Newest Addition to the Labor of Love Family

What a difference an hour and a half can make in one family's life!

"This little piggy went to market"... Big brother says hello.

Baby bliss!

Photos courtesy of Cindy Franklin Photography

Connection

Pfieffer Rose and her daddy; love at first sight! This little girl is one of the strongest, smartest babies I know. She knew exactly how to take care of herself and patiently waited for all of us professionals to figure it out. She taught me just how brilliant babies are and the importance of tuning in to listen to what they are trying to tell you during birth.

Welcome Baby Brinlee!

Your birth brings healing and joy out of past pain, fear and suffering. You are the best valentine gift; a family complete.

Welcome Home Baby Gavin!

A baby's homecoming is such a sweet time; especially if delayed by a stay in the NICU. Congratulations Kila & Mason! Enjoy your babymoon time.

A Chance to Do Something I've Never Done Before or Is this What it is Like to be a Nurse?

One morning recently I was getting ready to go to a La Leche League meeting when the phone rang. It was another doula, a friend, and she needed some help.She was stuck at an airport far away and one of her client's had just called to say her water had broken. Unfortunately her back up doula had been at another birth all night. Would I go to the birth? Of course! My friend said she would connect with her birth client and let them know I would be calling.

So as I pulled my pick up truck onto the freeway in Pismo Beach I answered a call back from the dad. He was fairly calm. We discussed how mom was doing. He said she was in labor but handling contractions well. I asked if he wanted me to come right over to their place? No, he thought I should go on to my LLL meeting as planned. I asked if I could talk to her? When he took the phone to her I could hear the labor sounds she was making; a deep breathy moan. Hmmmm...I'm thinking. Then dad came back on the phone and said she couldn't talk now. Hmmmm...I'm thinking. He said he would see me when the meeting was done. Hmmm...as I drove towards SLO I'm thinking that didn't sound like a mom in early labor. Hmmm...My gut said I don't think you're going to League today. So I drove past SLO and on over the grade to their place.

Driving down their windy country road I wondered what this would be like. I had never supported a woman I had never met. Usually I have spent many hours with my moms sitting in their homes, chatting, educating, answering questions, calming fears, instilling confidence and creating relationship. As the birth nears I become a unique blend of confidante, experienced guide, friend and mother hen. So I wondered what would this be like? Could I be effective? Would she respond to me, a total stranger?

When I pulled into their driveway dad came around the corner with a puzzled look. I introduced myself and he visibly relaxed. He took me to the sunny deck where mom sat leaning back in a chaise lounge looking very uncomfortable and obviously contracting. After the contraction subsided I introduced myself and told them their doula was very sorry she couldn't be there with her. Then we got down to business.

I suggested she would be more comfortable in a different position. Could I help her move? After getting her into a leaning forward position I began to gently rub her shoulders as I assessed where she might be in her labor by the rhythm of the contractions, her response to them, her flushed face and unfocused eyes. I thought either this was going to be a long difficult posterior labor or things were moving very quickly.

"When had she last been to the bathroom" I asked? "Could she try to do that with me?" We slowly worked our way through the sliding glass door and into their bedroom. From the deck across their bedroom to the bathroom counter was 3 contractions. We never made it past the bathroom counter. Leaning onto its' smooth surface with me giving sacral counter pressure she swayed and moaned and contractions flowed through her like a torrent.

I turned to dad and calmly asked when he had spoken to their midwife and what she had said. He informed me that she said she would come some time this morning and check how things were progressing. I instructed him to call her again and tell her I said it was time to come. He left the room.

Alone together my hands sent waves of quiet calm into her being. Then I felt her knees begin to buckle with the power of her contractions. Her body was being lead in the primal birth dance, rocking, swaying, head rolling, opening to the flood of sensations that would bring her baby. Having been a birth dance partner for many women I could sense where we were in our journey together, so I was not surprised when I heard her give a soft grunt with the next contraction letting me know her uterus was pushing.

