A Long Island Doula's Blog

The Birthing Vagina's Bill of Rights

2010-10-06T18:52:00.000-04:00

I was at a birth the other night supported by an OB. Never in my doula career have I ever witnessed any OB, midwife or nurse try to force their was into a woman's vagina, in this case a teenagers vagina.
But I did the other night.

Mom opted for Demerol. Demerol makes you dizzy, sleepy and 'out of it.' Dr Petraca, the OB, walked in to the room (first time meeting this laboring mother-to-be) and she was asleep, as was her own mother. No gentle waking, no gentle, amicable introductions were had. Instead, Dr. Petraca used a loud voice, as if mom was hard of hearing, telling her he was going to check her.

After getting mom centered in the bed, and her knees up, this doctor proceeded to pull on my clients legs and shout at her that 'she had to loosen up! She had to open her legs!' He 'needed to check her!'

Because I look at my clients, observe them, I could see that she was having a contraction. Quickly double checking myself, I glanced over my shoulder and saw on the TOCO monitor that she was in fact contracting.

Putting my hand out as if to say 'hold on' I asked, "Can we please wait until she finishes this contraction!?"

What kind of a doctor, what kind of a man tries to force his way into a woman's vagina?

The rest of this story will be talked about in another post, but from this experience I realized that our vaginas need a Bill of Rights. Just because a child is being birthed does not mean that a woman gives up ownership of her vagina. It does not become the property of anyone else, yet it seems to me that there are cases where a woman's vagina is treated as not belonging to her... and that infuriates me.

So, I started writing. I listened to my own vagina.

What would she like to say for herself and the other vagina's out there when in their birthing time?

While this started out kind of 'tongue in cheek' originally, I realized that my vagina was quite serious. This is what she told me.

The Birthing Vagina’s Bill of Rights

1. The Birthing Woman who spent nine months in gestation of her child(ren) retains ownership of me, her Birthing Vagina. Regardless of the fact that I am bringing forth children, I am not a separate object but am connected to a human being, The Birthing Woman. A Birthing Vagina does not become property of any birth center, hospital, medical staff, Nurse, Obstetrician or Midwife.

2. As a birthing vagina, I retain my right to choose whom and what I allow inside me and when I allow them inside me, and have the right to allow none inside me.

3. As a sacred portal into this world, I deserve and have the right to respect. Approach me with kindness and reverence. Enter me as gently as possible at all times after, and only after, you are given permission to do so.

4. As a Birthing Vagina, I retain my right of privacy. If requested by the Birthing Woman, all nonessential personnel may be asked to leave the room if permission is given to enter me. The Birthing Woman’s cultural and religious requirements of privacy should also be respected at all times by all members of medical and support staff.

5. My sister, Uterus must be honored and those with permission to enter me will wait until she is not surging. Unless there is a medical purpose for it, you will exit me before the next surge begins.

6. The Birthing Woman that I am a part of retains the right of informed consent and informed choice about any and all procedures that may potentially take place within and beyond me. This includes all augmentations, drugs and medications, including their risks and side effects to either her or the unborn child. She also retains the right to be told of any alternatives, and the right to deny any and all treatment as per the Patient’s Bill of Rights.

7. I retain the right to not be enlarged by cutting my sister, Perineum. I have the ability as a Birthing Vagina to stretch to pass the child through me. If I tear in the process I can be mended by a skilled physician or midwife, giving me the best opportunity, as per researched studies, for a healthier outcome. We have the right to be gently supported with counter-pressure and/or gentle massage and gentle assisted stretching.

8. As a Birthing Vagina, the Birthing Woman and I retain the right to birth the child(ren) in any position we agree is most beneficial for us, as well as the child, and not the attending medical or midwifery staff.

9. All third stage procedures should be done gently and respectfully, taking into account the feat I have just performed. The emergence of my sister Placenta should be given as much time as possible and if assistance is required, it should be as gentle as possible.

Translated by Tamrha Richardson CD(CBI)©

www.tamrhasdoulasupport.com

Reprinting and sharing welcome, with credit given.

A letter to Senator Flanagan of NY regarding the MMA Bill

2010-06-25T17:26:00.000-04:00

I found out today that my Senator is not on board the Midwifery Modernization Act bill, which frees midwives from obtaining written practice agreements, essentially permission, from an OB to practice. . I'm so disappointed... I've repeatedly called, put up the red flags to the Birth Net of the finger Lakes gals and have just sent him a letter.

Please call your senator, and assembly person and ask them to get on board with this if they are not already.

