then the doctor started spouting statistics on the dangers and risks of possible uterine rupture (which are real but far less occurring than you'd think) when my client stopped her and gently asked the million dollar question, "How many uterine ruptures during an attempted VBAC have you actually witnessed?" The doctor stopped, hesitated a moment, and replied, "None." The second million dollar question, "How many have occurred at this hospital since you've been practicing here?" Again the reply was "None" The partnering doctor inserted that she had witnessed four in all of her years of practice and how horrible they had been. When questioned further by my client she admitted that those ruptures occurred in a developing third world country and not here in the U.S. My client raised her eyebrows and looked her doctor in the eye and qualified, "Barring any unforeseen complications." The OB/GYN agreed to the VBAC, how could she not?
I had a great conversation the other day with a client of mine who is looking forward to attempting a VBAC. She shared with me the dialog she had with her doctor on whether or not she'd be allowed to try for a VBAC. They spoke at length on what conditions would not be favorable or put mother and baby at risk.
then the doctor started spouting statistics on the dangers and risks of possible uterine rupture (which are real but far less occurring than you'd think) when my client stopped her and gently asked the million dollar question, "How many uterine ruptures during an attempted VBAC have you actually witnessed?" The doctor stopped, hesitated a moment, and replied, "None." The second million dollar question, "How many have occurred at this hospital since you've been practicing here?" Again the reply was "None" The partnering doctor inserted that she had witnessed four in all of her years of practice and how horrible they had been. When questioned further by my client she admitted that those ruptures occurred in a developing third world country and not here in the U.S. My client raised her eyebrows and looked her doctor in the eye and qualified, "Barring any unforeseen complications." The OB/GYN agreed to the VBAC, how could she not?
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Don't let the title fool you. I am all for, and encourage every expectant woman to take Childbirth preparation classes. With the caveat that preparing for childbirth is somewhat like taking swim lessons without ever getting in the water. There's only so much you can do without jumping in. Unfortunately, there's no way to get your feet wet in the labor department. However, there are additional things you can do to be more prepared. Here are a few suggestions:
Before Birth:
* Establish a personal relationship with you and your partner. * Help you explore your birth options. * Assist in writing a birth plan. * Practice comfort measures. * Help you with questions regarding birth and where to go to find the answers so that you can make informed choices about your care. (We loan books!) * Be available for reassurance. * On call 24/7 for your birth. During Labor and Birth: * Hold your hand. * Massage you. * Help you breathe. * Walk with you. * Talk to you. * Comfort you. * Encourage you. * Help you to stay focused. * Suggest positional changes. * Hold you during contractions. * Keep you fed and hydrated. * Guide your partner. * Assist your partner. * Run, fetch, and carry as needed. * Hold your hair if you vomit. * Clean up if you do. * Bring you compresses, hot or cold. * Kneel, squat, bend, and lift as necessary to make you comfortable. * Stay with you continuously unless you ask me to step out. * Remind you of your birth plan and help you achieve your goals. * Remind staff of your birth plan and goals. * Create a space for you and your partner when considering options that deviate from your plan. * Support and respect the choices you make. After Birth: * Encourage the staff to allow baby to remain with you for the "golden hour" following birth for bonding and breastfeeding. * Assist with first feeding if necessary. * Make sure you and your partner are settled and ready for me to leave before I go. * Check in with you the following day and set up a time to review the birth with you. * Meet with you and your partner to review your birth, get feedback on my services, answer any non- medical questions, and admire your baby. * Be available with breastfeeding assistance if necessary. Ban the t.v. show Baby Story from ever being shown again
Start my own t.v. network... ANCN....the All Natural Childbirth Network featuring births without interventions, where the commercials would all be about positive birth stories and affirmations for birth, and breastfeeding advice. Give every new/expectant parent a mentor who has had a positive natural birth experience, and is experienced at breastfeeding. Make every OG/Gyn job shadow a homebirth midwife for one year before they begin their hospital training. Live in a society that would teach its children to understand and value the amazing design of the human body and trust in it. Put a birth center near every hospital, yet have it's own autonomy. Ban Pitocin, Ban infant formula. Buy every mother a baby sling or moby wrap. Put a milk bank next to every Mc Donald's in the world. Make childhood a lot longer and puberty a lot shorter....well I can dream can't I? Go to our facebook page and let us know what you wish you could do to make childbirth better! The final countdown has begun. Your due date is in sight or maybe you've passed it already and your mind is telling you you can't wait another day to have this baby out! Your doctor may be encouraging induction. You may be begging the doctor to induce! The seduction of induction calls to you. After all it's close to your due date and chances are if you had the baby right now things will turn out okay....right? Even the pain of labor doesn't phase you as you contemplate having to be pregnant even one more day. Your doctor may agree with you. After all they're equipped to handle things if the baby hasn't quite matured enough. That's what the intensive care nursery is for....right? Is it a chance you are willing to take? " Yes!" You may cry, but really?
