1. Lots of people like to make birth art jewelry, but rarely does any of it feature meconium.
2. I am not that into birth art jewelry. I am not that into meconium. Neither one really bother me. I'm just saying.
3. The first few hours of a home birth you will ask every one's permission to excuse yourself to eat, pee or get fresh air. After about 5 hours, you will announce it to everyone. After 12 hours you will find out if is okay to go sleep on their bed for a bit. After 18 hours you will sleep in the bed for bit without checking, asking or announcing. After 24 hours, you will sleep in the bed for a little bit with someone in it even if you aren't sure if it is the midwife, the day or the laboring mom or her mom.
4. Laboring in water sounds wonderful, but if your baby is making lots of meconium, you might like it less than you think.
5. Hot tubs and air conditioners in the same birthing room make no sense, or rather, make it both hot and cold and sticky and windy. This is especially true when the door is open and the hallway window is open.
6. Someone might cook at a home birth. Or you might just go take a bite of cheese of the block in the frig. Someone might serve you some falafel with yogurt and use a chucks pad as a place mat. You might find that you mind less than you thought you would.
7. Many women like to labor in the nude, especially if the feeling of clothing against their skin during a contraction is overwhelmingly bad. This is fine, but if she gets the chills it is hard to keep her warm - even if it is 100 degrees outside and half of her is in a hot tub.
8. There are certain mother's in the world who should really look inside themselves and see if they really want to be at their daughter's birth. I think this is fine; you should just know who you are and be cool with that. Not everyone is into meconium and some people really, really aren't into contractions (and their accompanying sounds).
9. Cats don't mind labor sounds as much as I thought they would. Neighborhood dogs are not big fans of labor sounds, but neighborhood people are pretty cool with it all - even when it sounds like whale song.
10. In general, for home birth, it is probably really nice if there is more than one toilet in the house. When mom wants to push on the toilet, there is no nice way to ask her to move so you can pee. Or so her mother can pee. Come to think of it, we should have asked the neighbors.
Tuesday, July 22, 2008
Monday, July 21, 2008
Battle Wounds from Birth
This was not the blog post I was writing in my head about my home birth clients. I know I have been extraordinarily lucky to be witness to and participant in so many wonderful, supported births. They have each looked different, but I have felt the mother supported in her choices, in her laboring, in the way she chooses to birth. I have not happened upon any sad outcomes to date in my work life.
The woman who became a mother this morning had a truly beautiful labor at home. At different points along the way it was difficulty, tiring, draining, but she was supported - by me, by her boyfriend and her mother (downstairs making toast and tea), and by two midwives. I felt they were rather hands off for my tastes, but mother and baby were well. At a certain point it became clear that a c-section was necessary. Her contractions had stopped. She was fully dilated with a breech baby in her vagina, right there. One could touch his testicles (I did not. That is out of my scope of practice). I thought of Kneeling Woman, her inner conflict with midwifery & the way it is being practiced in the shadows. Birthing at home is not a hill to die on. There are risks in birth. We ought not to always have trust your body chatter and ignore the obvious - that baby needs out of the vagina, preferably before he notices he is stuck and not after he is in distress.
I felt the fetal monitoring was perfect. He was clearly well & so was she, except tired. So tired, her body protectively & effectively stopped her labor. There was no hard head pressing on her cervix to give her an overwhelming her urge to push & it would take both strong contractions and an urge to push to deliver a baby. When the time came to make the decision to transfer she was fully present with the decision and able to make it for herself. She was fine medically (baby in vagina not actually an illness - no bleeding, no fever, no chills.) She was able to shower and brush her teeth. Her boyfriend packed her bag. I picked a coming home outfit for the baby from a drawer full of hand me downs. It was simple and complicated all in one breath.
