on my side in my bed trying to sleep a little in between contractions, but rest wasn't forthcoming. I stared at the birth pool, inflated but empty. We had changed the sheets that morning and all of the birth supplies were out. Everything was ready, but was I ready? Was the baby ready? I just couldn't shake the feeling that something must be wrong for me to be experiencing this type of labor.

A couple of hours passed with me just laying there, still contracting. I watched TV for a while. Eventually, about 11:30 I got up to use the bathroom. After I stood up from the toilet I had a contraction, just slightly stronger than the ones I had had in bed. I had the idea to just stand up for a little bit to see if the next contraction would come a little sooner. Five minutes later I had another one. And then five minutes after that I had a contraction so strong that I started moaning and rocking back and forth. I questioned myself. Could this be it? Was it just another false alarm? Suddenly I decided that I didn't care if it was a false alarm, I was going to get in my birth tub anyway.

I turned on the water to start filling the tub and walked out to let Mike know what was going on. On the way to the living room I was struck with another contraction. I had to stop to moan and sway. In the darkness I watched Mike sleeping on the sofa, debating whether to wake him. My moaning woke him up, though, and he immediately hopped up to assist me. Before I could finish telling him what was going on I had another contraction and the moaning and swaying resumed. Mike put his hands on my shoulders to comfort me, and said, "Oh, Amy!" Believe it or not this was my first experience having my husband be my labor support. In the hospital environment he had always been too intimidated, but at home we were able to be more comfortable and intimate. I finally was able to tell him that I was filling the pool and getting in no matter what. I didn't care anymore if we had the baby at home and we could just go to the hospital for a c-section in a couple of hours if the baby didn't come. I couldn't do it anymore.

I walked back to our bedroom and put on my swimsuit, top and bottom. My mom woke up, and I told her to go back to bed. In all of my craziness, I was worried that if she looked at me that labor wouldn't progress (kind of like the morning), but she told me that there was no way she could go to sleep. Fine, I thought. Whatever. I didn't have the energy to care about anything anymore, and I was very cranky. I called my doula and my midwives. I mentioned to Pamela on the phone that I just wanted to let her know that I was planning on going to the hospital for a c-section in a couple of hours, that I just couldn't do labor anymore. I could hear her smiling through the phone. All the while I was contracting and moaning every three minutes.

With everyone en route back to my house, I settled myself into the very warm water of my birth pool.

Sam's Birth Story, Part II

2008-06-23T11:10:00.000-07:00

Just a little after midnight, on Friday, May 23rd (39 weeks, 4 days pregnant), I woke up to go to the bathroom. After emptying my bladder, I knew it would be impossible to go back to sleep. I had had pretty bad insomnia for the past several weeks. Moving around in bed was just so painful, and I had to get up to pee every half-hour, so it was hard to see the point of trying to sleep for any length of time. I headed to the living room and watched the season finale of Grey's Anatomy and ate a bowl of cereal. At about 3 AM I went back to bed and as soon as I laid down I had a pretty intense contraction. I laid there to see if another one would follow -- it did, but not for another half-hour. Thirty minutes later, I had another one. Then another twenty minutes later, then ten minutes later, then five minutes later. They were definitely getting closer together.

All this time I just laid on my side watching the clock, until contractions seemed to be about 3-5 minutes apart, when I got up to get on the computer just to distract myself. I announced to my online due date club I was in labor, emailed some friends, and timed my contractions using contraction master. Because my labor with Charlie was about five hours total, I assumed I would be holding my baby before lunch time.After about half-an-hour of contractions that were about three minutes apart, I called my midwife, my doula and my mother at about 5:30 AM and woke Mike up to get the birth pool ready.

My contractions were strong, and I had to focus through them. I moved to the living room and bounced on my exercise ball, listening to Mike fill the birth pool with air (it was annoyingly VERY loud), and John, who had since woken up, trying to help while asking lots of questions. I felt irritable and just not able to focus. The chaos of my house that morning, as the sun was coming up, was not how I envisioned my beautiful homebirth. Soon the midwives arrived, along with my doula, Stacey. Stacey had been at my last birth, and has since become a very good friend and doula mentor. I couldn't imagine giving birth without her. I was happy to have everyone there, but as soon as they arrived it seemed that my contractions slowed and were no longer moving in a regular pattern. They were still painful and intense (I described them as 6 cm contractions, as they felt about as painful as the contractions I experienced when I was 6 cm along before I gave birth to Charlie), but very spaced out. I started to feel like a watched pot, and told everyone that I was going to go lay down in my bedroom and try and rest. I was really tired, as I had really not slept the night before. I laid in bed for more than an hour, listening to my ipod, trying to focus on my body, willing the contractions to come.