If you can stick it out you may find that the blessed anticipation suddenly turns to urgency. Suddenly your nesting urge increases. You're restless, even edgy. When was the last time you slept well? Turned around without having to pee? Suddenly you begin to cry. "Stick a fork in me, I'm done!" " I can't do this one more day!" And you probably can't. These are all signs that labor is imminent. It doesn't matter if you've started to dilate or efface up to this point. It can happen slowly or swiftly. The hormonal cascade that fires up labor has begun. Mother nature at her finest is producing a hormonal cascade that induces labor, prepares your baby for life outside the womb, brings forth birth, and bonds you to your baby. And you wouldn't have it any other way if you could do it all over again. You are perfectly and wonderfully designed to give birth. Trust yourself. God Bless, Suzann Lately it seems that I relate everything in my life metaphorically to the process of birth. Maybe it is because of all the reading, studying, and training I have been doing for my career as a doula. Maybe I'm just strange that way.
My twins are off to college this year. One has already flown the nest and the other leaves in a few days. I find myself feeling very similar to those days just before the birth of my babies. Anxious, excited, irritable, and, to be frank, ready for it to be over. Yes I know it will be painful to let go. To have an empty nest. But this limbo we've been suspended in this summer has worn thin. I need some action. Patience with myself had never been my strong suit. I'm ready to Do....anything but sit here waiting to get my last one out the door. The suspense is killing me! He's ready to leave and I'm ready to let go. Much like in childbirth, mother nature prepares you to let go. Childbirth is painful, but at some point toward the end you are so uncomfortable that the idea of labor pain looses it's hold on you and you're ready to dig that baby out with a blunt spoon if necessary. It's happening once again as I stand with one foot on my son's backside ready to push him out of the nest. I didn't think I would be able to endure the pain of letting go but I have my blunt spoon in hand ready to dig if necessary. It's time. I take a deep breath and I push..... Many of us want to have children of our own, but would like to skip that whole labor and birth part. It hurts and we don't like pain. Why would anyone subject themselves to that intentionally? Especially when there are alternatives like Epidurals or C-Sections! If they weren't safe methods then doctors wouldn't offer them, right?
While I definitely understand where you're coming from, and I don't pretend to be a hero, (I had an epidural with my twins) most people are not adequately educated about the risks these procedure can have to the well-being of both mother and infant. It is assumed that because it is offered and used frequently that the risks must be fairly low. Hmmmm are you certain? Wouldn't you like to know more about something that may run the risk of creating more problems than they fix? If I could only turn back the clock. I definitely would've done things differently armed with the knowledge I have now. There is a time and a place for everything including Epidurals and C-sections. I'm not saying never to have one but rather don't take them lightly and make informed choices. You can only weigh the pros and the cons if you know what they are. There are alternatives out there that you may want to consider first. You have the internet at your fingertips. Use it. Look up the statistics. Or make it easy on yourself and get a copy of Heni Goer's book, "The Thinking Woman's Guide To A Better Birth". She states openly that she is in favor of the midwifery model of care and natural childbirth. However, those decisions are based on extensive research and is all documented. She cites her sources and has an extensive index of resources. If you doubt her conclusions the sources are there for you to refer to. Other books I have found informative are: Birthing From Within, by Pam England and Rob Horowitz The Birth Partner, by Penny Simkin Gentle Birth Choices, by Barbara Harper Ina May's Guide to Childbirth, by Ina May Gaskin A Good Birth, A Safe Birth: Choosing and Having the Childbirth Experience You Want, by Diana Korte and Roberta Scaer REMEMBER to check with your local library or local doulas who may be able to loan out the books you need! God Bless, Suzann Let go. Surrender. It sounds so simple. A kid can do it and small children do it naturally, but as we grow we are trained to take control of our emotions and of our lives. It isn't acceptable to be out of control. We are encouraged to "take charge", "take control" and make things happen. The only place I can think of where we are encouraged to surrender is in our faith.