To find out more, and how to locate your representatives, as well as what to say, go the Free Our Midwives page. To find out more about the MMA bill go here

Here's my letter...

Senator Flanagan,

I do hope that after recieving all the phone calls yo your office, and being sent further information regarding the Midwifery Modernization Act, that is eligible as of Monday for a vote, you will realize that the women of Long Island, and NY State, want and deserve this option in pregnancy and birth choices.

Will you be on the side of these midwives, who's professional, wise ways create safer birth outcomes for NY women and babies, who's mode of care saves the state money? Did you know that the US sits at #44 in the WHO's list of countries with the worst maternal mortality rates? That means there are 43 other countries where I am safer, and more likely to survive childbirth, Senator Flanagan. This is the US. We are not a poor country. Why are women dying here? Why are women more healthy in other European counties? Why are they more likely to survive? Part of that reason is the Midwifery Model of care. Help make NY State one of the states to pull us up from those numbers and have healthier childbirth outcomes!

I was told today by one of your staff that you feel that women are in better hands because Obstetricians have gone to eight years of medical school. For the record, OB's never study normal, uncomplicated, natural births in their eight years of medical school. They study the pathology of pregnancy, the problems, the risks, etc. And that's wonderful, for some women and babies need those specialists. However, they walk out of medical school and begin to treat ALL women. And most women are not in the need of a specialist, or of a surgeon, because essentially that is what an OB is. A Midwife can do all an OB can do in a healthy pregnancy, except cut a cesarean section.

Not all pregnant women are high risk. The majority are healthy, pregnant women who's care providers are trained only in the problems... and therefore many often see only the problems. Or the possibility of problems, and then treat from a stand point of 'what -if' or 'safety' when in all actuality what they are often doing is harming women and babies. Hence, our World Health Organization ranking of #44. Of course, this is just a piece of that #44 pie for things like fear of litigation plays a huge part, but if I get into that I'll digress from the purpose of this email.

When necessary, our midwives are still going to work along side Obstetricians. This bill is not saying that they won't. What this bill does is free them from the written practice agreement, essentially the signature of an OB or group of OB's giving her permission to practice in their being willing to back her up. That's it Senator. That's all its aim is. Midwives will still refer their clients in need of those specialists to those specialists whether they be chiropractors, nutritionists, acupuncturists, or Obstetricians. They do this with all the rest without a written agreement, and there is no reason to suspect they would not refer out high risk clients to the OB's when the women need their specialties. The goal is a healthy mother and child.

Here is is the fact sheet that Im sure you have already received. Please do more research on this, Senator. NYS has some of the highest cesarean section rates in the US. We need our midwives! Near your Long Island office, St Catherine's has a section rate, in 2007 of 51.9%. That means more than half of the women that walk into that hospital are being cut. Good Samaritan has 49.4%, St Charles 47.3%,Mercy in Rockville Center is at 47.2%.In the city Lenox Hill is up to 40.1%, Long Island Jewish is at 40.3. 44.7 in Staten Island at Richmond University Hospital. ALL of these exceed the WHO's recommendation that no country have a section rate over 10-15 %.

You may find all the LI and NYC hospitals rates at an online list I created for Better Birth NY, of which I am the representative for here.

We NEED our midwives, Senator. And we need them to have the fetters removed. This is the 21st Century. Will you be on the side of women having access to all their birth options, or not?

Dr. Besser and a laboring girl in Haiti

2010-01-20T08:44:00.000-05:00

Dr. Besser Assists in Haitian Baby's Birth

The reason I posted this video was for a few things. I guess it was in looking at the language used from the doctor in this report. Its very true that this small clip cannot give us a very clear picture of what was going on. However, There were still a few things I noticed.

Dr Besser (whi is an MD and not an OB. I looked him up on Wikipedia) mentions that Sariah had a 'trained midwife', Maritann, there. He says that he thought she was lucky because of that fact. In the end of the clip you can watch the midwife massaging and possibly palpating the girl's belly. I'd be curious to know where the transverse worry stemmed from... yet the doctor says "I was worried about transverse or feet first and that she needed a c-section." He doesn't state the midwife was worried about this, yet again, this is a short clip. We don't know. I did find his asking to touch her kind and appropriate.

Dr Besser then mentions her waters were brown and not clear. 'This could be a sign of infection." Really? Could the mother having gone through a trauma of an earthquake create distress in the baby and cause the baby to pass merconium, dr.? Of course its not a great scenario, there being merconium present but itsn't that more likely due to distress than an infection?

