Massage Therapy-More Than Just Pampering by Tina Risley, CMT

Massage during pregnancy provides many benefits. Medical science has long recognized the value of massage therapy to aid in the treatment of many conditions and diseases. Studies prove massage reduces anxiety & depression. It can improve immune function & promote better sleep. The Touch Research Institute's studies on prenatal massage showed a decrease in anxiety and stress hormones (norepinephrine) which cross through the placenta to the baby. There were fewer pregnancy complications, as well as, a reduction in premature birth rates. The normal increase in blood volume during pregnancy puts stress on the whole circulatory system. Massage supports the circulatory and lymphatic systems by promoting the movement of blood and lymph. This action assists the heart and reduces swelling throughout pregnancy. Massage helps to alleviate stress on the weight bearing joints of the hips, pelvis, knees, and ankles, relieving soreness in the muscles that support the additional weight of the baby. Massage therapy provides a nurturing, soothing touch promoting an overall sense of well-being in the mother. Reassurance, nurturing, and relaxation for the mother have far-reaching impacts on her growing baby. Babies sense and respond to their mother’s stress level as registered by her heartbeat. The birthing process is often made easier and less complicated by regular massage during pregnancy and throughout the labor process.

Choosing a knowledgeable massage therapist with specialized training in prenatal/pregnancy massage is of the greatest importance.Take the time to get to know your massage therapist. Never hesitate to ask any questions you may have about pregnancy massage and discuss any concerns you may have with your therapist or prenatal care provider.

Massage therapists are not medical doctors and massage therapy should not be used as a replacement for routine obstetrical care. Remember you should always ask your doctor before beginning a massage regimen if your pregnancy has been diagnosed as high-risk or if you have pre-eclampsia, eclampsia, gestational diabetes or deep vein thrombosis. For all high risks pregnancies it is necessary for the therapist to work WITH the mother's prenatal provider. Moms with these issues can benefit greatly from massage support. In these special situations its powerful detoxing and blood sugar lowering effects require an experienced practitioner and input from the woman's doctor or midwife. Massage in general is contraindicated for broken bones, tumors, bleeding, burns and other acute conditions.

In conclusion, pregnancy can be one of the most fulfilling experiences of a woman’s life. Pregnancy massage is a wonderful tool to aid in making this special occasion a time of power and happiness by reducing physical and mental tension. Remember throughout your pregnancy that your body is working hard to grow your little one. Take the time to pamper yourself. You deserve it.

In Health,

Tina L. Risley, CMT

Tina can be reached at Barefoot MomEase

Women of SLO County Help Empower Your Sisters & Friends!

There is nothing more powerful than women sharing information. Most women make important decisions about their health care based on things they have learned from other women in their community. This exchanging of information and wisdom is a staple of women's conversations from time immemorial; from the local well at the oasis to the local quilting bee on the prairie. Today women go on-line in droves to connect on social networks; from chat rooms to blogs to web sites devoted to women's issues. It is time information about our local birth community was part of this conversation. You can help your sisters, friends, workmates and all the birthing women of SLO County. It is simple. You don't even have to leave your home.

If you have given birth in the last 3 years I urge you to let your voice be heard. By answering the questions on the Birth Survey you can easily let other women in our community know how happy or unhappy you are with your care provider, place of birth, doula & childbirth educator. You also will be helping the Coalition for Improving Maternity Services compile national statistics on what is really happening out there with issues, such as, induction & pitocin, epidurals, and cesareans. Perhaps just as important for other women to hear is how the office staff treated you, if your care provider listened to you, were you able to get all your questions answered, did they provide their statistics for c-sections, episiotomies and natural births. How would you rate the hospital staff? Did you feel well cared for? Did they offer breastfeeding help and was it helpful, etc.? Wouldn't you like the women in our community to know about the quality of care you received during your pregnancy, birth & early postpartum period?

For a pregnant woman finding a care provider, doula, educator and place of birth that match her values surrounding birth is critically important. These choices can make or break her feelings about her birth. Her birth has the power to impact her either positively or negatively. As an example, if she wants an epidural she should go to a doctor who supports that choice and if she doesn't want one she needs to find a care provider that supports THAT choice. Why? Because if she desires to birth with an epidural and doesn't receive one she will feel disempowered during the birth. For the woman that wished to birth without medication and then feels pressured to give in to an epidural she will feel victimized and helpless. The key is finding the right match for you. Look up a doctor, midwife or hospital.