Suddenly, it became clear that her midwives were not going to transfer her. I was shocked. I have never heard of this happening. Midwifery is not illegal here; it is just not licensed. They were afraid to go to the hospital, even though there was really nothing wrong, there would be no bad outcome today. She would not be receiving the benefit of their support on the way to the hospital, nor would they be there to give a medical update to the on-call doctors who were about to perform an unplanned surgery on someone who just got wheeled through the ER. Oh and by the way, try not to mention our names. So, it was a self-transfer. We drove one way, the drove another. The admitting process was a bit painful. We expected it, but it overall was manageable. The dad in waiting got some practice standing up for his family. My lovely client just focused inward and occasionally looked my way for reassurance. I told her it was okay to tune out the chatter, the dismay of home birth, oh, we'll see if you are really in labor, you can't have a vaginal delivery here....she knew it all, she knew it was coming & had prepared herself for surgical birth to the best of her ability in those moments. The rest was just salt in the wound - she'd been laboring for close on 36 hours.
The hospital staff were disgusted with the midwives for not showing up - one more cog in the wheel of communication. Although, to be fair, no doubt they were disgusted and disappointed that they could not chastise the midwives as well as the parents. Still I heartily agreed. They ought to have come. And as an extra measure of good faith on my part, I will truly say, there were some staff members who were extremely kind to her, to her man, and some even to me - a moment's humanity, a pause to appreciate this birthday. That this mother should be the casualty of some crazy mommy war spin off between hospital and home birth, well, it sickens me. Did The Business of Being Born movie do more harm then good? I like to think not. In general, I think open discussion and bringing things into the light is the way to go. What happened this morning rocked the ground under me a bit - those midwives leaving - those hospital staffers judging.
It was decided that because she did, in fact, have a baby in her vagina, that there was no time to wait for an epidural to work - she'd have to have a liter of fluids, it could take half an hour and they couldn't risk any last contractions pushing the baby out (skeptical voice inside my head: yes, that'd be awful, if he was like, accidentally born without incident) because breech birth is out of their scope of practices. OBs are no longer trained in it. I just want you to know that I get that. They don't do it- which was in fact what led this couple to contract with home birth midwives. They were not there to share her medical information, to advocate for the epidural - I have no medical role and this couple was just tired and needed their baby soon.
The bitter news came, it would general anesthesia. She'd be asleep and dad would not witness this birth. They separated us all. He into one waiting room, me a hallway and a door away in another "non-family" area. Yes, we were put in time out. Ha. Hours before we had shared a bed with this incredibly beautiful birthing woman. I stayed connected to them in the next hour with tears, prayer and meditation - things that don't mind so much about walls, hallways and hospital policies.
This new father came out to see me after his son was born, numb from joy, tear-streaked and relieved. We snuck into post-op together so I could meet this beautiful boy. He was lovely and fine. She was tired, groggy and had had extra blood loss & so very, very pale. She was cooing to him, holding him, loving him.
The midwives have called me twice. They wanted to check did everything go okay. Was the baby okay - did they give out our names to the hospital, by the way?
I am struck absolutely dumb. I can't find the words to speak. My exit strategy is sleep. I've gotten a few battle scars from the world of birth. I won't be forgetting these any time soon.
The woman who became a mother this morning had a truly beautiful labor at home. At different points along the way it was difficulty, tiring, draining, but she was supported - by me, by her boyfriend and her mother (downstairs making toast and tea), and by two midwives. I felt they were rather hands off for my tastes, but mother and baby were well. At a certain point it became clear that a c-section was necessary. Her contractions had stopped. She was fully dilated with a breech baby in her vagina, right there. One could touch his testicles (I did not. That is out of my scope of practice). I thought of Kneeling Woman, her inner conflict with midwifery & the way it is being practiced in the shadows. Birthing at home is not a hill to die on. There are risks in birth. We ought not to always have trust your body chatter and ignore the obvious - that baby needs out of the vagina, preferably before he notices he is stuck and not after he is in distress.