Then he says he emails doctors in the States. Why is that? He just before said she had a trained midwife there. How can a doctor a 1000 miles away really give an on target recommendation? They give a clip from Dr Moritz, located in New York. "Is there a heartbeat? It doesn't look good." What tells him that? The info from Dr. Besser most likely because sitting in NY how can he really make an evidence based call for a girl in Haiti? He can't, can he?

I was actually glad for some 'bells and whistles' of technology for this girl here. The ultrasound worked in her favor telling them that baby was 'in a better position that I thought.' High blood pressure? I'm not surprised either. I'm just glad for her that an unnecessary section was done for suspected mal position.

Dr Besser I'm sure had good intentions for this mother, but he had set out to do a story on "The impact of this quake on pregnant women and newborns." "What I didn't know was that it would unfold before me."

Really? Dr. Besser, don't you think you created some drama here? Possibly? We can't be sure, because we don't havethe whole picture, but I wouldn't be surprised. Made for a good story, this transeverse and breech woory. If she'd just birthed right there with her midwife, with no suspected mal-presentation... not so 'dramatic' to the ABC audience, is it?

VBAMultipleC Mamas!!

2010-01-17T19:04:00.000-05:00

Its possible! With support, faith, and intention... it is very, very possible!

Birth and The Origins of Violence

2009-09-27T19:26:00.000-04:00

One of my darling clients is a college student. She sent me this paper... and I need to share it. It's intense. Its full of lessons. Messages. Calls to stop certain actions and to take up other actions... or non-actions.

Babies are teaching us. Who's listening?

http://www.birthpsychology.com/violence/chamberlain1.html

No-Cry Nap Solution

2009-09-02T08:29:00.002-04:00

Elizabeth Pantley, the author of books such as The No-Cry Sleep Solution, The No-Cry Sleep Solution for Toddlers and Pre-Schoolers, The No-Cry Discipline Solution, and The No-Cry Potty Training Solution has just released a new book called the No_Cry Nap Solution.

While my own boys didn't and don't cry too much when it's nap time (I think the key there was that I didn't let them pass that time slot too often) when things happened during the days when they didn't get to nap for whatever reason -being out, family party, etc. - bedtime was often rough.

In this excerpt from the book, Elizabeth talks about an important piece of information that I think Parents need to understand about their children - how long can they be aake before the meltdown, or as she calls it the 'volcano' starts.

Read on....

The No-Cry Nap Solution
Guaranteed Gentle Ways to Solve All Your Naptime Problems
by Elizabeth Pantley

www.pantley.com/elizabeth

Buy the book at Amazon:
USA | Canada | UK

The Volcano Effect: Why Skipping a Nap Results in Meltdown

From the moment your child wakes in the morning he is slowly using up the benefits of the previous night’s sleep. He wakes up totally refreshed, but as the hours pass, little by little, the benefits of his sleep time are used up, and an urge to return to sleep begins to build. When we catch a child at in-between stages and provide naps, we build up his reservoir of sleeprelated benefits, allowing him a “fresh start” after each sleep period.

As shown on the sleep chart below, as children age, the length of time that they can stay “happily awake” increases. A newborn can only be awake one or two hours before tiredness sets in, whereas a two year old can last five to seven hours before craving some down time for a nap. When children are pushed beyond their biological awake time span without a break that’s when they become fatigued, fussy and unhappy.

Age “Happily Awake” span of time between naps

Newborn 1 – 2 hours
6 month old 2 – 3 hours
12 month old 3 – 4 hours
18 month old 4 – 6 hours
2 year old 5 – 7 hours
3 year old 6 – 8 hours
4 year old 6 – 12 hours

As the day progresses, and the sleep pressure builds, a child becomes fussier, whinier, and less flexible. He has more crying spells, more tantrums, and less patience. He loses concentration and the ability to learn and retain new information. The scientific term for this process is “homeostatic sleep pressure” or “homeostatic sleep drive” . . . I call it The Volcano Effect. We’ve all seen the effects of this on a baby or child, as it is often as clear as watching a volcano erupt; nearly everyone has observed a fussy child and thought or said, “Someone needs a nap!”

As a child progresses through his day, his biology demands a sleep break to regroup, refresh and repair. If a child does not get this break the problem intensifies: the rumblings and tremors become an outright explosion. Without a nap break, the homeostatic pressure continues building until the end of the day, growing in intensity – like a volcano – so that a child becomes overtired, wired and unable to stop the explosion. The result is an intense bedtime battle with a cranky, overtired child, or an infant who won’t fall a sleep no matter how tired you know he is.

