The Sitting Month
The rituals surrounding the postpartum experience vary from culture to culture. In some belief systems, new mothers have to get regular massages to help circulate the blood, rejuvinate her after the birth, and assit with healing. In China, the traditional practice is to be indoors for 30 days following childbirth along with following a regimented diet, not washing and even wearing particularly warm clothing. The practice is meant for women to have time to recover from birth. Even an uncomplicated vaginal delivery requires the body to heal. The uterus, which was the largest muscle in the body at full term, has to work to shrink back down to the size of a pear. The baby is nursing frequently to bring in the milk supply he or she will need requiring a lot of energy from the body. How would you feel to have people to support you so you could be there to snuggle with your newborn while the food was taken care of and someone else could change all those messy diapers? If you ever had to clean off meconium, the first bowel movements of a newborn, you know what I am talking about! *hint* olive oil on their bottoms does help it come off easier.
What do we do to support women who have just had a baby? We tell them that they have to see their baby’s physician a few days after getting out of the hospital – even if they have just given birth by c-section! For some women, it can be hard enough to get out of bed or sit comfortably. This doesn’t include other tasks like driving, carrying heavy car seats while your abdomen is still mush. Our North American culture doesn’t value this period of rest and bonding. We push new parents right back into chaos and they often don’t know where to begin. Of course this affects our abilities to breastfeed, to transition into parenting with confidence and support.
Who makes us food? Who looks after moms who are so busy with their newborn? This is where a postpartum doula can be your greatest asset. The postpartum doula isn’t there to take over your role as a parent. She is there to take the pressure off the other tasks – this can include cleaning the kitchen counter off, making some food for the freezer, taking pets for a walk. The postpartum doula isn’t just about household tasks though. She is also skilled and knowledgable in newborn care and breastfeeding. She can observe your latch, knows how to tell your baby is getting enough milk, keeps and eye out for signs of illness and can let you know what she sees and refer you to the right care provider. In the end, she is mothering the mother. We have all heard the saying that you can’t take care of others until you take care of yourselves. This is still true when you have a newborn but you rarely have a moment to get those things done.
Considering a postpartum doula? Meet with a few and see what they offer. You can also check with your insurance company (if you have extended health insurance) as some of them are starting to cover doula services! If your company doesn’t, suggest that they look into the research. Having a postpartum doula can do wonders for decreasing postpartum depression, increasing breastfeeding success (which is related to decreasing many illnesses, including some cancers, the need for orthodontics, etc), and increasing maternal and fetal health.
What would be your ideal postpartum experience? What traditions does your culture follow after childbirth?
The Birth of Cayden Alexander
I have had the honour of being invited into the birthing space of many women and families. I recently birthed my baby boy and since I couldn’t invite everyone into my bedroom, I thought I would share my birth story with you here as a way of extending my birthing space. I hope you enjoy the story of Cayden’s birth.
I had been having braxton-hicks contractions for weeks. Some days, they even lasted 8-10 hours. They weren’t getting stronger, longer, or closer together so we waited. My due date came and went. Of course, that was accompanied by many well-meaning, but often frustrating, is the baby here yet or why don’t you…*insert induction method here*. We waited for our baby to choose his/her birth day, even in the summer heat we have been having.
On July 11th, I woke up at 3:30am. I wasn’t actually sure why I got up but I figured I probably just had to use the bathroom like any other woman in her third trimester in pregnancy. I didn’t have a big dinner the night before so I went to the fridge and grabbed some grapes to snack on. When I got back to the bedroom, I had a contraction that felt different than the others. As I would suggest to any woman in early labour, try to lay down and get some rest. My braxton-hicks contractions also go away when I lay down so I would be able to tell the difference right there. The next contraction came and I hated laying down, so I got right back up and decided I would sit on my birth ball beside my bed. DH happened to wake up and asked me if everything was okay. We watched some DVD’s together for about an hour and I was starting to pay less attention to the show. I got up and walked around for a bit. I noticed the strength of my body working and I was letting that wash over me. I let myself moan and move as I felt comfortable. I felt one particular contraction where there was some more pressure. I knew things weren’t going to turn back and I told Jamie what I felt and that if I was feeling this again I was certainly going to page.