I felt the fetal monitoring was perfect. He was clearly well & so was she, except tired. So tired, her body protectively & effectively stopped her labor. There was no hard head pressing on her cervix to give her an overwhelming her urge to push & it would take both strong contractions and an urge to push to deliver a baby. When the time came to make the decision to transfer she was fully present with the decision and able to make it for herself. She was fine medically (baby in vagina not actually an illness - no bleeding, no fever, no chills.) She was able to shower and brush her teeth. Her boyfriend packed her bag. I picked a coming home outfit for the baby from a drawer full of hand me downs. It was simple and complicated all in one breath.
Suddenly, it became clear that her midwives were not going to transfer her. I was shocked. I have never heard of this happening. Midwifery is not illegal here; it is just not licensed. They were afraid to go to the hospital, even though there was really nothing wrong, there would be no bad outcome today. She would not be receiving the benefit of their support on the way to the hospital, nor would they be there to give a medical update to the on-call doctors who were about to perform an unplanned surgery on someone who just got wheeled through the ER. Oh and by the way, try not to mention our names. So, it was a self-transfer. We drove one way, the drove another. The admitting process was a bit painful. We expected it, but it overall was manageable. The dad in waiting got some practice standing up for his family. My lovely client just focused inward and occasionally looked my way for reassurance. I told her it was okay to tune out the chatter, the dismay of home birth, oh, we'll see if you are really in labor, you can't have a vaginal delivery here....she knew it all, she knew it was coming & had prepared herself for surgical birth to the best of her ability in those moments. The rest was just salt in the wound - she'd been laboring for close on 36 hours.
The hospital staff were disgusted with the midwives for not showing up - one more cog in the wheel of communication. Although, to be fair, no doubt they were disgusted and disappointed that they could not chastise the midwives as well as the parents. Still I heartily agreed. They ought to have come. And as an extra measure of good faith on my part, I will truly say, there were some staff members who were extremely kind to her, to her man, and some even to me - a moment's humanity, a pause to appreciate this birthday. That this mother should be the casualty of some crazy mommy war spin off between hospital and home birth, well, it sickens me. Did The Business of Being Born movie do more harm then good? I like to think not. In general, I think open discussion and bringing things into the light is the way to go. What happened this morning rocked the ground under me a bit - those midwives leaving - those hospital staffers judging.
It was decided that because she did, in fact, have a baby in her vagina, that there was no time to wait for an epidural to work - she'd have to have a liter of fluids, it could take half an hour and they couldn't risk any last contractions pushing the baby out (skeptical voice inside my head: yes, that'd be awful, if he was like, accidentally born without incident) because breech birth is out of their scope of practices. OBs are no longer trained in it. I just want you to know that I get that. They don't do it- which was in fact what led this couple to contract with home birth midwives. They were not there to share her medical information, to advocate for the epidural - I have no medical role and this couple was just tired and needed their baby soon.
The bitter news came, it would general anesthesia. She'd be asleep and dad would not witness this birth. They separated us all. He into one waiting room, me a hallway and a door away in another "non-family" area. Yes, we were put in time out. Ha. Hours before we had shared a bed with this incredibly beautiful birthing woman. I stayed connected to them in the next hour with tears, prayer and meditation - things that don't mind so much about walls, hallways and hospital policies.
This new father came out to see me after his son was born, numb from joy, tear-streaked and relieved. We snuck into post-op together so I could meet this beautiful boy. He was lovely and fine. She was tired, groggy and had had extra blood loss & so very, very pale. She was cooing to him, holding him, loving him.
The midwives have called me twice. They wanted to check did everything go okay. Was the baby okay - did they give out our names to the hospital, by the way?
I am struck absolutely dumb. I can't find the words to speak. My exit strategy is sleep. I've gotten a few battle scars from the world of birth. I won't be forgetting these any time soon.
Saturday, July 19, 2008
Thursday, July 17, 2008
Transitions
Not entirely sure where I am going, but clearly, I am not alone& I am moving along at quite a clip.
(photo credit to Thinker, thanks.)
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