Even more, a child who misses naps day after day builds a sleep deprivation that launches her into the volcano stage much easier and quicker. If she is missing naps and also lacking the right quality or quantity of nighttime sleep…watch out!

Newborns and young babies have a much shorter span in which their sleep pressure builds. They rapidly reach the peak of their volcano in one to three hours. This is why newborns sleep throughout the day, and why young babies require two or three or four daily naps.

Over time, as a baby’s sleep cycle matures he will be able to go longer periods between sleeps. It is not until age 4 or 5 that a child is able to go happily through the entire day without a nap, and sleep research suggests that even through adulthood a mid-day nap or rest break is extremely beneficial in reducing the pressure in all human beings.

The Volcano Effect is not something reserved only for children! This biological process affects adults as well. Understanding this can help you interpret what is really going on in your home at the end of a long day, when children are fussy and parents are grumpy – resulting in a whole mountain range of volcanoes.

Sleep pressure can be exaggerated by environmental issues such as the previous poor night’s sleep, on-going sleep deprivation, or daily stress. What's more, each person’s moodiness feeds off the others, causing contagious crankiness. And then you’ll find yourself losing patience and saying to your child, “I’m sorry, honey. Mommy’s just tired right now.” (This is a very telling explanation we don’t often stop to analyze.)

This Volcano concept brings to light one more important point: Quality naps can make up for lost night sleep – but extra nighttime sleep does not make up for missed naps, due to the homeostatic sleep pressure concept. Therefore, no matter how your child sleeps at night – great sleeper or poor sleeper -- his daily naps are critically important to release the rising sleep pressure.

Excerpted with permission by McGraw-Hill Publishing from The No-Cry Nap Solution (McGraw-Hill, 2009).

'Spotlight to Nightlight': Mayim Bialik: From Teen Icon to Unconventional Mom

2009-08-28T18:20:00.001-04:00

Find the original article and video interview at
http://omg.yahoo.com/blogs/goddess/spotlight-to-nightlight-mayim-bialik-from-teen-icon-to-unconventional-mom/270?nc

posted by Ali Landry - Thu Aug 27 2009, 10:44 AM PDT

Mayim Bialik attends a performance in 1990 Ron Galella/WireImage.com Mayim Bialik arrives at a premiere in 2009 Michael Buckner/Getty Images

Anyone who watched TV in the early '90s knows Mayim Bialik as Blossom Russo, the lovable teen who lived with her two brothers and hung out with her best friend, Six. After making her mark as a Gen X TV icon, Mayim took nearly 15 years off to earn a doctorate degree and start a family. She now has two young sons (Milo and Fred) and has returned to TV in high-profile guest spots on "Bones" and "Saving Grace." On this episode of "Spotlight to Nightlight," host Ali Landry catches up with Mayim and talks about her non-traditional approach to parenting.

Ali's Take
I have to say that I was both nervous and excited to talk to Mayim because I had heard she had a very unique parenting style. There are so many interesting/somewhat controversial things that she is doing with her family: elimination communication, bed sharing, home schooling, home birth, and choosing not to vaccinate her kids. I knew it was going to be an enlightening interview.

First of all, Mayim needs to write a book. She has a way of presenting this style of parenting in such a way that it is understandable, relatable, and less "taboo." I was completely captivated. She made me think about parenting in a completely different way. I love and appreciate how in tune she is with her children's needs. I mean, for you to be able to successfully practice elimination communication you really have to know your child and every little sign they are giving you and then be disciplined enough to follow through. She also spoke about bed sharing, which I had always read was so dangerous. I can remember waking up in the middle of the night panicked from a dream that Estela was in the bed with us and under the covers, or being afraid I'd fall asleep while nursing. Mayim explained that there is a very safe way to have a family bed, but that there are rules. She and her husband use separate blankets for themselves so the baby is never covered by mistake. Also, the baby and toddler never sleep next to each other. One thing that Mayim has done with her kids that I could totally relate to is baby wearing. Wearing Estela was one of my favorite things besides nursing her that really bonded us and instantly calmed her. I still will wear her today because we both enjoy it so much.

I could go on and on about my interview with Mayim. What I really appreciated was that she said all of her parenting choices were made through lots of research and that while they work for her family, they are not for everyone. I am definitely going to research some of her parenting techniques and will try to incorporate some in my next go 'round.

Make YOur Own Baby Slings!