Guess what? Sierra Vista isn't even on the survey yet because in the 2 years it has been going no one has input any information about their experience there. We owe it to our sisters, friends, coworkers and all the women in our community to stand up and be counted. Please take the Birth Survey!

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.

New Mothers Grow Bigger Brains Within Months of Giving Birth

A new study once again shows the benefits of motherhood for the mother. Although you may feel like your brain is slower because of lack of sleep, the stress of transforming your life, and learning a new set of skills all at the same time. You actually have revved your brain up in a number of critical areas which promote better bonding and mothering. This study was done on breastfeeding moms with no signs of postpartum depression. They will do further study on groups of women with postpartum depression and non-breastfeeders to help them understand if or how these issues play a role.

ScienceDaily (Oct. 20, 2010)

Warmer Feelings Toward Babies Linked to Bigger Mid-Brains

Motherhood may actually cause the brain to grow, not turn it into mush, as some have claimed. Exploratory research published by the American Psychological Association found that the brains of new mothers bulked up in areas linked to motivation and behavior, and that mothers who gushed the most about their babies showed the greatest growth in key parts of the mid-brain.

Led by neuroscientist Pilyoung Kim, PhD, now with the National Institute of Mental Health, the authors speculated that hormonal changes right after birth, including increases in estrogen, oxytocin and prolactin, may help make mothers' brains susceptible to reshaping in response to the baby. Their findings were published in the October issue of Behavioral Neuroscience.
The motivation to take care of a baby, and the hallmark traits of motherhood, might be less of an instinctive response and more of a result of active brain building, neuroscientists Craig Kinsley, PhD, and Elizabeth Meyer, PhD, wrote in a special commentary in the same journal issue.

The researchers performed baseline and follow-up high-resolution magnetic-resonance imaging on the brains of 19 women who gave birth at Yale-New Haven Hospital, 10 to boys and nine to girls. A comparison of images taken two to four weeks and three to four months after the women gave birth showed that gray matter volume increased by a small but significant amount in various parts of the brain. In adults, gray matter volume doesn't ordinarily change over a few months without significant learning, brain injury or illness, or major environmental change.
The areas affected support maternal motivation (hypothalamus), reward and emotion processing (substantia nigra and amygdala), sensory integration (parietal lobe), and reasoning and judgment (prefrontal cortex).

In particular, the mothers who most enthusiastically rated their babies as special, beautiful, ideal, perfect and so on were significantly more likely to develop bigger mid-brains than the less awestruck mothers in key areas linked to maternal motivation, rewards and the regulation of emotions.

The mothers averaged just over 33 years in age and 18 years of school. All were breastfeeding, nearly half had other children and none had serious postpartum depression.

Although these early findings require replication with a larger and more representative sample, they raise intriguing questions about the interaction between mother and child (or parent and child, since fathers are also the focus of study). The intense sensory-tactile stimulation of a baby may trigger the adult brain to grow in key areas, allowing mothers, in this case, to "orchestrate a new and increased repertoire of complex interactive behaviors with infants," the authors wrote. Expansion in the brain's "motivation" area in particular could lead to more nurturing, which would help babies survive and thrive physically, emotionally and cognitively.

Further study using adoptive mothers could help "tease out effects of postpartum hormones versus mother-infant interactions," said Kim, and help resolve the question of whether the brain changes behavior or behavior changes the brain -- or both.

The authors said that postpartum depression may involve reductions in the same brain areas that grew in mothers who were not depressed. "The abnormal changes may be associated with difficulties in learning the rewarding value of infant stimuli and in regulating emotions during the postpartum period," they said. Further study is expected to clarify what happens in the brains of mothers at risk, which may lead to improved interventions.

The Seamstress

My doula journey takes me into people's homes and hearts. I am sometimes a receptacle for their smoldering anger or deep despair. I am always honored to help a woman along her path to peace and understanding. Birth trauma occurs when our hopes and dreams go awry. The wounds are deep if we felt unsupported at the moment our plans splintered into a million pieces of sharp glass raining down on us, and the grief process long. This poem is for all the seamstresses out there. The cesarean epidemic has infected our hospitals like a disease causing a disproportionate number of our mothers to begin motherhood disheartened, disillusioned and disattached from their selves. They are all seamstresses.

