Improving Birth article

Have you heard of improving birth? Have you heard of the blog Improving Birth? As a huge birth advocate, I am always trying to figure out ways to improve birth in our country. How can I become an asset? How can I provoke change? How can I teach and encourage women?? These questions will always be asked until there IS change. That is what Improving Birth is all about. I found an article posted back in December that I wish I could have written. If I had written it, these are the words I would have used. And because I love how well this is written, I am posting it word for word with a link, rather than just linking it. Thank you, Improving Birth, and all birth advocates who are working to make a change.

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I Don’t Care How You Give Birth

Cristen Pascucci, a political and communications specialist, recently joined Improving Birth’s executive board.

Elective C-section?  Ocean waterbirth?  Seriously, go nuts.

You may think that because I chose (and fought) to give birth with no drugs in a hospital, I think everyone should.  Or, that because I rant and rave about our bloated surgical birth and artificial induction rates, that I would do away with these medical interventions.

Absolutely not.

First and fundamentally, I believe that it’s your body, your baby, your birth.  There are many options around birth, and I hope you avail yourself of them–and when you do, it’s none of my business.  There is no one-size-fits-all birth.  I have friends who have given birth across the spectrum from homebirth with no access to pain medication, to a planned epidural at 2 cm dilation, to full-blown elective “convenience” surgery scheduled months ahead, and I stand firmly behind each of those women in their human right to make their own decisions.

For me and my baby, a drug-free birth was of the utmost importance.  It was for personal reasons, really, not because I’m some flaming hippie who doesn’t believe in hospital voodoo.  It was a choice I made and prepared for because I knew it was the best thing for both of us–mostly my baby–that had absolutely nothing to do with being anti-medication or anti-establishment.

Second, these medical interventions save lives when used appropriately.  That is why they were created in the first place.  Sure, their overuse contributes to more dangerous conditions for moms and babies, but when they are used prudently and out of necessity, they preserve life.  In the U.S., in theory, we have the resources to have the best possible outcomes.

What IS important, and what I care deeply about, is that you go into birth with your eyes wide open; that your decisions are based on full and accurate information; that you understand the risks, benefits, and alternatives of your various birth options; that you work with your care provider, and that he or she respects and supports your wishes.

Birth doesn’t always go according to plan, which is why it’s not enough to create a “birth plan” and call it a day.  Sure, most of the time it is safe, but that doesn’t mean it’s predictable.  It’s very possible, even likely, that you and your support team will be called upon to make decisions during labor.  It’s these gametime decisions that can make the difference between a positive experience and a traumatic, dangerous, or disappointing one.  There may not be time at that point for in-depth explanations about the risks, benefits, and safety of various interventions or procedures, so you’ve got to be informed ahead of time of what might come up.

And, probably even more important, you’ve got to have a support team who is on the same page.

If you go into birth unprepared, you are placing your dignity and the safety of your self and your baby directly in the hands of people you may have never met and who may or may not respect you and your wishes.  It could go either way. It’s a huge risk to take.

good example of this is my own birth story: when my care provider was strongly suggesting to me a procedure (an artificial induction at close to 42 weeks pregnancy) that was NOT the only or even the safest option.  I was lucky enough to have better information that allowed me to make a different decision, for a different outcome, that I firmly believe was the safest for me and my baby.  But a little less preparation on my part, and it never would have happened.  What happened with my care provider happens all too often.

I say all this to say that what is truly important, and I think a lot of “birth advocates” would agree with me about, is that you are prepared, informed, and supported in whatever you desire.  You can’t make decisions about what’s best and safest for the two of you if you aren’t informed and supported.  And information and support don’t happen on their own.

When you’re educating yourself about these decisions, you might be surprised at what the evidence shows: surgical birth increases your chances of death by six times, but it can also save your life.  Epidurals can prevent a surgery, just as they can increase the odds of your having to have it.  Natural, unmedicated birth can be the safest option, or it can be impossible.  Every one of these things has lasting effects.  How will you navigate these choices?