At some point my mom came in to let me know she was there. I shared with her that I thought things were slowing down and I was discouraged. I had assumed that the baby would be here before noon, but it seemed like that wasn't going to happen. Around 8:00 AM, Lennon, the midwife's apprentice, came in to let me know that Pamela, my midwife, was going to go back to Salem to go to her other job, but that she would come back as soon as I needed her. Lennon also let me know that it was very common for moms' labors to slow down as the sun comes up, as it is when our house starts getting busy and our other children need our attention. Stacey also came into my room to see how I was doing. I expressed my frustration. Why was I having these painful contractions 10 minutes apart, when in my last labor these types of contractions seemed to get closer and closer together? I worried that something might be wrong. Both she and Lennon assured me that everything was fine. That I would develop a regular labor pattern, but that things probably wouldn't pick up until the nighttime, when the kids were in bed.

I asked Lennon if she thought I should have a vaginal exam to check my dilation (I hadn't had one during all of my pregnancy, and actually had a goal to not have one at all -- I wanted to be able to just trust my own instincts when it came to labor and pushing). Lennon was willing to do one, but she asked me what I hoped to gain by that information. She reminded me that my current dilation was no indication as to how long I would labor. I decided against the exam. I was just frustrated and impatient. At 9:30 AM I sent everyone home with the hopes that I would be calling them shortly when labor picked up. I almost cried as I heard their cars pulling away.

Meanwhile, my contractions, painful, but irregular, continued.

Sam's Birth Story, Part I

2008-06-23T10:59:00.000-07:00

Never has a pregnancy seemed to stretch out over eternity. Never has a pregnancy seemed to pass by in the blink of an eye. Looking back over the last 10 months, I am amazed at all that has occurred, and all that I have experienced and learned while pregnant and giving birth to little Sam. I am reminded of how ordinary pregnancy and childbirth are -- thousands and thousands of women experience it every day -- but also how growing a baby inside of you (a soul that started out as two cells), and then laying eyes on your baby for the first time, is the greatest miracle ever to be experienced by a mother. I feel so blessed to have experienced this miracle again in my life.

I wasn't thinking about the miracles of childbirth, however, when I was puking my guts out for the first six months of this pregnancy. I truly had never felt so miserable. Sudden movements, bright lights, or any smell at all would send me running to the kitchen sink. I honestly wished I could curl up in my bed, in my dark bedroom, for the rest of my life (or at least until the baby was born). Everyone I talked to said they thought I must be pregnant with a girl this time because of how much more sick I was.I also heard from several people that the third pregnancy and birth can really throw you for a loop, so I should prepare for anything. I had felt so awesome after giving birth to Charlie, often referring to it as the perfect labor and birth, and felt daunted by the idea of trying to manage something that might be more difficult. Especially since Mike and I had decided even before I was pregnant that if we had another child we would do it at home, with the assistance of a midwife. While having Charlie in the hospital was just fine, and everything turned out great, my post-partum experience there was pretty horrific, and neither of us felt like it was the right place for us to have another baby. I found an amazing homebirth midwife, who had an equally amazing apprentice, and I started getting really excited about actually experiencing a birth at home.

At 20 weeks I went in for a routine ultrasound and was thrown my first "loop". The technician assured me throughout the screening that the baby looked great and healthy, but I could just tell that something was up. I had a nagging feeling for a day or so, and kept bugging my midwife for the report (for some reason it took several extra days for her to receive it). Three days after my ultrasound she called to tell me that I had a complete placenta previa. I was totally in shock when I heard the news. I couldn't get ahold of Mike, so I called my doula (and friend), Stacey, and just cried and cried to her about the idea of trading in my homebirth for a surgical one.A complete previa means that the baby's placenta was situated directly over my cervix, which, if by 37 weeks the placenta had not moved, the baby would need to be delivered by cesarean section. Also, with a previa, there was a likelihood of pre-term bleeding and premature birth, as any strenuous activity or dilation and effacement could cause severe bleeding. I felt like I had been hit with a ton of bricks. Not only was I looking at the real possibility of having a surgical birth (the Internet didn't offer much hope of a complete previa resolving), but there was a real possibility that I might have to go into the hospital for a long term stay if I did experience any bleeding and that our baby could be born pre-term, possibly needing a NICU stay. Interestingly, about a week before I found out about my diagnosis, a family friend had been hospitalized at 28 weeks for a complete previa. She ended up having to stay in the hospital for about five weeks before they delivered the babies by c-section. Mike and I started trying to make plans for what we would do if we were faced with the worst case scenario.

Around the same time, our youngest, Charlie, started experiencing some very strange health issues. He would wake up shaking uncontrollably, with muscle weakness and balance problems. This went on for several days before I took him to the doctor for testing. It could be anything to a strep infection to the onset of a muscular dystrophy. We had no idea. After a week of sleepless nights and so many tears, all of the test results came back negative. Although most of the issues had resolved, we still weren't sure what the cause was.

With all of this stuff going on, it was really hard to feel excited about my pregnancy. I didn't even want to read any of my birth books or talk about the birth. When people would ask me about my pregnancy, I didn't really know what to say. It seemed like just when I was starting to feel physically better, I was mentally at my worst. The unknown of everything that was going on was more than I thought I could handle. My husband, however, remained optimistic through it all, encouraging me to have faith that things would work out as they were meant to, that all would be well.