The Seamstress

We sat amongst her disillusionment and despair
piecing together the scattered remnants of her destroyed dreams.
The disarray of her disappointment spread around us
disconnecting her from the fabric of her life.

We sat disentangling the threads of her distrust and disbelief
from the dishonesty of those she thought had cared;
vainly trying to dispel her disenchantment.

The disjointed story spilled from her wounded heart
discouraged tears distorting the lines of her face.
The silver needle plunging in and out
as she desperately tried to repair the damage.

Together we examined the jagged edges of their handiwork
searching for patterns and matching the pieces.
How had this disaster happened;
this horrendous disruption to her plans?
Had she lost all of her abilities of discernment?

__ __ __ __ __ __

Carefully they stitched the edges of her womb together.
Her birth desires disintegrating around her
she lay in disembodied disgrace upon the cold metal of the steel table
discarded, dismissed and dispossessed.

Disheveled and disoriented she lay upon the gurney.
Could they not see the gaping wound they left upon her heart
her life blood disgorging onto the sterile white sheets?

Gathering together the fraying edges of her heart
she pressed discomfort, anger and disloyalty to her breast
bravely trying to staunch the unending flow.

__ __ __ __ __ __

Dislodged from all her instincts
her disordered mind distorting her visions for those first precious days of life.
Distraught she began incessantly working
the needle flashing in and out
feverishly sewing together the crazy quilt of her life.

Would she forever be at a disadvantage
disqualified for motherhood by her disfigurement?
Was there no way to close this wound that would not stop leaking
to rid herself of this terrible disease?

__ __ __ __ __ __

We sat discussing, sharing and disclosing
patching over the disharmony of her soul.
Disengaging from blame or guilt
we discovered a mother willing to sacrifice her body and her dreams.

# # # # # # # # # #

I became fascinated with the word and syllable 'dis' as I thought about this piece. First because of the dis-ease women feel with their bodies and their mothering abilities after a traumatic birth. Secondly because feeling they were dissed during the process is a large component of their grief. Third the syllable 'dis' turns a positive into a negative which is what they feel happened to their birth experience.

When I researched the meaning of dis this is what I discovered:

The Many Meanings of Dis

Pronunciation: dēs,
1. lady; woman.
2. Female deity; especially one promoting fertility.

Pronunciation: dis, Slang
1. To show disrespect for; affront.
2. To disparage; belittle.

Pronunciation: dis, Classic Myth
1. A god of the underworld.

As a Latin prefix
1. meaning “apart,” “asunder,” “away,” “utterly,”
2. having a negative, or reversing force when used as an English formative
Example: to change ability to disability; or affirming to disaffirming

I was stunned to learn Dis was both a female fertility deity and a god of the underworld. Now I see my seamstress as wrestling with these opposing gods; trapped in the depths of the underworld; struggling to sew her way back up to the light.

An Out-of-hospital Birth Center Birth from a Father’s Perspective

I am including this birth although it is not local but it does have a local connection. I met Jessica and Clayton when they participated in one of my childbirth class series. Jessica gave birth to their first daughter at French Hospital. Everything went very smoothly and they felt very good about their experience and their care by their midwives and the nursing staff. Then they moved away.

On Monday, September 20, 2010 Jessica gave birth to their second daughter. Feeling empowered by their first experience they chose an out-of-hospital birth center for this birth and planned a water birth. I was excited to hear about their story and wanted to share it because our community is about to have our own out-of-hospital birth center complete with birth tubs. Besides Clayton was always such a sweet, enthusiastic, supportive dad during classes and Jessica was such a great birther I couldn't resist including them in my birth story project.

The birth of Shiloh Rose...

It was Saturday, September 11th and I was excited for a number of reasons. One reason was that the Ocean Beach Jazz fest was happening all day just a couple miles from my home. The other reason was that I had a sneaking suspicion that my 2nd daughter would be born that day. That morning as I was eating breakfast with my buddy Danny, I noticed that Jessica was running around in a flurry cleaning everything. Now Jessica keeps a tidy home but her efforts that morning were extreme. I looked at Danny and said “I think Jessica is going to have our baby today... she seems to instinctively be preparing for it.” At that time there were no major contractions to speak of so I went down the street to catch some first rate live Jazz.

The music was great, over 8 stages of sounds to choose from! At about 2:30, half way through Charlie Hunter, I received a text from Jessica that said “My Water Broke!” I immediately returned home to my dear wife who was excited to finally be in labor 9 days after our "due date". I asked Jessica if she had called the midwife, but she was waiting until she knew for sure she was in labor. After some convincing on my part she eventually made the call. Our midwife Brooke agreed to meet us at the birth center whenever we felt ready.