Remember: ”If you don’t know your options, you don’t have any.”

So, no, I don’t care how you give birth, as long as it’s your way–and I trust that, as your baby’s mother, you’ve made certain that “your way” thoughtfully considers the best scientific evidence, supported and vetted by your care provider.  (Here is a wonderful summary of the current best evidence for common birth practices and procedures.)  The final decisions about your baby and his or her birth lie with you, the person who is ultimately most invested in your own and your baby’s safety and best care.

And I hope you have the safest, most wonderful experience you can have, bringing your baby into the world.

Hannah’s Home Birth Story

Here is a beautiful home birth for your Monday morning! This birth comes from a very dear friend of mine. Her little girl is almost one–hard to believe! These photos are incredible and the story is so encouraging. Enjoy!

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I will start by telling you the end of the story.  Hannah Lynn Thurlow was born at 3:30am, weighing 8lb11oz and measuring 21-1/4” with an Apgar of 9/10.  If you are like most, that is where your interest in my baby, a perfect stranger to you, ends.  If you are a mother or mother-to-be curious about alternative birthing methods, read on!

My birth tale ends like most stories, so you can breathe a sigh of relief.  Here’s the juicy part: Hannah is my first baby.  Oh wait, here’s the really juicy part: she was born at home on my couch thanks to some olive oil and a great midwife named Paulette.

Two and a half years ago, my husband’s company moved us to North Dakota.  On our first anniversary, we decided to start trying to conceive and were successful almost immediately to our great relief and joy.  And that’s when people started telling me their aw-ful birth stories.  Now, I know this is a common phenomenon – like a rite of passage for every first-time mom to be baptized by horror stories – but these mom’s weren’t yarning me some ole’ crusty sailor fables about how much it hurt and how bad they tore.  Each mom had a disappointing story about how the staff or the doctor treated them at the local hospital.  To add icing to this terror cake, they would tell me about dirty shared showers with splatters of blood from other laboring mothers as the only resource for “water birth” in the labor wing.  Yeah.  Splatters.

Three years ago a friend of mine had a “home birth” at a midwife’s home-like birthing office in a peaceful, jetted tub surrounded by vanilla candles and loving family.  I figured, heck, let’s by-pass the splatters and figure out this home birth thing.

Thankfully, my a different friend ran into someone at a chiropractor’s office who knew someone who knew someone that knew the well-seasoned, protected, and venerated Midwife Paulette.  Paulette is what some call a direct-entry midwife.  In other words, during the 1970’s when the hippy movement was going strong and Ina May was starting life on The Farm, Paulette lived in North Dakota among some free-spirited women in the boonies with little to no hospital access.  A midwife was born.  When she and I first spoke on the phone, she had delivered 554 babies.  Hannah was number 572, a mere three months later.

Paulette is popular.  Paulette is the only home birth midwife serving over half the state of North Dakota.  She has long silver-white hair which she ties neatly in a bun.  Her eyes are sparkling blue, and she always smiles with a chuckle following closely behind.  If one could imagine the perfect, motherly midwife, it would be Paulette.

But, before I met her, I figured she would either be absolutely normal or a total weirdo, pseudo-spiritual, voo-doo-esque gal because those are clearly the only two options for a crazy, direct-entry midwife, right?  During our first conversation she told my husband and I that she considers it an honor to be “God’s hands on earth welcoming new life into this world.”  She believes how we enter this world is a major factor in forming the baby’s early sense of peace and well-being.  Even though this may sound voo-doo and weird to some, coming from her smiling, glowing face, I suddenly felt everything would be “a-ok” with her assisting our home birth.  Out of her birthing history, she had lost two babies due to circumstances completely out of her control.  She had delivered breech babies, surprise twins, and surprise triplets.  She had back-up oxygen, hemorrhage stoppers, herbs, know-how, sanitized tools, patience, a stethoscope, references, and all kinds of other tools in her tool bag of midwifery.