Meanwhile, my midwives were also very optimistic that things were going to be just fine. My midwife's apprentice, Lennon, had actually read some research that indicated that my previa was in the perfect position to move. They encouraged me to visualize it moving, and suggested some herbs to take that had been related to successful resolution of the diagnosis. It helped to feel like I could actually do something rather than sit around for eight weeks waiting to learn my fate. Finally, finally, finally, at 28 weeks pregnant, we discovered that the placenta had actually moved (a full 7 cm away from my cervix) making it totally possible to have the baby vaginally and at home. I felt like those ton of bricks that had been weighing me down for the past two months were finally shrugged off my shoulders. I was elated, and actually started thinking about the upcoming birth, trying to connect with this baby inside of me for the first time.

I Had a Baby!

2008-06-23T10:57:00.000-07:00

On May 24, we welcomed a new little boy into our home. Now you know why I've been such a slow blogger. I've decided to share Sam's birth story on this site (it is in several parts, and is still on-going) and plan on publishing a slide-show of his birth once the story is complete. I should be back to doula work late Fall, so don't hesitate to contact me if you are due after that time.

The Joys (and Ease) of Babywearing

2008-03-23T22:08:00.001-07:00

My sister carrying my niece, Ava, in a ring sling while touring the fabric district in L.A.

I knew when I had my second child that I wanted a way to keep baby attached to me during the day, so that I was able to have my hands free to care for my older son. I had used a Baby Bjorn when my first was small, but that caused my back to ache and I don't think it was very comfortable for baby. So I did a lot of research and eventually had a ring sling made for me, and then went on to make my own pouch and then a mei tai. I was bitten by the baby wearing bug.

Charlie loved the pouch!

There are so many carrier options, that with a little bit of research parents can find the perfect carrier (or carriers) to suit their lifestyle. A good place to start is The Babywearer website. There you will find descriptions of different carriers, reviews of particular products and the vendors that sell them. Locally, there is a babywearing group that gathers regularly to troubleshoot issues, try on different carriers and promote the idea of babywearing.

Charlie, as a newborn, cuddled in my ring sling.

I wish I had pictures of me wearing my children as they have gotten older, but with the right carrier it is possible to carry your child until they are over 30 pounds with no discomfort. It makes having a stroller pretty obsolete. And making dinner with a fussy baby who wants to be held a piece of cake.

I'm Back!

2008-01-15T17:39:00.000-08:00

I apologize for my long absence, but I'm excited about the upcoming months and all that is happening in the birth world. Look forward to more regular posts from me.

I just had to share this amazing video, showing a woman singing her baby down during labor. It is absolutely beautiful and inspirational!

Madeleine's Birth Story

2007-10-10T19:57:00.000-07:00

September 25th 2007

On Tuesday morning, at (35 weeks, 6 days pregnant) before she went to work, McKenzie had the sensation that maybe her bag of waters had broken. She made the decision to just keep an eye on things and continued on with her day. As time went on, she became more concerned that she may be leaking amniotic fluid, so she called her doula, Amy, to get her opinion. Amy suggested that she contact her doctor and get an opinion from them, but also told McKenzie that everything was probably fine and not to worry. McKenzie trusted her instincts and despite speaking to someone at her doctor’s office who did not think that her water had broken, insisted that she get checked, so she and her husband went to Labor and Delivery. Once she had checked in, it was determined that McKenzie was correct, her bag of waters was ruptured and her baby was going to be born that day. She was feeling some mild contractions at that point. After a vaginal exam, her doctor wasn’t sure if the baby was head down, so an ultrasound was performed and McKenzie and Treven discovered that their baby girl was in a breech position. She would need to be delivered by cesarean section. The surgery was scheduled for 9:00 p.m., as McKenzie had eaten on the way to the hospital (wanting to keep up her strength for impending labor).

Despite the change of plans, McKenzie and Treven maintained such a positive attitude, focusing on getting to meet their healthy baby. McKenzie’s mother arrived at the hospital around 7:00 p.m. and was soon followed by McKenzie’s father, step-mother and then her brother. The grandparents were so excited for the birth of their granddaughter, although a little nervous about what their daughter may have to go through. All during this time, the baby’s heart rate was monitored with an external fetal monitor, and her she sounded very healthy and active. At 8:00 p.m. the anesthesiologist consulted with McKenzie about the details of her surgery. Twenty minutes later, family left McKenzie and Treven for the waiting room, allowing the couple some alone time to reflect on their impending parenthood before the surgery.

At 8:30 Treven’s mother and brother arrived and were able to go back and quickly wish the parents luck before they also came to the waiting room to wait it out. Everyone anxiously awaited any news and were watching the doors for Treven’s face. At 10:45, Treven finally came into the waiting room to let everyone know that Madeleine had been born at 9:24 p.m., was 6 pounds, 6 ounces, and 18 inches long. Baby was doing well and had been able to nurse and spend time with mom and dad very soon after delivery. Much cheering and hugging ensued. The grandparents (and doula) were invited back to see mom and baby in the recovery room. McKenzie looked so happy and proud, and despite her trembling arms, was able to cuddle little Madeleine to her with ease. She was a natural mother. Everyone gushed over the very adorable baby and took lots of pictures.