Now Jessica wanted to labor in the comfort of her own home as long as possible before heading to the birth center. I was in support of that, however about a week prior, in my prayer time I felt the spirit speak to me that when labor began, the baby would come quickly. I spent the next couple of hours preparing our things and loading them in the car. We had packed pajamas, swim trunks for the water birth we had planned, music, video camera, all sorts of clothes for mama and baby. The additional car seat was installed and family members were contacted.

During those couple hours, I could see the contractions becoming stronger. She began getting very quiet and still when they would hit. At this point I suggested that it was time to go. She said that she wanted to eat a quesadilla first... I did too. Following our pre-game meal we left Kairah with Aunt Robin and hopped in the car to meet Brooke at the birth center. We arrived at 5:15 pm. The birth center was so peaceful at that time of day. It was Saturday evening and there were no people in the waiting room and no one else there giving birth. We talked a bit with Brooke and had a look around to select which room Jessica wanted. By now it was about 5:30. Jessica had been having contractions throughout our conversation but was still very much engaged with us. Then Brooke asked to check Jessica’s progress. To all of our surprise she said that Jessica was dilated to 10cm which meant she was ready to push the baby out!

It was Jessica’s desire to have a water birth so Brooke turned on the faucet to fill the tub. I began setting up the video camera as well as preparing some music. During that time I watched Jessica have an intense contraction while laying on her side in bed. It was then that she said “I’m ready to hop in the tub now”. After a couple minutes I went in to check on Jessica who was kneeling ninja style in the tub. The water was about up to her hips in this position. I took a minute to put my hand on her shoulder to comfort her. When I looked down I was shocked to see that the head of our baby was crowning! I asked Jessica if that was the baby’s head and she said yes! Brooke responded in astonishment, "The Baby is coming out?" Jessica nodded yes. The next thirty seconds was a whirlwind. Brooke turned off the water, I moved the video camera, and Jessica pushed one more time. I adjusted the camera just in time to capture Jessica reaching down into the water to deliver her own baby. It all happened so fast! Jessica reclined into the tub without even breaking a sweat saying “Hi little one, That was fast!” Shiloh Rose Connolly was Born at 5:42 pm. I couldn’t stop laughing in amazement. There was no build up, no drama, no “you can do it Jessica”. We were literally there less than a half hour and Jessica delivered so fast no one but her and the baby were ready! I then got to climb in the tub and meet my new daughter. She was so beautiful. She was so captivating. We hung out in the tub for about 15 minutes and then decided it would be a good time to cut the cord. I had the honor of that task. After I cut the cord, Shiloh nursed for the first time... effortlessly. After getting out of the tub, Jessica, Shiloh and I were left alone to spend time together. It was all so amazing! I was so proud of my girls. We couldn’t have asked for a better situation. We were laying together in a queen size bed in the comforts of a room that could have easily qualified for a bed and breakfast suite under different circumstances. There was no commotion, no interruption, no sick people across the hall. It was only us, with Brooke and her assistant in the other room if we needed them.

A couple hours later, we let the word out to all our friends and family. This was the first time we formally announced her name! The first to arrive were Robin and Kairah! It was so awesome to introduce Kairah to Shiloh. Kai had been preparing for months anticipating her new role as a big sister and finally got to hold Shiloh for the first time. Soon after, the Pearsons arrived bearing gifts of birthday cake, champagne and best of all... Sushi! My family also began to file in from all corners of the state. My mom traveled from the Central Coast, Heather came from LA and my Dad and his family drove from Lake Arrowhead to be there. It was such a glorious time of celebration. We all took turns for a personal photo shoot with Shiloh as well as taking turns watching the ever so short birth video. The day ended at about 10:30pm with us loading Shiloh into the car and bringing her home for the first time to begin her new life as a Connolly. The Good Lord was so faithful in answering our prayers! All of our expectations were exceeded, and most importantly we have a new member of the family that we are so excited to do life with!

Welcome Shiloh Rose Connolly! I promise to be a good Daddy!