Dad came in and I inquired what the midwife had said. "She's on our road" he announced. "and will be here any minute." I breathed a sigh of relief. I am a doula not a midwife. I am not trained in catching babies. I have non of the necessary equipment. A few contractions later the midwife walked in, assessed what was going on and calmly went into action readying her supplies, talking to the mom and dad and smoothly stepping into the primary support role.

Usually a midwife has a trained assistant but it was clear to us that this baby wasn't going to wait for an assistant to arrive. As best I could I worked with the midwife, getting supplies, holding things, and handing things, while at the same time talking to the mom to give her confidence in her abilities to birth her baby, taking photos, and guiding dad into positions where he could remain a connected part of the process. Very soon a beautiful baby girl emerged into this world and into her moms waiting arms, healthy and happy.

I continued in my new dual role during the mother's repair and clean up, alternately fetching for the midwife, stroking mom's hair, taking more photos, cleaning up their rug, putting their towels in the washing machine. Finally it was time to go. Mom, dad and baby were in bed glowing and in love. Food and drink were at hand, family was arriving. They thanked me once again for being there, for not listening to dad's suggestion to go ahead to the League meeting and for everything I had done. Then I walked out of their door.

It has taken me weeks to process this new experience. I still don't know why she listened to me. Why she willingly followed my every suggestion. Why did she have confidence in me?

Is this what it is like to be a labor & delivery nurse? You walk into a room with people you don't know and yet you need to be able to guide them during one of the most intimate and intense moments of their lives. You have to assess where the laboring woman is in the process in order to call the doctor or midwife to come in time for pushing. When they arrive you have to support the mom at the same time playing step and fetch it for the doctor. When it's all done the family walks back out of your life and the connection is broken.

I can tell you I have worked along side some excellent labor nurses. Women that have known how to seamlessly flow from one role to another. The best ones are able to instill confidence and a sense of caring within minutes of entering the room. They are able to enter a room without disturbing its' energy or the rhythm of the labor. They listen to the mother as she progresses through labor and will try to encourage the doctor or midwife to honor the mother's wishes for her birth. Apparently I have learned a lot from these wonderful nurses.

Of course I have learned just as much from struggling with nurses that do not have an aptitude for being with birthing women. They don't generate the right kind of energy for laboring with a woman.

A good doula or nurse needs to be able to emanate confidant guidance without taking control. Their presence needs to create a sacred space in which the woman feels secure to birth. They become the mother's sanctuary in the storm. Now I know this can happen within minutes of meeting if the labor guide brings an open & intuitive heart to the birth.

Rewriting Her Experience

New big brother Lincoln thinks his new baby sister is pretty special. I think she is too. She taught her mom what a high it is to birth naturally. Often the power of preparation, positive thinking and a second baby combine to transform feelings of regret or inadequancy left over from a first birth experience into jubilation, awe and empowerment. Congratulations!

A huge thank you to Trina Dart who was my back up doula for this birth. She stepped in when I couldn't and provided excellent support and care. She made a world of difference during the birth.

Congratulations on a Successful V-BAC!

Dear Anna,

Thank you for letting me share in your journey. Your acceptance of the challenges and possible risks along your path are an inspiration. You never lost sight of your strong belief that women were meant to have babies. You embody true female empowerment which is vulnerable, thoughtful, physical and heroic. Congratualtions on bringing into this world your beautiful 9 pound 13 ounce baby girl, Paloma!

A Letter to Baby Jalilah

Dear Jalilah,

I hope you will come to know your mother as I know her. I wish you could have seen how hard she worked, how much she cared and how difficult her path. She is a powerful woman who will perservere and survive against incredible odds. I know she has so much to give you. Now that the first difficult weeks of colic and latch on and lack of sleep and healing are fading the blessings of motherhood can flourish and grow. Love her little Jalilah all of her days because I know she loves you with all of her heart.

Welcome Annika!

Congratulations to Tiffany and Jeorn!

The road of life is never smooth and straight but it is the ups and downs, twists and turns that help us grow.