Although McKenzie didn’t get to have the exact childbirth experience she wanted, she was able to deliver a very healthy baby with the encouragement of her husband and loving family. I felt so honored to be able to support McKenzie and Treven at the birth of their daughter. It is something that I will always remember.

Kegels -- the Exercise For "Down There"

2007-09-19T07:43:00.000-07:00

I remember being about 34 weeks pregnant with my second son when my midwife sat me down and had the "kegel talk". She basically informed me that if I had a desire to minimize perineal tearing at birth, prevent urine leakage, and have a speedier recovery, I needed to get serious about doing kegel exercises on a regular basis. Previously, I had been half-hearted, at best, in my efforts to exercise my pelvic floor muscles, not doing anything with any regularity -- a kegel here, a kegel there, even though I knew the potential benefits. I suppose, until my midwife got serious with me, I didn't truly understand the benefits of kegels for not only pregnant women, but women of all ages.

The Kegel exercise is named after a doctor who developed the exercises to tone and strengthen the pelvic floor muscles. These muscles act like a hammock, holding up the uterus, bladder, and bowel. A strong pelvic floor prevents organ prolapse (vaginal, uterine, rectal) and urine leakage, while promoting healing to the perineum. The exercise also tightens and strengthens the muscles in the vagina, providing greater sexual sensation.

It may take a little practice to find the right muscles to exercise, but a great way to initially practice the contraction is to try and stop the flow of urine while you are going to the bathroom (do not make a habit of stopping and starting your urine flow, as it can actually weaken the pelvic floor, but just try it initially to find the right muscles). If you succeed, then you have just practiced the most basic move. Try it a few more times until you feel confident that you know what muscle to squeeze. You should feel your vagina tighten and your pelvic floor move upward. In relaxing the squeeze, you will feel your pelvic floor move down and your vagina relax. As your muscles get stronger -- and you get more experienced -- this movement will become more pronounced.

As far as a regimen goes, most proponents of the exercise say you need to do about 200 a day to get the benefits. My midwife recommended finding four different times a day that I could spend five minutes doing kegels. I usually was only able to fit in two times a day. I recommend that each session include 10 sets of 10 quick squeezes (with a 10 count rest in between each set of 10) followed by 10 sets of long squeezes (with a 10 count rest in between each set of 10). This should develop into a lifelong habit so that you can see lifelong results.

How to Avoid a C-Section

2007-09-11T22:47:00.000-07:00

I recently read an article posted on CNN (linked to by several blogs that I read) which listed very succinctly five ways to avoid a c-section.

1. Don't get induced unless medically necessary

2. Labor at home until you're approximately 3 centimeters dilated.

3. Choose your hospital, and your practitioner, carefully

4. In the delivery room, ask questions if your practitioner says you need a C-section.

5. Get a doula.

Please read the whole article to get more details. With the amount of hospitals who are willing to allow patients to attempt V-BACs (Vaginal Births After Cesarean) nearly disappearing off of the landscape, it is even more important for pregnant ladies to be informed of their practitioner's and hospital's cesarean rates. And while a doula cannot "protect" a woman from getting a c-section, working with a doula can help you endure the last weeks of pregnancy, avoiding induction, and labor in the comfort of your home for as long as possible.

Wondering Whether to Hire a Doula?

2007-08-23T16:00:00.000-07:00

If finances has been a concern in whether or not to hire a doula for your upcoming birth, I wanted to put it out there that I will be offering my services at a HUGE discount while I am working towards DONA certification. Please contact me if you would like more specific information.

What About Dad?

2007-08-20T13:13:00.000-07:00

Many fathers may wonder how having a doula present at birth will affect their role in their child's birth. I think it's natural to feel nervous about the prospect of bringing another person into the birthing space. Penny Simkin, P.T., a world-renowned doula and birth educator wrote the following, which will hopefully put dad's mind at ease.

Myth 1 - If a woman has her partner, the doula becomes redundant.

Reality - The doula may be the only person at the labor besides the partner who is there solely for the emotional well-being of the woman. The nurse, the doctor, the midwife have other priorities that compete with the emotional care of the woman: for example, breaks, shift changes, clinical responsibilities, office hours and hospital policies. The doula has few or no other priorities. She stays through shift changes, and until after the baby is born She is not just another stranger with the couple; she has the woman's needs as her sole priority. In some cases, the couple will bring several other friends or family members into labor with them. Sometimes these people can be uncertain of how to help which leads to confusion and actually adds to the woman's stress. The doula can direct and coordinate the efforts of a group of people, giving them all something useful to do, so they work as a team on the woman's behalf.

Myth 2 - The doula "takes over", displacing the partner and interferes with their intimate experience.