Mares Don't Like to be Watched

This is the first installment in a series I have been thinking about writing for some time. Over the years I have learned so much from so many about how to be a good doula. Every time I support a woman I either learn something new, renew my understanding of something ,or see an old truth from a fresh perspective. But I see clearly now that my beliefs and understanding about how best to help laboring women wasn't learned at my doula training. It wasn't learned through all the birth books I have read. It wasn't even learned through the birth of my son. My real doula training and my core beliefs about birth predate all of that. As crazy as it sounds I have come to realize that I learned how to be a good doula through my work with horses. The skills I needed for guiding women through the intensity of natural birth I honed in grass pastures, show arenas and barns. Some of my most amazing teachers were the brood mares I met along the way. Their ability to listen to their bodies and do exactly what needed to be done blew me away. Horses are fascinating and fabulous creatures. This set of stories is dedicated to the wisdom of the mares.

************

I lay still in my sleeping bag trying not to make the rusty springs of the old metal cot squeak, listening in the cold dark. I could hear Lunette on the other side of the wall rustling the straw as she moved about the deeply bedded foaling stall. The quiet was so complete in the dark of the old barn I could hear the mare's teeth grinding as she peacefully chewed her alfalfa. The stillness was broken by the screech of a far off owl calling to his mate. Lunette stopped in mid chew to listen but there was no answering call to hear and the intense quiet slowly settled back over us like a blanket; even deeper than before because of the sharp interruption. I tried to quiet even my breathing so as not to disturb the heavily pregnant mare. Finally Lunette relaxed, blew a big warm horsey sigh, lowered her head and went back to contentedly eating.

I lay in the dark trying not to doze off as the hours passed. Carefully I moved my arm out of the warmth of the sleeping bag and raised my wrist to my face. Peering down I could see the dial of my watch glowing in the dark; almost one o'clock. As quietly as I could I unzipped the sleeping bag and wriggled out. The cot gave a rusty groan as I stood up. Looking over the half wall into the dimly lit stall I could see the brood mare standing, neck straining, head up, eyes wide, on high alert from my noisy progress. I talked to her calmly then walked to the other side of the barn. Picking up the phone in the tack room I dialed Betty's number and woke her up.

"Hi Betty. Its time for the second shift."
"How is she doing?" inquired the owner of Belvidere Welsh Pony Farm.
"She is fine; not as restless as last night" I informed her.
"Okay. I'll be down in a minute. Just let me make a cup of coffee."
"Do you want me to stay until you get here?" I asked.
"No; no need for that. I'll be there in five minutes. You go on to bed and get some sleep. It sounds like we might be doing this for a few more nights."

I hung up the phone, walked wearily out to my beat up Chevy pick up, climbed in and started the reluctant motor. I longed for my cozy bed warmed by Mike's body. It was just a quick two minute drive from the barn but it felt like miles. Steering down the dark sandy farm road next to the soy bean field I wondered when Lunette would decide the time was right and have her foal.

I climbed the steep stairs to our little farm house and quietly opened the porch screen door. Spot jumped down from the shabby upholstered chair where he slept on the screened porch during good weather. He met me with a shaggy wag of his plumed tail. Too tired to stop and pet him I eased out of my old leather boots and went inside. Pausing only long enough to peal off my clothes, I carefully slid under the cold covers on my side of the bed trying not to wake Mike. Before I could close my tired eyes the phone rang.

"Come back. The foal is here!" Betty excitedly gasped in my ear.
"What?" I answered in disbelief.
"She foaled. Hurry!" and the phone went dead. I scrambled into my clothes, pulled on my boots and ran.

When I entered the old converted dairy barn I could see the dim glow of the lights coming from the foaling stall and heard Lunette nickering to her new baby; a low, deep rumbly sound with the hint of a whisper in it; a special whinny only share between mother and foal. She proudly stood on guard over a wet bay bundle of colt half buried in the deep yellow straw. As soon as she recognized me she dropped her head and went back to the important business of being a new mom; alternately licking the colt's haunches dry with broad strokes of her pink tongue and drinking in it's odor with deep wuffling draughts of her nostrils. Betty knelt in the straw with an old cotton terry towel in her hands vigorously rubbing dry hair of the foal's shoulders slicked down by amniotic fluid. I grabbed another towel from the birth kit sitting ready by the open door of the stall and went in to help.

"I can't believe it" I said amazed. "She wasn't showing any signs; no sweating, no nervousness, no looking at her sides, nothing."
Betty just chuckled and explained, "Mares don't like to be watched."