I did a lot of research and musing before fully committing to the home-birth plot.  I found great resources at my local library, which included The Business of Being Born along with some other more home-spun DVD’s of natural births and a handful of books.  I learned which trouble signs to look for (amniotic fluid that is not clear, breech concerns, erratic or slow heartbeat, etc).  I researched natural pain relief and practiced labor easing moves on my appropriately red birthing ball.  I ordered essential oils to be massaged on my low back to ease pain and strengthen my uterus.  I attended birthing classes at the local hospital.  I maintained a healthy diet and consumed lots of birth prep herbs (red raspberry, etc).  We filled up our inflatable birthing tub while at the same time packing a hospital bag just in case.  I had concurrent care with a Certified Nurse Midwife should we have needed to deliver at the hospital.  I opted to have the 20 week ultrasound to rule out concerns over immediately needed, life-saving surgeries for our baby based on physical abnormalities.  I went in for my blood sugar labs and fetal non-stress test.  Lastly, I talked to other mothers who had successful home births to find encouragement and inspiration.

After all the preparation, I prepared more by finding scriptures to encourage me during the labor and filled my iPod with worship music as I knew my greatest strength would come from the Lord – my source of life and centeredness.

Then, I waited.  I waited for that glorious moment when labor starts.  I thought labor would start with a bang, like the shot at the beginning of the Kentucky Dirby or something.  Hannah was nine days late, and for seven of those nine days, my body decided to play around with the idea of labor.  I had real-deal contractions for almost the entire seven days.  When labor intensified and my labor finally began, I had actually been to the hospital the previous night because my contractions were strong and only two minutes apart.  Paulette lived one hour and 45 minutes away from my house, so we figured the hospital may be the wisest choice in case a baby was about to be born.  Instead, the nurse gave me a morphine shot in my leg to help me rest (I hadn’t slept for five nights) and sent me and my 2.5 cm cervix home.

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As per what usually happens, my water did eventually break after another day of hard contractions.  Did I mention Hannah had a 14” head?  Yeah.  We blame that factor for why her head would not drop, engage my thinning cervix, and get the party started sooner.  To overcome her big head (or short cord as the other theory goes), I spent the day squatting over a towel during contractions and pushing forcefully on the top of my fundus, or Hannah’s butt if you want to think of it that way.

At 7:00pm on June 7th, my water broke during a pee-pee break right into the toilet.  The waters were clear.  I was elated.  My mom predicted Hannah would be out by 9:30pm.  Not so.  With all the pre-labor/real-deal labor, my uterus was tired.  So, it (my uterus) would have a go at extracting said wee-one, then take a break.  In other words, though I was dilated to 9.5 cm’s with a slight lip, my contractions never became regular.  Paulette was relaxed and unworried.  She advised me to focus all of my energy downward – to lower my voice, visualize the ground opening up beneath me, and to breathe toward the center of the earth.

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I bobbed around to different positions in the birth pool.  Sometimes on my knees with legs spread wide.  Sometimes leaning over the edge holding my husband’s hand while he read me scriptures.  Sometimes floating back with my neck resting on the edge and my hands squeezing the convenient handholds.  I ate some banana with peanut butter.  I drank some electrolyte/vitamin water.  I got out occasionally for Paulette to listen to Hannah’s heartbeat and to use the bathroom.  I sang along to songs.  I prayed.  We all prayed.  The work was painful, hard, and, by the time midnight rolled around, long.

I was really tired.  More tired than I had ever been.  But also alive, excited, nervous, and focused on the end goal.  I wanted to meet my sweet girl and hold her.  I instinctively reached into my cervix to feel the top of Hannah’s head.  At first, the whole length of my index finger fit.  After more work, the second knuckle.  After more work, the very tip.  I was focused.  I was in a bit of a labor trance, cherishing every breath and hoping for the next breath and strength to push.  My husband was tired and worried and wishing he could help more.