Reality - The doula can actually bring the couple closer. By making sure that the partner's needs are met (food, drink, occasional back rubs, and reassurance), the woman and partner can work more closely together. The doula allows for the partner to participate at his own comfort level. Some partners prefer to be there only to witness the birth of their child and to share this experience with the woman they love. They may not want to play an active role and do not want to be responsible for the woman's comfort and emotional security. The doula can fill in and allow the partner to participate as he wishes, without leaving the woman's needs unmet. When the partner chooses to be the major source of emotional support, the doula can supplement his or her efforts by running errands, making suggestions for comfort measures, and offering words of reassurance and comfort. During a long tiring labor, she can give the partner a break for a brief rest or change of scene. While the doula probably knows more than the partner about birth, hospitals, and maternity care, the partner knows more about the woman's personality, likes and dislikes, and needs. Moreover, he loves the woman more than anyone else there. The combined contributions of partner and doula, along with a competent, considerate and caring staff gives the woman the best chance of an optimal outcome.

Myth 3 - The doula has her own beliefs about how the birth should go, and imposes it on the woman or couple.

Reality - The doula's true agenda is to help ensure that the woman's or couple's agenda is acknowledged and followed as much as possible. If the doula is thoroughly familiar with the couple's wishes and their birth plan, she may actually think more about it than the couple, especially when labor is intense and things are happening rapidly. The doula can remind the staff or the couple of some items on the birth plan that are forgotten, but which later might be important. Sometimes if a birth plan is not followed, the couple later look back with regret or disappointment. The doula helps with decision-making by asking questions that will ensure that the right information is given to the woman or couple so that they can make an informed decision. She may also suggest alternatives for the couple to consider. She does not, however, make decisions for the couple. In summary, the doula helps make the birth experience to be as rewarding and satisfying as possible.

As one father said, "I heaved a big sigh of relief when she (the doula) walked in. I hadn't realized how much pressure I had been feeling. She not only calmed my wife, she calmed me down."

I know my own husband was so happy with our doula's services that he wished we could have paid her twice her fee, because her presence made him feel so much more relaxed and able to focus on the birth, rather than worrying about me.

Birth Planning

2007-07-09T11:42:00.000-07:00

Many pregnancy websites and books suggest that you write up "birth plan" before your delivery in order to share your preferences with your care provider ahead of time. You can also have that birth plan put in your file, so that those that you come in contact with at the hospital or birth center will have access to that information. Things that you might include in your birth plan are your desires for who is present at your birth, ideas about pain management, what you want done with baby after delivery, etc.

I heard something interesting last night at my doula meeting, from some very wise and experienced doulas about how to write a birth plan. They suggested that instead of trying to orchestrate every detail of your birth from lighting to cord clamping (using the laundry list templates that you can find around), pick about three things that are most important to you about the labor and birth to write down and document. The idea is that if you focus on the big picture and less on the minor details, you will be more likely get what you want when you ask for the big things, and receive a warmer reception from your physician and attending labor and delivery nurse.

Those long lists with all of the check-boxes do have a use, however, in my opinion. These can be used as great communication tools for your partner, doula, and your care provider prior to delivery. They can not only help you form ideas about what you would like your birth to be like, but to also identify things that you can be flexible on. It is important to ask whoever is delivering your baby what they perceive as "typical" for their deliveries -- Do they encourage movement? What pushing positions are "allowed"? What is their percentage of episiotomies? What tends to happen to baby after delivery? Do they delay cord clamping? Do they take baby right away or do they put the baby on mom's chest? These types of questions can help you get a feel for your doctor's style, especially if she takes the time to answer your questions and meet your concerns, if you have any.

When approaching birth, it is important to balance a feeling of "go-with-the-flow" with "honoring mother's and baby's experience", as many aspects of your birth you just will not have any control over (timing and length of labor and pushing, how baby is engaged, etc.). This should not diminish the fact, however, that you are the most important person, save baby, in the room when you are in labor. You deserve to be respected, honored, listened to and spoken to directly. If your partner and doula are aware of your "ideal" birth, they will have the ability to support you in a way that will leave you with positive feelings about your birth experience. And if you can single out a couple of the most important things to you and share them with the hospital staff, in writing, you will be more likely to have them "hear" you without overloading them with too much information.

Picking out your most important wish for each stage of labor makes it simple:

What is your most important need during labor? Do you want to be allowed to move? Do you want to labor in the tub? Do you not want medication offered unless you ask? Do you not want an IV?
What is your most important need while you are pushing? Do you want to try squatting if baby is having difficulty descending? Do you want to push on your side (protecting your perineum)? Do you want someone to count for you or do you want silence?
What is your most important need once baby is born? Do you want the cord clamping to be delayed? Do you want baby immediately on your chest? Do you want to establish nursing before tests and weight are done?

Remember to share this short list with your care provider ahead of time, so they can tell you that they are completely on board for what is on your birth plan. Better yet, have them sign it. For the majority of the time that you are laboring (even if you have a midwife) you will be attended by a labor and delivery nurse who will be accustomed to "hospital policy". If you have something on your birth plan that is different than what is normally done at your particular hospital, your nurse will have your doctor's written permission in hand (they might also call them for further confirmation) to allow you to exercise your wishes without the impediment of the hospital staff. This is why a shorter list is so useful and will most likely have a warmer reception than a three page script.