************

This story was a glimpse into something called foal watching that is a part of the cycle of the seasons on a breeding farm. Every breeder wants to be there when foals arrive. But mares, as prey animals, are genetically coded not to foal when anyone or anything is around because this might put their foal in danger during those first couple of critical hours when the foal is most vulnerable to attack. In order to survive in the wild a mare needs to be able to run away. She instinctively knows that once her water breaks and the birth process has begun she will be incapable of running away, therefore she is easy prey. Once the birth process begins it is very rapid and the foal is on its' feet within the first hour and can keep up with the herd within a couple of hours. So when a mare is watched it triggers her adrenaline and other stress hormones. As long as these hormones are flowing through her veins her labor will be suppressed. This is why brood mares like to leave the herd and search out a well known secluded spot to birth.

So what is a breeder to do? Lots of money has been made creating high tech devices that alert the owner who is in an apartment or room on another part of the property when the mare has begun giving birth. Even more money has been spent on outfitting stalls with remote controlled video cameras so foal watchers can observe from a room far enough away to not disturb the mares. Horse breeders have long understood what our scientific medical community still doesn't get, that intervention in any form, even just watching, should be done in such a way as to disturb the natural physiologic process of birth as little as possible; to only step in and make your presence known when absolutely necessary. To be a good doula you need to learn the art of being present without intruding on the process until you are needed.

Why You Need to Create a Balanced Healthy Harmonious Pregnancy

Two new books delve into an issue I have been educating women about for almost 20 years: “Origins: How the Nine Months Before Birth Shape the Rest of Our Lives” by Annie Murphy Paul and “More than Genes,” by Dan Agin, a neuroscientist at the University of Chicago. They explain what current science and studies tell us about the effect creating a balanced healthy pregnancy has on your baby later in life. Actually they are looking into the connection between an unbalanced, unhealthy life style during pregnancy and the outcome for your baby later in life. Several studies have shown how your baby's weight at birth can have health effects for him or her in midlife. Now their is evidence that suggests pregnant women exposed to stress, pesticides, junk food, poor nutrition, illness and other factors may have a life long impact on their children's health and mental abilities. Childbirth educators, doulas and midwives have been telling expectant moms this for years.

Long before we had scientific studies to prove this it just made sense to me. Why? Because of what we know once your baby is outside your uterus about the long term health benefits of giving your baby the ideal nutrition it needs through breastfeeding. Your breastfed baby has less chance of ending up with juvenile rheumatoid arthritis or asthma. As an adult he or she has a reduced risk of getting diabetes, Crohn's disease and ulcerative colitis, as well as, having a healthier cholesterol level the rest of their life. To top it all off breastfed babies have higher IQs. So if feeding your baby exactly right after they are born has all this impact it only makes sense to me that feeding your baby well when they are inside you must also have an impact. Actually I believe it may have an even greater impact because of the magnitude of the creation process going on in utero. You are building your baby one teeny component at a time and the complexity of the finished project is miraculous. You are setting up their nervous system, their hormonal system, their brain and the chemical balance within it, as well as digestion, respiratory, circulatory and eveything else. We know that as an adult a healthy lifestyle through diet, exercise and low stress impacts all of the interconnected body systems I just mentioned and greatly improves our chances of living a long productive life. How can it not have a profound impact on your baby in utero.

Part of me hesitated to post about this because I hate laying guilt on mothers. But another part of me said if this information could encourage just one pregnant woman to make some life changes that would impact her baby for life it was worth more maternal angst. Get healthy before you conceive. Or the minute you know you are pregnant start making choices that will benefit you both. If you need information or support in your quest for a healthy pregnancy contact me about joining my Healthy Beginnings class series.

To learn more about this issue: Nicholas Kristof's op ed piece in the New York Times.

Experience Watsu

There is nothing more earthbound than a heavily pregnant woman. Waking or sleeping, she feels more and more weighed down as she slowly plods through the last weeks of pregnancy; her belly swollen with baby and amniotic fluid.

Now imagine the same woman stepping into a pool of warm water and floating, weightless. Her eyes are closed as light and shadows play across her eyelids. Her ears are submerged, so only muffled sounds can be heard. She is cradled in the supportive arms of another, who gently rocks her to and fro to the rhythm of her own breathing. The baby floats submerged within her womb in the warm, dark amniotic water, gently cradled within the mother’s pelvic bones. They are one, together, weightless and free. Their energy flows freely and all tension about the impending birth drifts away. The mother-to-be achieves a deep level of peaceful relaxation, entering an altered state; bliss. This is a state through which the journey of natural birth is much more possible. Floating somewhere between dreaming and wakefulness the mother-to-be feels her body gently letting go, stretching, lengthening, opening and releasing.