2009-08-23T08:41:00.003-04:00

The other morning I was watching one of those HDTV crafty shows (I was trying to wake up... as these two boys think Mama sleeping past 6:30 in the morning is the funniest thing since Sponge Bob). The hostess made a baby sling... and it was so super easy! It was one of those simple over the shoulder pouch-like ones. There may be other styles out there, and I'll investigate them and post, but for now, let's start easy. If you can use a sewing machine, you can do this! Just think of all the pretty slings of various patterns and colors you could make! The rings can be found at a sewing shop or online.

Try these links...

http://mykarmababy.com/pages/BabySlingPattern.php

http://www.mayawrap.com/n_sewSling.php

This is a great resource with other links to sling sites, yahoo groups and the like : http://www.slingrings.com/patterns.php

Their resource link is extensive! : http://www.thebabywearer.com/lists/Sewing.htm

You can also buy the rings through the above site.

I think my boys may be too big for a sling now... but I want to make one! ;)

The Benefits of Childbirth Support

2009-08-21T16:45:00.001-04:00

Very often, women who are planning to have their husbands or mothers or sisters present at their births, women who are planning cesareans, or planning to have Epidural drugs during their births, think that hiring Childbirth support, or a Doula, isn’t necessary.

Such is far from the truth.

Every laboring woman deserves a Doula present. Every laboring woman, no matter what choices she made to birth her child, deserves the one on one care a Doula, or a professional childbirth support woman, can provide. Obstetricians do not offer this service. Nurses do not offer this service. Hospital based midwives do not, usually, offer this service. A Doula does.

DONA, a Doula certifying organization, uses the saying “Mothering the Mother” to cap phrase a Doula’s job. She cares for the emotional and physical needs of a woman in pregnancy and in birth, creating a relationship that is quite special. She provides information to the mother and her partner on various topics of pregnancy and birth, if the parents care to make informed choices for themselves. She is an extra pair of hands to massage the mother when the partner tires, she does not leave the mother’s side during her labor (except to eat during labors that may be long), she is educated and experienced in childbirth and its normalcy. Often, Doulas serve the partners as well a the laboring woman.

” I felt empowered by her, as did my husband. She is so good at what she does that there’s very little video or pictures of the baby [being born] because my husband was less photographer and more birth partner, this time around. Because of Tamrha’s support, I was able to have the kind of birth I wanted.” ~Helen

Many studies show the benefits of hiring this special woman to your birth team. When Doulas are present, there are …

· 50% decrease in Cesarean births

· a 60% decrease in the use of epidurals

· oxytocic drug use decreases by 40%

· 25% shorter labor time

· 40% reduction of the use of forceps or vacuum

· better breastfeeding outcomes

· increase in mother/infant interaction

· decrease in postpartum depression and anxiety

· higher self esteem for the new mother

· greater satisfaction with the birth experience

Since ancient times, in just about every culture, women have always supported women during childbirth. The word ‘doula’ itself comes from the Greek language, meaning ‘a woman who serves.’ During the last century when most births moved out of the home and into hospitals, it was this person, the Doula or labor support that was left behind. Today, however, many women are returning to the past and seeking out these specially trained women to add to their birth support teams.

Why Have a Birth Plan?

2009-08-21T16:44:00.000-04:00

“Want a drink? Here’s some tea, with cream and two sugars. Don’t like your tea that way? Or don’t like tea at all? Well, sorry – that’s our standard beverage. If you wanted something different, you should have told us before. There’s not much we can do about it now.
Like that attitude? What if the item in question wasn’t a cup of tea, but your baby’s birth: the culmination of nine months of waiting and wonder – and the beginning of an incredible new life?”

This quote comes from an article on Pregnancy Today on why its important to have a birth plan. I think its a great way to look at the situation.
http://www.birthplan.com/why-would-you-want-a-birth-plan/

As a Doula, I always suggest my clients create a Birth Plan. I look at it like a learning tool, because in my early experiences as a Doula, as well as my experiences being the pregnant woman, I’ve found that there are so many subjects in a birth plan that many couples don’t even know they have a choice about! From the atmosphere in the room, to what a woman chooses to wear, from whether or not she wants pain medication offered to her, to how she wants her baby cared for after the birth, going over a Birth Plan can show a couple all of the various options they can have.