If it makes you feel any better, I was one of those who brought a three page script, along with about 17 extra copies (in case it got lost), to the hospital. I don't recommend it. Everything turned out okay, but I definitely got several eye-rolls from my nurses when I asked them if they had read my birth plan.

Induction -- Risky Business or Blessed Reprieve?

2007-07-02T15:48:00.000-07:00

Much of the information for this post was taken from Penny Simkin's book Pregnancy, Childbirth and the Newborn (pages 260-261).

Inducement, or the artificial starting of labor before it begins spontaneously, is probably the most common medical intervention during late pregnancy. While the majority of inductions are elective or planned, some are for medical reasons. A few of the most common reasons your physician might suggest this type of induction are:

Prolonged pregnancy
Prolonged rupture of membranes
Fetus who is no longer thriving or growing in the uterus
You are suffering from an illness, such as high-blood pressure or diabetes, which puts both mother and baby at risk.

When any of these conditions is presented, usually tests are performed and monitoring is done to determine the readiness of the mother and baby for birth. It is important to understand that some hospitals and physicians may have specific policies that determine when your baby is to be born (before 41 weeks gestation, within 24 hours of membrane rupture, etc.), despite the health of mother and baby. All medical interventions carry with them risks, which I'll talk more about later on, so it is important to find out what your care provider's policies are ahead of time, so that you can make sure you are both on the same page when it comes to how you would like your child to be born.

As mentioned earlier, the vast majority of inductions are for non-medical reasons, and the induction rate is increasing at the same pace as the cesarean rate (could there be a link?). There are many, many reasons that someone may decide to have an elective induction. These reasons include:

Convenience for the caregiver or mother is the most common reason for elective induction. Many doctors work in large practices where they are only on-call during certain days of the week. A woman may want to deliver with a specific doctor and therefore will schedule when she is available. Doctors also like to deliver their primary clients' babies. They are eligible to receive the largest chunk of the fee if they attend the delivery.
Predictability is very appealing to many women, especially those with other children, whom they will have to find care for when they go to deliver their baby. Women who experience very rapid labor and birth, or live far away, may worry that they will not make it to the birth center on time.
For some, the last few weeks of pregnancy are unbearable.
Both women and caregivers may worry that if they wait for the baby to be born spontaneously, he will grow too large and will not be able to fit through the pelvis and cause damage to the perineum. Please note that studies have found that fetal measurements done by ultrasound and by external measurement cannot be counted as predictors for actual fetal size. There can be as much as a 10% margin of error using these methods.
Sometimes caregivers and their patients go ahead with an induction simply because there seems to be no apparent reason not to do it. The cervix is ripe (soft and effaced), the baby seems big enough, and the mother is ready to have her baby. The question becomes, "Why not?" rather than "Why?"

Induction is seductive. It can be one of the greatest temptations a very pregnant mother can face, but it is important to understand that it is not a risk-free procedure, especially for first-time mothers. Here are some things to think about:

Babies have something called a "fetal-placental clock", which greatly influences when she is ready to be born. Babies continue to mature and develop in the last few weeks of pregnancy and may benefit from a few more days in the uterus.
As mentioned, induction is not risk-free, and there is no guarantee that it will be successful. The chances of a cesarean are much greater for those that choose induction as opposed to those with spontaneous onset of labor, especially for first-time mothers (which is the group most likely to go over-due).
An induction can take as little as four hours or as long as three days. A long or unsuccessful induction is more likely if there is little dilation or effacement before admission to the hospital, and if you are a first-time mother.
Continuous monitoring is pretty much inevitable if you are induced. You will be limited in where you are able to position yourself (usually on your side or on your back, in bed), which can make it very difficult to deal with the intensity of contractions.
You usually are not allowed to eat solid foods while Pitocin is running, though you can usually drink clear liquids. If you have a long wait, you can get pretty hungry.
Induced labors, even in early labor, may be more painful and intense than a spontaneous labor, usually leading to more interventions to assist in pain relief.

If you or your physician are considering an induction, make sure that you are clear if it is medically indicated or elective. Weigh your options so that you can make an informed decision that is best for you and your baby. When offered an elective induction, some women decide to wait for labor to begin spontaneously, while other may decide to go ahead with the procedure, feeling that the benefits outweigh the potential risks. Only you will know what is best for you and your family.

Stay tuned for: Possible Ways to Get Labor Going on Your Own

Zara's Birth

2007-06-18T12:38:00.000-07:00

At only 36 weeks of pregnancy, Tina’s membranes ruptured at 1:00 am, after Tina rolled over in bed. Margo was asleep and Pedro was gone moving bees. Because she was a little concerned that her due date was still a few weeks away, Tina decided she wanted to go to Labor & Delivery to get checked out, so she called Pedro and asked him to come home and called her parents to come stay with Margo. Tina was settled in her hospital room by 3:00 am. She received an IV, and was waiting for contractions to begin. After eating breakfast, we tried a little acupressure, to see if we could get some contractions going. We also walked around the third floor of the hospital, hoping that it would encourage the baby to move down and get ready for birth. We walked and walked and walked. When Tina’s day nurse arrived, she unhooked the IV from Tina’s arm so that she could walk more freely. Meanwhile, Tina continued to leak more amniotic fluid, whenever she felt a contraction.