Hannah began to crown.  Paulette had me lean back so she could see better and assist.  For almost a half hour, her brown, waving hair would crown, then my uterus would quit, and her head would suck back in.  It was both exhilarating and frustrating!  Eventually, Paulette determined that perhaps more movement and the help of gravity would get things moving along.  She suggested I get out and walk (yeah right!) over to our couch.  With the help of my husband and mom, we somehow got my wet, contracting form over to the towels and blood pads Paulette had quickly spread on the couch.

I hated it.  I didn’t want to be out of the nice, helpful water.  I wanted a water birth.  But more than anything, I wanted Hannah out of me!  The new location did the trick.  The extra discomfort woke my uterus back up.  The contractions were stronger.  Then, the olive oil came out.  Paulette asked my mom to fill a peri-bottle with olive oil to help her stretch and massage my perineum.  Hannah was anointed with oil before she breathed her first breath!  After two peri-bottles full of oil and more pushing, Hannah’s head finally crowned.

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At 3:27am, Paulette muttered something like, “We’ve got to get this baby out,” which suddenly worried me that there could be something wrong if I didn’t hurry up.  On the next contraction, I gave ‘er all I had.  Paulette noticed the contraction had stopped and told me to stop pushing.  I just shook my head and kept bearing down.  And, it worked.  At 3:30am, the second phase of labor was over.

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Hannah’s umbilical cord was too short to bring her to breast immediately, so we waited for it to stop pulsing.  My husband cut the cord, and I clumsily latched Hannah for her first taste of nature’s best food.

The rest of the story is simple.  No IV fluids.  No foot pricks.  No antibiotic goop in Hannah’s eyes.  No obligatory trip to the nursery to check her vitals and give her the ole’ body temperature test.  No HepB or VitaminK shots.  Just nursing until my uterus expelled the placenta (all while balancing over the toilet – let me be the first to say it was bloody and not too comfortable for my tired body).  I showered.  My husband gave Hannah a spit bath after she was weighed and measured.   He dressed her.  Paulette examined me.  We nursed.  We ate a HUGE breakfast.  Then, we all slept in our own beds.  We were weary.  We were home.

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I would do it all over again in a heartbeat.  I hope to have a homebirth for all the babies we may have in our future.  There is nothing easy about natural labor.  It’s not glamorous (I have pictures to prove it).  The big point for me is that my body was made for labor, and I succeeded.  A certain amount of pride and strength comes with that.  After hearing more birth stories, I know home birth is not for everyone nor is it for every birthing occasion.  I may need a baby-saving c-section someday.  I may birth at a hospital.  If you do not think home birth is your best choice, by all means, do not feel guilty or like less of a woman.  If you do choose home birth or natural birth at a birthing center, know with absolute certainty that you can do it.  Because, after all, I was crazy enough to do it on my first baby with no clue of what I was about to experience.  I hope you enjoyed our story.