However…

Doing this at 36 weeks may not be the best timing. Its my belief that looking at the topics in a Birth Plan is something a couple should use when interviewing potential doctors or midwives. Why? Because if you choose to eat lightly during your labor, as is a option in a birth plan, or if you choose not to have a medical induction (barring the fact that it is MEDICALLY necessary (a topic that will come up in another post)) or if you want your newborn’s physical examination to be done on your chest and you suddenly find out that your OB or midwife will not permit this, its very late in the game to be switching care providers. Its not that it cannot be done, but why not start out with a care provider that’s on the same page as you and your partner, who has a philosophy about birth that is in line with yours? I’ve heard the stories of the doctor taking the birth plan and throwing it in the trash or the doctor who says to their client, “You should stop reading books and just listen to me.”

Some women may worry that they don’t have the knowledge to make decisions about their birth. I think there is nothing farther from the truth when it comes to the vast majority of women, because most women are perfectly healthy and able to birth their babies without intervention. Rest assured that just because you create a Birth Plan, does not mean it cannot be adjusted if necessary. It is not set in stone. If you state on your Birth Plan that you don’t want any pain medication, and yet during your labor you opt for it, no one will hold you to the Plan… unless you really want them too. The plan simply states your preferences, with the knowledge that they can be changed at any time.

All of this said, I heard from a long time L&D Nurse that a Birth Plan handedto the nursing staff may not be enough to forgo certain standing orders your OB might have. Let’s say you opt to not have a routine IV or for a HepLock (what’s basically the start of the IV needle into your arm.) or no routine Pitocin (a drug that is synthetic Oxytocin) to augment your labor. You may get to the hospital only to find out that your OB has standing orders that all of their patients receive this upon presenting in the hospital. A Nurse will not forgo this just because you are holding a Birth Plan stating you don’t want it, even if you tell her your OB ok’ed it.

Instead, get from your care provider a order slip that they have to fill out and give to you, which you bring with you to the hospital once you are in labor. Keep it with your Birth Plan and give it to the nurse as you are admitted.

There are many online resources that you can use to create a Birth Plan. Check out a few versions as some will have different questions, some are more thorough as well.

Lesson's Learned Supporting a 14 year old Mother

2009-08-21T16:42:00.000-04:00

I’m a Doula. That might be a word you aren’t familiar with. The short and sweet version of that answer is that I provide women and their partners with physical, emotional and informational support during pregnancy, childbirth and the postpartum period. I attend the birth with them, continuously remaining by her side, helping to create a safe, secure place for her to give birth, whether they choose a hospital, birth center or home birth for their baby while providing my professional knowledge of childbirth to the woman and her partner. It’s an amazing job, both trying and incredibly rewarding. I not only see babies being born, but families being born.

When I first got word of this potential job, I was a bit taken back. This girl was fourteen years old. In various ways she’s a kid herself. Through my mind ran thoughts such as ‘this could be a really difficult job.’ However, at the same time, or maybe a spilt second later, I knew she was ‘my mom’ (that’s doula terminology right there, ‘my mom’. Of course we aren’t talking about our biological mothers, but our clients, our ‘mom’s’). Now, I couldn’t have known that she was, at that point, my client. The email was a notification about a lottery drawing for the job looking for doulas within an organization I belong to, who were interested in providing services for this mother-to-be. Yet, she was mine. I knew it. I felt it. I trust that inner voice all the time. It’s served me in many, many ways.

So, after I was notified that I indeed officially had the job, I wasn’t very surprised. However, I couldn’t have guessed how much I would take away from this birth; how much I would learn from a fourteen year old girl.

Upon meeting my client, I was pleased to find out that she’s a lovely, sweet girl. Teens, I hear, can often be trying clients (even the not so pregnant ones!) yet this particular teen was truly a wonderful young girl. Actually, every teen I’ve supported has been wonderful. She was more educated about pregnancy and birth than I expected her to be and looked forward to her birth experience. Furthermore, I could not detect any fear in her of the birth process. At first I attested it to the fact that I had just met her and that she was not ready to open up to me yet. I could not have been more wrong.

At another meeting I asked her flat out, “So, what kinds of fears do you have about this?”

Her response to me was a shrug along with her telling me that all she was really scared about was the needle for the epidural. She didn’t want that. This fourteen-year-old girl wanted a natural, drug free childbirth.

Looking back now, I could have attested her lack of fear to her being uneducated about birth. But that wasn’t the case. My client knew a lot about birth. She also knew what she wanted and what she didn’t want, including an obstetrician who didn’t talk to her, who didn’t give her time to ask questions, voice concerns or investigate her options. By the time I met her, she had fired that doctor and was looking for someone who would be nicer to her, who would not judge her or her situation and with whom she felt comfortable with. And this was all self directed. While her mother and family were supportive, I could tell that this came from the girl herself.