This is water massage, a unique form of bodywork also known as water shiatsu or Watsu. Invented in 1980 by Harold Dull, it combines elements of massage, joint mobilization, shiatsu, muscle stretching and dance. Its therapeutic benefits are for everyone and can bring new life into long neglected muscles, joints and ligaments.

As a birth professional I have witnessed the amazing benefits specifically for pregnant women. They go beyond relieving the typical aches and pains of carrying a baby to term. Watsu combines the deep breathing of the Bradley method, the trance state of Hybnobirthing and the gentle stretching of prenatal yoga within the weightlessness of water. Requiring no intellectual effort on the mother’s part water massage frees both her body and mind to prepare to birth confidently. As a doula, I have held many women in my arms during labor, so I find Harold Dull’s goal particularly poignant; “a world where everybody holds and floats each other in their arms.”

To experience this amazing technique connect with kinesiotherapist Kay Heaton:
544-4280. kay@clubk-aquaticintegration.com

To see prenatal Watsu for yourself visit: http://www.youtube.com/watch?v=vpDrmfNz98k

A Cultural Perspective on Mothering

African Mother by Denise Cummings

Below is a beautiful piece on mothering from an African perspective. It is filled with wisdom. The author, a mother from Kenya, reminds American women that we need to slow our lives down when we have a baby and get back to the basics of mothering. How does this woman become so wise? By following the wisdom of her grandmother. Woman to woman; generation to generation women learn everything they need to know from each other. When we go off the path our babies are quick to tell us if we will only use our hearts to listen.

Why African Babies Don't Cry:An African Perspective

by Claire Niala
A mother, osteopath & writer based in Nairobi, Kenya

I was born and grew up in Kenya & Cote d'Ivoire. Then from the age of fifteen I lived in the UK. However, I always knew that I wanted to raise my children (whenever I had them) at home in Kenya. And yes, I assumed I was going to have them. I am a modern African woman with two university degrees and I am a fourth generation working woman - but when it comes to children, I am typically African. The assumption remains that you are not complete without them; children are a blessing it would be crazy to avoid. Actually the question does not even arise.
I started my pregnancy in the UK. The urge to deliver at home was so strong that I sold my practice, setup a new business and moved house / country within five months of finding out I was pregnant. I did what most expectant mothers in the UK do - I read voraciously: Our Babies, Ourselves, Unconditional Parenting, anything by the Searses - the list goes on. (My grandmother later commented that babies don't read books - and really all I needed to do was "read" my baby). Everything I read said that African babies cried less than European babies. I was intrigued as to why.

When I went home I observed. I looked out for mothers and babies and they were everywhere (though not very young African ones - those under six weeks were mainly at home). The first thing I noticed is that despite their ubiquitousness it is actually quite difficult to actually "see" a Kenyan baby. They are usually incredibly well wrapped up before being carried or strapped onto their mother (sometimes father).

Even older babies already strapped onto a back are then further protected from the elements by a large blanket. You would be lucky to catch a limb, never mind an eye or nose. It is almost a womb-like replication in the wrapping. The babies are literally cocooned from the stresses of the outside world into which they are entering.

My second observation was a cultural one. In the UK it was understood that babies cry - in Kenya it was quite the opposite. The understanding is that babies don't cry. If they do - something is horribly wrong and must be done to rectify it immediately. My English sister-in-law summarized it well. "People here" she said "really don't like babies crying, do they?"

It all made much more sense when I finally delivered and my grandmother came from the village to visit. As it happened - my baby did cry a fair amount, and exasperated and tired, I forgot everything I had ever read and sometimes joined in the crying too. Yet for my grandmother it was simple - nyonyo (breastfeed her!). It was her answer to every single peep.
There were times when it was a wet nappy, or the fact that I had put her down, or that she needed burping that was the problem, but mainly she just wanted to be at the breast - it didn't really matter whether she was feeding or just having a comfort moment. I was already wearing her most of the time and co-sleeping with her, so this was a natural extension to what we were doing.