Kale’s Birth Story

Randalin, from Harvesting Kale,  has become one of my most favorite blogging mamas and friends. She’s an incredible writer, which is hard not to notice in her writing of Kale’s birth. Randalin is mama to baby Kale, such a sweet boy with great hair and a beautiful smile! This home birth story is one of the most beautiful I’ve ever read and Randalin’s account of it is incredibly encouraging and moving. Click HERE to see more incredible photos from this birth.
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On Thursday May 6th, three days before my due date, I woke up after dreaming all night about having contractions. I went to the bathroom and noticed a bit of blood – my first sign that labour might be starting soon! I continued to feel crampy all day, but was hesitant to get too excited knowing that labour could still be many days away. Kris was working out of town, but was expected to be home that evening and so I kept him updated but tried to play it cool. I just didn’t want us to get too excited! I went ahead and had lunch with a co-worker and spent the afternoon sipping tea and catching up with my neighbour.
At around 5pm I went to the bathroom and saw what I thought was part of my mucus plug. Luckily Kris was already on his way home.  I know that losing your mucus plug doesn’t necessarily mean labour is going to begin soon, but along with the cramps, I started to really believe that the baby could be on its way.
Once Kris got home we picked up a bottle of wine and went out for dinner where I ordered the spiciest item on the menu. We left the restaurant around 9pm and this is when I noticed that my cramps were getting more regular and a bit more intense. I continued to play it down and tell Kris that it was just cramps, but then he pointed out they were coming every 10 minutes. I think he realized I was in early labour before I accepted it myself!
When we got home we started to get things ready for our home birth “just in case.” We set up the spare room with all the supplies – plastic sheeting on the bed, old sheets, and plenty of towels. We then put in some laundry and did a quick clean of the house. We had our wine and I took a gravol, but sleep still wasn’t possible. By this time I knew that my cramps were really contractions, since they were coming every ten minutes and with increasing intensity. Every time I had a contraction I would have to get up to pee. I didn’t think it was possible to pee every 10 minutes, but that’s exactly what happened all night long.
On Friday May 7th we got up around 7am. I hadn’t slept for more than 10 minutes at a time and as a result of my getting up so often, Kris didn’t get much sleep either. Around 10am I went to the bathroom and there was a gush of bright red blood. I called our midwife, Leslie, to let her know and she decided to come and check in on me. She got there about an hour later and after a quick check, told me that I was 2-3 cm and very soft and she expected that we would have a baby that day! Even though I knew it was labour, I was still a little shocked to hear that it would be so soon!
Leslie gave me a shot of gravol to help me get some sleep since I was exhausted from the night before and knew I had a lot of hard work ahead of me. Once Leslie left we called our Doula, Monique, to let her know and then I tried to lie down and get some rest. Kris went out and got a few last minute things and I curled up in bed and listened to some music. I didn’t manage to get any sleep, but was able to rest. Kris came home with the McDonalds I was craving, but I couldn’t get much down. The combination of contractions and excitement made for a very queasy tummy.
At 2pm we started to fill the birth pool up since my contractions were getting more intense. We weren’t sure how long it would take to fill the pool so even though I wasn’t ready to get in, we wanted to have it filled just in case. We called Monique and asked her to come over at that point. While we were waiting, we heard the cat rustling around with the plastic tarp that was covering the filled pool, followed by a splash and then a wet cat running by! It was good to have a laugh!
 When Monique got there I got into the pool for a little bit and immediately felt better. Our hot water tank is not the best, so the water wasn’t as warm as I’d like, but the buoyancy was a great help. I was feeling my contractions a lot in my back, hips and thighs and the water really helped to ease that. Monique suggested that I get out of the pool since it was still early in my labour and the water was slowing down my contractions. Kris was also able to sneak a nap in at this time while Monique and I took a slow walk around the block in the pouring rain. I felt bad dragging Monique out in the bad weather, but I need to walk. When we got back I sat on the birthing ball in the living room while listening to some music and eating a sandwich. My contractions were erratic at this point. They would be 4-5 min. apart for awhile, and then they would be 10 min. We were timing the contractions with the aid of a stop watch on the computer and every time one started I would yell for someone to click on the start button. At this point walking around helped the most, even though we have a small house and there isn’t much room to walk!
 By 5pm I was back in the pool with regular contractions. I was on all fours in the pool with my arms and head resting on the edge. Kris sat on a chair beside the pool and every time I had a contraction I would grab his hands, look into his eyes and moan. He was an unbelievable support and so much stronger than either of us expected! Monique reminded me to keep hydrated and gave us a few suggestions for trying different positions. I felt so relaxed and in control at this point that when Monique asked us if we wanted to call the midwives I told her no. My contractions were 4-5 min. apart and gaining in intensity so Monique convinced us to give Leslie a call (later Monique admitted that she was getting worried that we were waiting too long to call the midwives and thought we might just have the baby ourselves!).