I’ve had adult clients that can’t advocate for themselves this way, who are too fearful to fire their doctors and look for another who they are on the same page with. I was both proud of her and amazed by her. With some education from me, my client chose a midwifery service for her birth. I was so excited for her and so glad she was advocating for herself this way, even with some emotional hand holding from me when it came time to actually ask for the appointment (but hey, that’s part of the job), because really her perception of prenatal care and birth could have been so damaged had she continued with her original care provider.

When the night of her labor arrived, my client was not yet finished with her 37th week. I had expected her to go early, as many young women tend to do, and while I also advise that my clients labor at home for as long as possible, I did feel that the best thing to do was to call her midwives right away. Her contractions were still only 40 seconds long while being about 5 minutes apart, and she was handling them well, talking to me calmly, but still her dates put her in the pre-term birth category.

We met at the hospital along with her mother and her boyfriend as well. I watched her through contractions as we stood at check in. She was breathing lightly through them, they were still relatively short in length. In my mind I thought she was in early labor but when I was told, after she left triage, that she was 6 – 7 centimeters dilated, I was shocked. Lesson number one: women can have very productive contractions even if they are not lasting as long as the textbooks say.

When I try to look back and divide her labor into stages, from physical observation alone, I can’t. Not really. Except for her vocalizing the feeling of pressure and for some slight nausea, my client stayed just as calm and quiet through her labor as she was when she first called me on the phone.

This young girl never said ‘I can’t do this.’ She never asked for pain relief. She never shouted, she never cried, she never was afraid. She talked to her baby softly during contractions, both in English and in her first language. When she was complete (ten centimeters) she was excited. I have never seen an expression of pure excitement on a laboring mother’s face before.

During her childbirth education class with me, I explained to her how the baby, when descending through the birth canal before crowning, will be visible for a little while during a contraction and then sink back into the body after the contraction is over. Mother Nature is amazing because during this part of the birth, the baby’s head is gently stretching the mother’s perineum. I told her, “It sort of looks like the baby is playing peek-a-boo.”

I’ll never forget her asking me, right at the start of her pushing phase, “Is she playing peek-a-boo yet!?”

It will be a precious memory for a very long time.

Another wonderful memory will be this mother’s expression once we told her that we could now see her baby’s hair. Pure excitement doesn’t even explain it well enough. Nor will my telling you that this amazing young girl was the first woman I’ve ever seen reach down and pull out her own baby, all while exclaiming, “My precious baby girl!” It was one of the most beautiful mother-child meetings I’ve been blessed to witness.

It’s been a while since I cried at a client’s birth, but it was impossible for me not to at this one.

In the days and weeks after this particular birth, I’ve asked myself so many questions and learned some very important things. While some of those things I cannot express without breeching any confidentiality, one of the most important things I learned needs to be shared and talked about. And that’s why I am telling people this story, both in conversation as well as through this article.

This mother did not have the fear that so many of my clients have had and I attest that to two things. First she has only lived in the US for a few years and second, because of her age, I don’t think there was enough time for this girl to be programmed to fear childbirth the way so many other American women do.

Let’s take certain shows on television that are about birth. As a childbirth professional, I see so many things wrong with such shows, as well as film portrayals of birth, but before being educated the way I am, I watched those shows and felt fear. They instill fear and anxiety in women, telling us that all birth is dangerous, all birth has to be within a hospital setting in order to be ‘safe’ and that a woman’s body alone does not really know how to birth her baby. The message is that she can get pregnant and grow the baby, but not birth the baby without all the bells and whistles of managed care, hospitals and Obstetricians.

Female family members and female friends, who for some reason feel the need to tell other pregnant women their ‘horror stories’ help perpetuate fear and distrust in this biological process. While I understand the need to talk about a birth experience, what good does it do a pregnant woman to have the seeds of doubt planted into her mind? Why should she fear one of the most important moments of her life? Why do we do this to each other? Positive and inspiring birth stories need to be shared amongst women. Those are the seeds we need to plant.

How many fourteen-year-old girls do you know who have been present at a birth with someone like an aunt or their own mother? How many fourteen-year-old girls do you know who have seen home birth? Who have cut an umbilical cord? My client did. Before she ever became pregnant or gave birth herself, she saw and participated, in a support role, for her cousin’s birth at home. I can’t help but wonder how this impacted her pregnancy, labor and childbirth. And I wonder what difference it would make if other young women witnessed the births of their family members in a normal, supportive environment. How would this help build their perception of birth? How would this witnessing of natural, normal, supported, beautiful birth affect young women?