By 10:00, Pitocin was started in her IV line, as a regular contraction pattern was not starting on its own. Tina requested an epidural at 11:00 am, and the procedure was completed by noon. Tina was hoping to get some rest (Pedro had done a little napping on the sofa in her room), because she had been up for so long, but the excitement of seeing her baby soon made it difficult for her to fall asleep. She was only able to eat liquids at this point, so she enjoyed a vanilla milkshake and a Diet Pepsi. When she was checked by her doctor at 12:30 pm, Tina’s cervix was dilated to 3cm and was 50% effaced. Another check by the nurse at 3:00 showed that she was still at 3 cm, but her cervix was 100% effaced. Her Pitocin was adjusted and in only an hour, with Tina feeling a lot of pressure, she had dilated to 9 cm. It was nearly time to push!

At 4:45 pm, Tina’s doctor arrived to help deliver the baby. Tina had tried a little pushing earlier, and the nurse commented that she was doing an excellent job. Pedro positioned himself above Tina, while she was pushing so that he was able to support her and see the baby be born. Tina worked so hard and did such a wonderful job pushing her baby out. Within fifteen minutes, a little girl was born to much cheering and happiness. She weighed 5 pounds, 5 ounces and was 18 1/2 inches long. She was a tiny, little thing, but very healthy, and her Apgars were 9 and 9.

After much discussion during the day between Pedro and Tina, they settled on the name Zara Gabriela for their beautiful girl. She is a wonderful addition to their family.

Tell Me Your Story

2007-06-17T19:01:00.000-07:00

Recently I picked up a copy of Ina May Gaskin's new book, Ina May's Guide to Childbirth, and I was excited to see that the first half of the book was nothing but first-hand accounts of births over the past thirty or so years. It was wonderful to read the different stories from a variety of women, all recounting their very personal experience with birth. Giving birth, however it occurs, is a common experience shared by the vast majority of women -- despite country of origin, religion, size, wealth, age -- it is a tie that binds us mothers together. Most women, if you ask them, can recount, with much detail, the events that took place at the birth of their children. Being able to share a birth story, can bring back those feelings of joy, fear, excitement, anxiety, pride, exhaustion, and exhilaration, allowing us to relive probably the most memorable experience of our lives. When we hear or read others' stories, we learn that birth is different for everyone; no one experiences birth the same way. We learn that women are powerful and magical, that we are, for all intents and purposes, goddesses as we create and bring forth life.

When I was pregnant with my first, I was a birth story junkie. I was hooked on seeking out and listening to and reading about others' birth experiences. I hope to share and link to birth stories through this site, as I continue to learn more about the amazing event of birth. If you would like to share your birth story with me, and have it linked on the sidebar, send me the link via comments or an email.

Services

2007-06-07T22:23:00.000-07:00

If you are thinking you might be interested in hiring me to be your doula, please contact me, and we can schedule a consultation face to face. This is at no cost or obligation to you, and it will give us a chance to meet, in person, so you can decide if I am a good fit for you and your family. I encourage all pregnant moms to interview at least three doulas before making a decision.

Once hired, I provide 2-3 prenatal visits. I am also available to you by phone or email to answer questions outside of our appointment times. Some things that we might do during our visits are:

Map out a birth plan
Discuss comfort measures that might work for you
Practice relaxation techniques
Talk about previous birth experiences and attitudes
Ask and answer questions
Pamper you with a hand massage or foot soak

Two weeks before your due date I will be "on call" and ready to go 24/7. As soon as you go into labor, I am able to come and assist whenever you would like. Some moms want help laboring at home, while others want to meet at the hospital. I will stay with you until 1-2 hours after the baby is born, making sure that your needs are attended to before I leave.

We will have at least one post-natal visit in your home within two weeks after the baby is born. This allows us to discuss the birth, and I can answer any questions you might have about breastfeeding, newborn care, sibling adjustment, etc. During that visit I can also assist you with any tasks that you might need help with, so that you are able to enjoy your time with baby.

I am able to attend hospital births in Corvallis, Salem and McMinnville (Oregon) and home births anywhere in the Willamette Valley. If you live outside of these areas, and are interested in hiring a doula, feel free to contact me as I may be available or can refer you to someone who is closer to you. Please email me for information about my rates.

Contact Information

2007-06-07T08:50:00.000-07:00

I am able to attend births in the Salem, Albany, Corvallis and McMinnville area.

If you would like more information about how a doula can help you have the birth of your dreams, please email me at sweetpeasdoula@gmail.com.

I promise to get back to you in a timely manner.

Meet the Doula

2007-06-06T17:47:00.000-07:00

My name is Amy. I am a 31 year-old mother of two small sons, and the wife of an accountant. In a previous life I was a social worker and a high school counselor. I live in Dallas, Oregon (about 10 miles West of Salem). Through my own experiences of birth, one an interventive, two-day induction and the other a drug-free, natural experience, I developed a passion to work with women, helping them achieve the birth of their dreams.