An Example of the Wonder of Birth

Welcome Little Slugger!
Some births are so full of surprises they confound even the "professionals". Thank you Baby Ryan for reminding all of us that labor and pain are not one and the same and that birth is new every day.

Bodie's Birth: An Example of How Our System Should Work

I am going to tell you the story of Bodie's birth because it is a good example of how I wish our system always worked. When I first spoke to Bodie's Mom she was looking for childbirth classes with someone who believed in natural childbirth and would be supportive of her choice to birth at home with a Licensed Midwife. We started the group classes at the end of October and I quickly learned what a sweet, intelligent woman she is.

Bodie's parents were seeing Edana Hall, L.M. for their prenatal care and planning a beautiful and peaceful birth at their home in Pismo Beach. Being a medical professional herself she was very clear on her reasons for wanting a homebirth. She explained, "Having worked in hospitals I can tell you they are a great place for sick people but if you aren't sick you don't want to go there. I'm not sick. I'm just pregnant."

As time passed I secretly began to hope I would be invited to their birth. I love going to homebirths. With all the hospital births I do, homebirths help me stay grounded to how women really birth. Even the "natural" births I help create at the hospital are not as empowering for the birthing women. I was sure this couple was preparing for a really special birth.

The first sign that everything might need to go a different direction was just over the horizon. Both her midwife and I had some concern about the baby's size and growth rate. We both had done the right thing and counseled the mom on her diet and she conscientiously made changes in her eating patterns. Her midwife also encouraged her to slow down at work and in life and focus on growing a healthy baby and Bodie's Mom did the right thing and followed her advice.

Eventually as the weeks passed and the baby's growth seemed to be slowing down in spite of the Mom's diligence her midwife did the right thing and sent her to Dr. Cedars, a local perinatologist, for testing. He discovered that the baby was in an alarmingly low birth weight percentile for the number of weeks gestation. Could her dates be wrong? No, Bodie's Mom was sure of her dates.

When the Midwife was told what the tests revealed she immediately did the right thing and told Bodie's Mom she was no longer a good "candidate" for a homebirth. Only healthy women with healthy babies should be giving birth at home. Bodie was no longer considered healthy. She gave the Mom the name of an O.B. for her to get in touch with right away.

Bodie's Mom chose to work with Dr. Yin. At her first appointment Dr. Yin did the right thing and explained to the parents about the need to monitor Bodie much more closely than another baby from now until he was born. Although understandably frightened they agreed that careful watching was necessary.

Putting aside her dreams of a homebirth was difficult even though she completely understood the gravity of the situation. Transitioning to the idea of a hospital birth was also scary. Her Midwife recommended she hire a Doula to guide her through this changing landscape and stand by her side. Bodie's Mom called me. I was invited to her birth but it wasn't going to be the birth I had been wishing for her.

Dr. Yin did the right thing when she advised Bodie's Mom to take it one week at a time. Perhaps things would turn around and the baby would do ok until closer to her due date. She might then be taken out of the high risk category. We hoped it would work out this way and Bodie could be born at French Hospital.

We worked together on things she could do safely and naturally at home to promote her body to move towards an inducible state. It began working and she began off and on to have mild contractions. But there came a day when through the appropriate use of technology it became clear it was riskier for Bodie to continue inside the womb than outside.

So Bodie's Parents did the right thing and checked into Sierra Vista Hospital where they have a Neonatal Intensive Care Unit at the level that Bodie might need. Mom was already having mild contractions. Her Doctor did the right thing by trying a different approach to the induction than simply hooking her up right away to pitocin. I worked with the parents and we did lots of walking the halls together.

At one point I stopped by the nurses' station to speak to their nurse. I explained I wanted her to know that once Bodie's Mom was in a more active labor I knew she was going to need to be monitored much more frequently than usual. The nurse was pleasantly surprised I felt that way. I expressed my concern about Bodie and my understanding that I knew he might not deal with the stress of real labor well.