The trust in herself, trust in the process of birth, and the lack of fear that this young girl had during her pregnancy and child birth made her experience so very different from many other births I’ve supported, not to mention shorter. A first time mother with a ten-hour birth, from start to finish. That’s pretty wonderful, if you ask me. And it supports all the research that says that support, and lack of fear will shorten the length of labor.

She taught me lessons that I will never forget, that I will look back on and utilize when supporting my future clients. I can’t thank her enough for such a gift. I hope that by reading this one small story, you too will spread it around to your female friends and family members as well as the men who love and support them.

Birth can be so much different than most women in this country know it. This one girl, her beautiful baby and their birth story are proof of the possibilities.

Tamrha Richardson is a Certified Birth Doula and Childbirth Educator in training through Childbirth International. A mother of two, she is passionate about pregnancy, childbirth, and women’s reproductive rights. Tamrha is the Local Representative for Better Birth New York, an online resource for NY women supplying information on birth options. As a co-leader of the Long Island Chapter of ICAN (International Cesarean Awareness Network) she supports women seeking information on VBAC’s and Cesarean prevention. She is a member of The Long Island Doula Association and the Metropolitan Doula Group. Tamrha can be reached through her website www.tamrhasdoulasupport.com or by calling 631-357-4933. Visit her blog at http://alongislanddoula.wordpress.com/

Mother’s Last Skin-to-Skin Goodbye Saves her 20oz Baby

2009-08-21T16:41:00.000-04:00

Sometimes a preemie doesn’t need to be hooked up to 10 different machines to be given the chance to survive.

When Carolyn Isbister put her 20oz baby on her chest for a cuddle, she thought that it would be the only chance she would ever have to hold her.

Doctors had told the parents that baby Rachel only had only minutes to live because her heart was beating once every ten seconds and she was not breathing.

Isbister remembers:

I didn’t want her to die being cold. So I lifted her out of her blanket and put her against my skin to warm her up. Her feet were so cold.

It was the only cuddle I was going to have with her, so I wanted to remember the moment.” Then something remarkable happened. The warmth of her mother’s skin kick started Rachael’s heart into beating properly, which allowed her to take little breaths of her own.

We couldn’t believe it – and neither could the doctors. She let out a tiny cry.

The doctors came in and said there was still no hope – but I wasn’t letting go of her. We had her blessed by the hospital chaplain, and waited for her to slip away. But she still hung on.

And then amazingly the pink color began to return to her cheeks. She literally was turning from gray to pink before our eyes, and she began to warm up too.

The sad part is that when the baby was born, doctors took one look at her and said ‘no’.

They didn’t even try to help her with her breathing as they said it would just prolong her dying. Everyone just gave up on her,” her mom remembered.

At 24 weeks a womb infection had led to her premature labor and birth and Isbister (who also has two children Samuel, 10, and Kirsten, 8) said, "We were terrified we were going to lose her. I had suffered three miscarriages before, so we didn't think there was much hope." When Rachael was born she was grey and lifeless.

Ian Laing, a consultant neonatologist at the hospital, said: “All the signs were that the little one was not going to make it and we took the decision to let mum have a cuddle as it was all we could do.

Two hours later the wee thing was crying. This is indeed a miracle baby and I have seen nothing like it in my 27 years of practice. I have not the slightest doubt that mother’s love saved her daughter.”

Rachael was moved onto a ventilator where she continued to make steady progress and was tube and syringe fed her mother's pumped breastmilk.

Isbister said, “The doctors said that she had proved she was a fighter and that she now deserved some intensive care as there was some hope. She had done it all on her own – without any medical intervention or drugs. She had clung on to life – and it was all because of that cuddle. It had warmed up her body and regulated her heart and breathing enough for her to start fighting.

At 5 weeks she was taken off the ventilator and began breastfeeding on her own. At four months Rachel went home with her parents, weighing 8lbs - the same as any other healthy newborn. Because Rachel had suffered from a lack of oxygen doctors said there was a high risk of damage to her brain. But a scan showed no evidence of any problems and today Rachel is on par with her peers.

Rachel's mom tells us, "She is doing so well. When we brought her home, the doctors told us that she was a remarkable little girl. And most of all, she just loves her cuddles. She will sleep for hours, just curled into my chest. It was that first cuddle which saved her life - and I'm just so glad I trusted my instinct and picked her up when I did. Otherwise she wouldn't be here today."

Find out more about skin-to-skin contact with preemies at www.kangaroocare.com