It wasn’t long after that when I decided to grab my phone and page the student midwife involved in my care, Heather. Heather called me back and suggested I take a bath and call her back in 30 minutes. I didn’t want to sit down at all, so I opted for a shower instead. Jamie helped me get in and he went off to get the bed together for the birth. He picked up my phone when it began to ring only minutes after being in the shower. It was Wendy – one of my midwives (Aynsley, my primary midwife was off call that day). She and I spoke for a few minutes and she said she was
coming right over. She left Jamie her cell phone number in case things progressed quickly before she arrived. I spent the next 30 minutes or so in the shower, moaning and leaning against the wall. I did notice that when I was worried about being watched or felt like I was being watched, the contractions got further apart. I just had to loose myself in my own body’s momentum and trust that it would bring my baby into the world. I also asked him to call my own doula, my best friend Melissa who made her way down.
After getting out of the shower, I went back to our room where I got comfortable leaning forward on our bed. Wendy arrived a few minutes after and did an exam – 7cm. She quickly went downstairs to get the rest of her equipment and called in a second midwife to attend the birth since it certainly wouldn’t be long now. Wendy set up her equipment – medications, oxygen tanks, etc and I knew I was still very much in my “doula brain space” instead of in my body. I don’t remember about how much time went by but Christine, another midwife arrived at our home and came into the bedroom. It was wonderful to see her again. The last birth I attended as a doula, when I was about 34 weeks pregnant , Christine was the primary midwife and we spent about 30 hours together. She commented on how she loved our bookshelf in our room and was looking through “Circle Round” to find a passage about the umbilical cord that she loved and wanted me to hear for my birth. Jamie took out his laptop and played some music for me. I never did plan my music for the birth like I did with our daughter, Siobhan. However, I am really glad he did take it out because the songs he played were touching – Circle of the Sun and Little Acorn. Christine helped me put on my birthing necklace that
was made at my blessingway Melissa planned/hosted. Each of the beads represents a blessing for the birth and I added some for the women and families I attended in birth and the blessings they passed on to me. I was back on the birth ball, rocking but I was no longer moaning. The contractions were still there but I was in a different place. I was in a safe place where I knew that my body was doing the work it was meant to do. Here we shared lots of laughs. I was so calm during what is usually the most intense part of the labour. I felt like I could sleep and I apologized many times for my health care providers being bored.
Heather arrived and we discussed the option of rupturing the membranes. The baby was still high so in good doula fashion, I asked her about the risks and benefits and Jamie and I discussed what we thought about it. We decided to go for it and Heather broke the amniotic sac and we all celebrated the clear fluid because we knew baby was still happy. Of course, with the fluid that was cushioning the head out of the way, the baby began to descend further into the birth canal. I found my favourite spot squatting beside the bed. Christine was on the other side of the bed holding my hands and Jamie began to use counterpressure on my back. I really liked that and laughed that he really does pay attention to all the doula stuff I talk about (not that I doubted that in the first place). It wasn’t long before I was spontaneously pushing. Jamie sat on the bed and I had my arms over his legs, squatting, and pushing with the force of my contractions. He kept encouraging me, as did our midwives. Wendy and Heather were on the floor and took a pillow covered it with a chux pad. At one point, Christine asked if she could take a picture of Jamie and I because it just looked beautiful. I don’t have qualms about birth shots (but those aren’t ones I am sharing on facebook) so I told her to go ahead. Wendy and Heather told me that they could see the baby’s head and that the baby had lots of hair. Of course that was accompanied by stretching and burning but my body adapted my breathing without me thinking. I would change into a pant breathing when I needed it and back to pushing when I felt that urge too. Soon enough I heard Wendy tell me that Heather was doing a fantastic job protecting my perineum. Christine, who was holding the Doppler at this point, commented on the fetal heart tone and said that there was good head compression. Then they said the baby was born up to the eyebrows. With the next push, the rest of the head was born, followed by the shoulders and the rest of the body. The baby was placed immediately on my chest and they all helped me up onto our bed. Christine and I rubbed the baby’s back to help stimulate breathing and heard some lovely cries. He was born at 10:32am.
The placenta we helped a little because I had low platelets and we wanted to keep the bleeding to a minimum. I even instinctively starting doing my own abdominal massage to help while holding our little one. The placenta only took 6 minutes and it was beautiful, healthy and intact. The midwives helped me get cleaned up a little and checked for any tearing. There was a very very small tear that was almost not even
worth repairing. Wonderful!
We invited in the others who were in our living room to meet our new little one and took a few pictures. Jamie made me a sandwich and got me more to drink as I was nursing him since almost after birth. Then we had the fun part, weighing him! Wendy layed out her scale, which I love by the way, and we put Cayden in. Then she started to read off “9lbs…one, two, three, four ounces”. My jaw dropped! I was completely shocked, even my eyes were stuck open. I couldn’t believe his size!