Unfortunately that is exactly what happened. Shortly after starting into a more active labor pattern Bodie's heart rate was alarmingly up. This is a clear indication of stress. Our nurse hurried into the room and gave Mom oxygen, had her lie on her left side which is a position that is easier for the Mom to get oxygenated blood through to her baby, and called Dr. Yin. I explained what was going on to Bodie's parents and tried to began to prepare them for the emotional transition that their son might need to be born surgically. Lots of healthy babies have "funny" heart tones at times during labor and are born just fine vaginally but we all knew Bodie wasn't a healthy baby.

By the time the Doctor arrived the heart rate was back in the normal range. She wasn't alarmist and instead did the right thing by taking a let's wait and see approach. She stayed close by at the nurses' station where she could watch Bodie on the heart monitor. But it wasn't long before Bodie's heart rate began to climb again and it was clear how he needed to be born. I explained again to Bodie's Parents why this was now the safest option for their baby. Dr. Yin seemed surprised I was supportive of a cesarean.

What the medical staff didn't seem to realize is that an experienced Doula should know the difference between how healthy babies respond to labor and a compromised baby. A good Doula should champion staying the low tech natural path as long as the mom and baby are healthy. If mom or baby aren't healthy a Doula's role changes. She becomes a conduit for information about what is going on around the couple, since often the staff need to act quickly and don't have time to fill in all the details for the parents. The staff also doesn't have time to deal with the parents emotions but a good Doula meets that need as well. When plans change their is always fear mixed with grief that needs to be addressed. Life changes very quickly at that point.

So we all went to the O.R., Bodie's Mom first to be "prepped" while I waited behind with Bodie's Dad. This is a particularly difficult time for fathers. Very soon Bodie was out and it became clear there had been multiple issues contributing to Bodie's tiny size, none of which could have been prevented by anything his Mom could have done. There is nothing different that would have happened if she had chosen to see a Doctor for prenatal care or planned a birth in a hospital. Ultimately no matter what path she chose it would have lead her to that moment.

I am happy to report that beautiful Bodie has doubled in size in the few weeks since his birth. He is healthy and getting stronger everyday and so is his Mom.

This is how I wish our system always worked. This is how it is done in the Netherlands and they consistently have better outcomes than the U.S. All women are initially seen by Midwives. They assess them and determine if they need to plan a hospital birth with an O.B. or with a Midwife, or if they will be birthing at home with a Midwife. Each time prenatal care is given they are re-evaluating. Is she still a homebirth "candidate". If at anytime leading up to the birth or during the birth she is no longer a "candidate" they turn care over to the appropriate care provider. This care provider continues to work with the midwife and accords her the professional respect she deserves. After all she did the right thing.

Thank yous to Edana Hall, L.M., Dr. Cedars, Perinatalogist, and Dr. Elain Yin, O.B. for their quality care of Bodie and his Mother. I want to say an individual thank you to Dr. Yinn who took the time to get me re-connected with my mom down in the Recovery Room.

Diane's Poem

December 25, 1997

Jennifer,

When I try to put into words what we have achieved together, it seems so simple that the intensity is lost. I am left with emotions and the process which words can not recreate. Metaphors and poetry will have to suffice. . .

Thank you for offering your strength,

you became a safe harbor in a storm.

Thank you for seeing my vision

and allowing me to face my dragon

and ride it through the fire.

Thank you for sharing my excitement,

the magic of anticipation as the journey began.

Thank you for understanding each transformation,

as I became a person I did not know,

in a body no longer mine.

Thank you for cleansing my spirit,

as my body flowed from every pore.

Thank you for singing my song with me

and guiding it's harmony to follow nature's melody.

Wishing you love and peace this Christmas & New Year,

Diane

A Mom & a Dad's Perspective

Mom

Jennifer,

Thank you! Thank you! Thank you! Swimming to the raft really helped, along with moving around and trying different things, (shower, rocking chair, hot tub, etc.) Gus is a happy drug free boy as a result!

Heather

Dad

Jennifer,

This is a big thanx for helping us bring Gus into the world. There were times I really wanted to go home, crawl into bed and hide under the covers...

Ernie