According to Ina May Gaskin, one the foremost midwives in the nation, only when you fully surrender to or let go and embrace the body's instinctual rhythm and power can your body successfully give birth. This takes an understanding of how the body works and how it has been designed to give birth successfully. Giving birth is something you do, not something that happens to you. It is not a medical procedure. It is a natural biological process that we women were designed and created to do! Okay. Still easier said than done, right? So how do we create that for ourselves? It is easier to accomplish in a home birth setting where we can stage our environment for our comfort and be in a familiar, safe, setting. A midwife usually spends more time with their client and established a more personal relationship. So, how do we take that into the hospital setting? It starts with finding a doctor and hospital that provide you with a sense of security. Taking the time to get to know your doctor and making sure your needs mesh with their philosophy is your responsibility. It won't happen in the exam room. Schedule office time where you can sit face-to-face (with your clothes on) and have a list of questions, wants, and needs, to discuss. Do this as often as you need and really get to know your doctor. Do this with the partners as well as they might end up attending your birth. Remember, they work for you! Find POSITIVE birth stories. If you can't find any personal ones look on line, there are plenty out there! Take a hypnobirthing class. Buy or borrow the video "Orgasmic Birth" as something to strive for. Practice guided imagery with your partner and doula. Bring something comfortable to wear for your birth. A hospital gown implies that you are a patient needing medical attention. If you don't have anything comfortable enough there are birth skirts for sale online, check them out! Bring music that makes you feel good. Singing will actually help your cervix dilate and dancing will help rock the baby into position for birth. Talk with your nurse about entering quietly and keeping your room an intimate space. Dim the lights, shut the curtains, whatever will help you relax. A hospital is never going to be as comfortable as your own home, but you can personalize it by bringing comfort items from home and surrounding yourself with loving support. Good luck and God Bless, Suzann I'm frustrated! Maybe you can help me with a problem I'm having. I don't understand why anyone, given the choice, would choose to give birth without a doula.
To choose not to have with you someone who's passion in life is to see you successfully through your labor and birth. To prefer not to have a person who has established a personal relationship with you and yours and it dedicated to meeting your needs and those of your birth partner. To not see the benefit of having someone help you with exploring your options so that you have the knowledge to make informed choices regarding your care. Do people not realize just how little time and attention they are going to get from the staff at the hospital? Do they not realize that the nurses are often attending to multiple mothers and that they usually don't spend that much time with you until the actual time of delivery? Do you really think that your husband or partner won't forget most of what they learned when you are screaming at them to get the h.. away? Do you not see the emotional and physical strain it puts on your partner to be your sole support in a situation they inadequately trained and prepared for? Do you really not understand that your doula will not leave you unless asked to for the entire length of the experience? That your birth can be eventful without being stressful? Please, somebody, explain to me why a person would choose not to have a Doula at their birth. I just don't understand. God Bless, Suzann It has been brought to my attention that I'm very good at pointing out to people what a Doula can do for you in the physical sense, but have been negligent to cover the emotional and mental benefits that engaging a doula may provide. So let me start by sharing my own experience in having a doula with you.
When I was expecting my twins I admit that I was terrified at the prospect of giving birth to two babies and all the potential problems that might occur for both them and me (yes, I did a little too much research for my own mental health). So I did the sensible thing and asked my sister Judy, a NICU (Neonatal Intensive Care Unit) nurse and veteran labor and delivery nurse, to attend my birth. Just knowing that I had someone who had a working knowledge of birth, the hospital, and what I might be dealing with reduced my anxiety tremendously. She helped me explore my options, figure out what I could and couldn't deal with, and reminded me to discuss it all with my doctor to make sure we were on the same page. I don't know about anyone else, but I had a lot of trouble focusing and remembering as my term progressed and it was comforting to know someone had our back. Her role in our birth was to be there for the babies should they need attention in the NICU. This would allow my husband to stay by my side while in the delivery room and not be torn between leaving me and being with the babies. I cannot put into words the comfort and strength her presence brought to us. I could focus on delivering baby B because Judy was able to follow the neonatalogist with baby A and report back that all was well. She was, literally, my cheerleader as I worked to push my babies into the world, bringing laughter to alleviate the tension and ease my my fears. On my husbands behalf, having Judy there took a lot of the pressure off of him to be-all and do-all for me. He was more able to focus knowing that she was there to cover all the bases should he not know what to do. It also decreased his anxiety because he knew her presence was a comfort to me. After the birth my husband was worn-out from the long night and morning of labor and delivery. Judy eased our transition by sending him home for the last good night's rest he'd get in a very long time and stayed with me and the babies that night. She assisted me in position and latch for breastfeeding, with diaper changing, as well snuggling my little ones so I could get some rest. Her support, comfort, and encouragement made for a blessing second only to the miracle of my babies. I didn't know beforehand the impact that experience would have on my life. It was and is the very reason I chose to become a doula. She made me feel strong, supported, and empowered in my birth choices. Her presence bolstered me, strengthened me, and gave me confidence in my ability to be a good mother. I will forever be grateful. Now it is my turn to pay it forward. She is, what I hope to be for you. God Bless, Suzann |