The first time I heard the word doula was from the childbirth educator who was teaching the class I attended before the birth of my first son. She, herself, worked as a doula, and I just thought it was the strangest thing that anyone would want a complete stranger to attend their birth. When I found myself pregnant again, several years later, and feeling a lot of anxiety about how my second birth might play out, I thought about the prospect of hiring a doula for myself. It turned out to be one of the best decisions I ever made, and I attribute the presence of my doula to helping me achieve the peaceful, natural birth I had dreamed of.

That experience inspired me to pursue doula training through DONA (Doulas of North America) and to learn as much as I can about pregnancy and childbirth. I love to listen to others' birth stories, and I believe sharing our stories can help spread a positive message about birth in our society. I hope to include birth stories on this blog. Please email me at sweetpeasdoula@gmail.com if you would like to learn more about how a doula can assist you in your labor and delivery.

What Is a Doula?

2007-06-06T15:21:00.001-07:00

The word doula is derived from Greek and meant a servant (a woman) who attended to other women. The meaning has changed slightly to now mean a woman who assists another woman and her family achieve the type of birth that they desire. Usually a doula meets with the pregnant woman two or three times before the birth so that they can establish a relationship and so that the doula can learn what the woman's desires and wishes are for her birth -- like laboring at home, no interventions, changing positions during labor, massage, holding baby and nursing before baby is taken, etc. Every woman is different in their desires and vision of their birth, and, of course, things can happen that are unexpected, so it is important to play out all scenarios. The main "work" that a doula does comes when the woman goes into labor. The doulas job is to totally support the laboring woman, providing comfort measures, and also to support the mother's partner in fulfilling his role as a support person, as much as he feels comfortable. A doula is knowledgeable of different laboring positions, relaxation techniques, and the general physiology of birth, so that the mother's experience during labor will be improved and she will usually have a shorter labor and pushing stage. Usually a doula will stay with the family for one or two hours after the birth, to make sure everyone is settled and that breastfeeding has been established. Two post-partum visits in the home are arranged in order to check in on mom, to see how she is adjusting, and to also debrief the birth with her.

Doulas are not medical personnel. I am not trained to deliver a baby or do vaginal exams. My job is to work with the medical team (nurses, doctors, midwives) to help the mother achieve the birth she desires. I am also not there to replace the mother's partner. I know some women who have spouses that really want to be intimately involved in all aspects of the labor and delivery, desiring to be the mother's primary labor coach. That's great. The doula would then be there in a secondary capacity, maybe providing suggestions for laboring positions, providing refreshment, helping to keep mother comfortable, and allowing the partner to take breaks as needed. Some men feel very overwhelmed by the whole experience, and wouldn't even know where to start. Seeing their spouse in pain can be very stressful for some men, and the doula is there to assume a primary role, including the partner to the degree that he desires to be. All of these things would be discussed ahead of time.

Doulas are not just for women who desire an unmedicated birth. Some women may go into a birth knowing they want an epidural, others may not be sure. Just because a mother receives an epidural, doesn't mean that she doesn't need encouragement and support. She may still need an advocate or her spouse may need his own support. A lot of first-time moms aren't sure what to expect, so it is nice to have someone there to support in every type of scenario. Some women even hire doulas when they have a planned cesarean, simply because there is a lot going on at the birth, and usually mother and baby are separated for a short while, causing the partner some conflict about who to stay with. Doulas can be there to continue their support of the mother, when the father goes with the baby, and assist in breastfeeding, immediately after mother and baby are reunited.

The cost of a doula varies by where you live and is usually based on cost of living. When I initially looked at hiring my own doula, I didn't think that there was any way that we could afford it, but we went ahead and did just because I had been feeling so much anxiety. Afterwards, my husband said that he would gladly have paid double the price, just because of how wonderful our doula was and how instrumental she was in helping both of us through the process. Please read Charlie's Birth Story if you would like to learn more about how my doula assisted me during my labor and delivery.

Statistically, doulas are proven to reduce cesarean rates by 50%, epidurals by 60%, the use of Pitocin by 40%, the need for a forceps or suction delivery by 30%, and women who use a doula have been shown to have a labor that is 25% shorter than women who don't (this was taken from the book Mothering the Mother). Those are pretty good statistics. If you are interested in finding a doula in your area, check out DONA's (Doulas of North America) website. They have a listing of all certified doulas by state and then city.

Welcome to Sweet Peas!

2007-06-06T13:14:00.000-07:00

Welcome! I have decided to create this blog to document my profession as a doula, while also opening up a forum to discuss a variety of topics related to pregnancy, birth, breastfeeding and parenting. Information is power when it comes to developing ideas about how we want our own birth and parenting experiences to be like, and I think that everyone should feel empowered and confident to make the decisions that will be best for their own family. I named my business after the pet names I have for my two little boys, John and Charlie. They are my inspiration for all of the birth work that I do.

Check back soon to read more about what doulas do and about what services I provide.