 Leslie arrived and then a short while later, Marissa, a new student with the midwife clinic. It was my first time meeting her – naked in the pool and moaning with every contraction. Leslie and Marissa set up their equipment in the spare bedroom and Monique and Kris continued to help me through the contractions. I have to say it again – Kris was amazing. When our eyes locked during a contraction I seriously felt like it was just him and I in the room and I had this overwhelming sense of connection with him that I’d never felt before.
Leslie checked me around 7pm and I was 7-8 cm! She called the back up midwife, Gabrielle, and I knew this meant that the hardest part was about to come. Gabrielle came around 8pm and by this time my contractions were coming very quickly and were very intense. I was so exhausted!! Meanwhile, an incredible thunder and lightning storm raged outside and I remember worrying about what would happen if the power went out.
The atmosphere was so relaxed. The lights were down low, the midwives were sitting on the floor leaned up against the wall, Monique was snapping some pictures and Kris helped me work through the contractions. Despite everyone’s relaxed attitude, I was getting louder and louder with every contraction and withering in pain in the pool. Despite the intensity of the contractions I still felt as though the pain was manageable and I was managing to rest between contractions, refocus and let go of the pain before the next one started.
Shortly after Gabrielle arrived, it was time for me to start pushing. Unlike everything I read I didn’t get the urge to push. Before the labour I had told our midwives that I wanted to push when I felt like pushing but at the moment I was so thankful for their coaching because I don’t know if I ever would have pushed!
I tried a few different positions, but found that sitting on the birthing stool in the pool was the easiest way for me to bear down and push. With every contraction the midwives asked me to give three good pushes – pushing for as long and as hard as possible. After a while I felt as though I couldn’t push anymore. I was so tired and every muscle in my body felt depleted. Up to this point, the pain has been manageable, but the pushing stage was another story. I was finding it increasingly difficult to keep my noises low and open and they started to turn into screams of despair and pleas for the midwives to do something – anything! – to get the baby out. Unfortunately there was nothing they could do – it was all up to me.
Kris originally sat outside the pool directly in front of me, but as my pain intensified I saw his eyes fill with tears and I knew that watching me in that amount of pain was shaking his strength. He decided to move behind me where he could hold me and I could lean into him with every push.
After an hour and a half of pushing, Leslie had me reach down and feel the top of the baby’s head. I think at this point I screamed, “I don’t want to feel him, I just want him out!!” Despite the fact that he was so close, I felt like it was going to be impossible to get him to come the rest of the way. While Kris tried to hold me from behind, Gabrielle had my left leg and Marissa and Monique had my right leg. Leslie thought she was going to have to hop in the pool because I was floating way from her as I begged them all to let me go! I was starting to panic and Gabrielle sensed it because she grabbed me by the chin and forced me to look directly at her and told me that I had to focus and listen to Leslie. It was exactly what I needed.
After a few more pushes, I felt an overwhelming pressure and then a giant sense of relief as his head came out. Looking down into the water, I could make out his head and had to stop pushing while the midwives moved the cord and seconds later, he slipped right out and was on my chest. It was an unbelievable moment of love, combined with sheer exhaustion and elation that it was over.
That moment was the most awesome moment of my entire life.
We were so incredibly lucky to be able to have that moment together as a family. Kale let out a couple quick cries, but nestled quickly against my chest. Kris had his arms around us and I felt as though no one else in the world existed besides us three. It was so incredibly powerful.
I had to get out of the tub pretty quickly since the water temperature had dropped and they wanted to get us both warmed up. Kris held on to Kale while I made my way over to the bed to deliver the placenta.
In the next couple of hours, Kale and I were both checked out, I delivered the placenta and received a few stitches. The whole time Kale was getting checked over right beside me and as soon as they were finished, he was in my arms. I took a quick shower, ate some peanut butter and toast, called my mom and the midwives helped me get started with breastfeeding. Meanwhile, Kris and Monique emptied the birth pool, set up our bed and did the laundry. By 12:30pm, only three hours after Kale was born, the midwives and doula had tucked Kris, Kale and I into bed together with some last minute instructions and then we were alone.
I cannot convey how incredibly grateful I am that we had such an amazing birth experience. I am so moved to tell this story a thousand times because it has become such a defining moment in my life. I’ve had some pretty great things happen to me in my 30 years. But a natural home waterbirth? Nothing tops that.