The midwives cleaned up their equipment, helped us strip the bed and many hugs were shared. Then they left us to have some time to ourselves. Cayden nursed for a few hours after birth then took a nap. It happened to coincide with Siobhan’s nap time so she and I snuggled in our bed and took a nap too. A perfect ending to a beautiful birth!
Trusting Technology
How easy it was to understand our bodies when we spent all day being conscious of them. Our bodies did our work, laboured in the fields, cooked meals, hunted and fished. We also spent more time with Mother Nature as she showed us life and death in very tangible ways.
As we began to make things easier with technology, we began to let go of some of our understanding of our bodies. We looked at ways to make all kinds of “work” faster. This includes birth.
Many parents feel a comfort about being in the hospital for the birth. As a doula, I know that it is their choice to birth where they feel most comfortable, but I do get to wonder what makes them feel at ease there. After all, you see few staff members, are hooked up to many monitors (most often than not), and intervention rates are certainly higher the earlier you walk in their doors. When I ask people that question, the answer is the technology – in the event of an emergency, all the equipment is right there.
We have come to rely on our computers, cell phones, things that go beep to tell us when something is wrong. In birth, when women are hooked up to fetal monitors, rarely do I witness a staff member ask the woman how she is coping, what she feels or anything. They walk straight in, look at the monitors, make assumptions about strength of contractions, and leave again. Our technology is seperating us from getting to know our bodies again.
How do we trust that our bodies can do this work of birth? I think we need to give it a chance, even for a few extra minutes. If women choose to labour at home for sometime prior to going to the hospital, they often notice that as the contractions become stronger, they are still able to cope well. The body actually planned that one out. As oxytocin (which is the hormone responsible for the contractions) increases, it also releases an opiate-like hormone in the body to help with the pain you would be feeling.
I am certainly glad that when the technology of a c-section for example was needed for a true emergency, that women have had access to that care. I try to make sure that I am always aware of the use of technology and keep my focus on the birthing woman and her support team. No matter how much technology she chooses to have involved in her birth, it is her experience and as a doula, I don’t want to see her replaced with beeping, screetching, paper wasting machines.
Where do you feel technology is appropriate for birth? Do you think we have gone too far in some cases?
The rise of the induction epidemic
Without fail, as a woman approaches her due date, my phone begins to ring or I begin receiving e-mails about the possibility of induction. Many health care providers are talking about induction as early as 36-37 weeks gestation. A normal pregnancy could be anywhere between 37-42 weeks. This means that the baby could miss out on a month of growth.
Although there are generally two types of induction (medical and non-medical), they both speed up the process of the baby’s arrival. Here is what I see in my practice. Women go into the hospital for an induction, usually right around their due date because there is a fear that due dates are expiry dates (when in reality, it is just a guess). Many will start with a prostoglandin gel. This gel is applied to the cervix in hopes that it will help it get softer (or efface). For most women, this needs to be done 2-3 times. Following this, women are monitored, sent home and told to come back every 4 hours. This amounts to very little sleep and rest before a baby is born! Usually, women are then given an IV and pitocin is started. This medication is supposed to bring on contractions. The contractions though are usually stronger than normal labour with even fewer periods of rest. This is very stressful on a woman’s body but we see the effects on the baby too. Babies use the rest between contractions to settle their heart rates. When it comes to contractions with pitocin, they get little rest and often their heart rates begin to climb. If you are looking to avoid an epidural or a c-section, you may also want to avoid induction which increases those possibilities.
Why is it so wrong for us to want our babies in our arms? Afterall, we have waited a long time to meet these little ones who have been patiently growing inside. These babies may not be ready to meet us – they may still have organs developing, may feed less effectively, or have other concerns develop as a result. The March of Dimes has some more information on this.
What can we do about induction? The best thing we can do is ask questions with our health care provider. What are the benefits of induction? What are the risks to myself and my baby? What other options could I look into? What if we decide not to induce – would mom and baby still be healthy? There are certainly times when induction for the health of mom and baby may be best and this is why you should always discuss things with your health care provider – even “natural” methods of induction.
It is really difficult in our society to let the baby choose it’s birth day. Here, I speak from experience. I am currently only a few days past my “due date” and the phone calls, e-mails, and visitors are all pouring in with questions about if the baby is here yet or what can we do to speed it up. It is frustrating and with hormonal changes at the end of pregnancy, this is one of the last things you want to hear. The good news is, for myself included, the babies do all eventually come out! We just have to be patient and let the hormones that control birth do their job too.