I suddenly learned the not-so-difficult secret as to the joyful silence of African babies. It was a simple needs-met symbiosis that required a total suspension of ideas of "what should be happening" and an embracing of what was actually going on in that moment. The bottom line was that my baby fed a lot - far more than I had ever read about anywhere and at least five times as much as some of the stricter feeding schedules I had heard about.

At about four months, when a lot of urban mothers start to introduce solids as previous guidelines had recommended, my daughter returned to newborn style hourly breastfeeding. She needed hourly feeds and this was a total shock. Over the past four months the time between feeds had slowly started to increase. I had even started to treat the odd patient without my breasts leaking or my daughter's nanny interrupting the session to let me know my daughter needed a feed.

Most of the mothers in my mother and baby group had duly started to introduce baby rice (to stretch the feeds) and all the professionals involved in our children's lives - pediatricians, even doulas, said that this was OK. Mothers needed rest too, we had done amazingly to get to four months exclusive breastfeeding, and they said our babies would be fine. Something didn't ring true for me and even when I tried (half-heartedly) to mix some pawpaw (the traditional weaning food in Kenya) with expressed milk and offered it to my daughter - she was having none of it.

So I called my grandmother. She laughed and asked if I had been reading books again. She carefully explained how breastfeeding was anything but linear. "She'll tell you when she's ready for food - and her body will too." "What will I do until then?" I was eager to know. "You do what you did before, regular nyonyo". So my life slowed down to what felt like a standstill again. While many of my contemporaries marveled at how their children were sleeping longer now that they had introduced the baby rice, and were even venturing to other foods, I was waking hourly or every two hours with my daughter and telling patients that the return to work wasn't panning out quite as I had planned.

I soon found that quite unwittingly I was turning into an informal support service for other urban mothers. My phone number was doing the round and many times while I was feeding my baby I would hear myself uttering the words, "Yes, just keep feeding him/ her." "Yes, even if you have just fed them" "Yes, you might not even manage to get out of your pajamas today" "Yes, you still need to eat and drink like a horse" "No, now might not be the time to consider going back to work if you can afford not to". "It will get easier". I had to just trust this last one as it hadn't gotten easier for me - yet.

A week or so before my daughter turned five months we traveled to the UK for a wedding and for her to meet family and friends. Especially because I had very few other demands, I kept up her feeding schedule easily. Despite the disconcerted looks of many strangers as I fed my daughter in many varied public places (most designated breastfeeding rooms were in rest rooms which I just could not bring myself to use), we carried on.

At the wedding, the people whose table we sat at noted, "She is such an easy baby - though she does feed a lot". I kept my silence, then another lady commented, "Though I did read somewhere that African babies don't cry much." I could not help but laugh.

My grandmother's gentle wisdom:

• Offer the breast every single moment that your baby is upset - even if you have just fed her.
• Co-sleep. Many times you can feed your baby before they are fully awake, which will allow them to go back to sleep easier and get you more rest.
• Always take a flask of warm water with bed to you at night to keep you hydrated and the milk flowing.
• Make the feeding your priority (especially during growth spurts) and get everyone else around you to do as much as they can for you. There is very little that cannot wait.
• Read your baby, not the books. Breastfeeding is not linear - it goes up and down (and also in circles). You are the expert on your baby's needs.

Reading this reminded me of something that happened years ago when my son was just a few months old. I was already back to riding and training horses, as well as, teaching lessons. I would take him with me and teach as I carried him around in a Snuggly. I was determined to continue my professional horse life and be a mom, i.e. super woman you can do it all.

One day I was teaching a young girl at her home on the Mesa. Joe began to cry and nothing I did would make him stop. He didn't want to nurse. He didn't need his diaper changed. He didn't need a nap. So I ignored him, raised my voice above his cries and valiantly kept teaching.

After a while my young rider's mother came out of the house carrying a baby blanket. She was a vastly more experienced mother having had many children by then. She calmly said, "I think your baby doesn't like the wind" and began tucking the blanket over his head and stuffing it into the sides of the Snuggly sack creating a warm little cocoon. It was magic. His cries immediately stopped and he opened his eyes and calmly peered up at me. His face quite clearly said, "Thank goodness somebody came along who knows something about babies!" Along the way I learned so much from so many women more experienced in motherhood than I. I am forever in their debt.

Do you have a story of an experienced mom helping a young mom? I would love to post it. E-mail me at jjmstover@sbcglobal.net.

This article appeared on The Natural Child web site. A wonderful on line resource for new parents at: http://www.naturalchild.org/.

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.

A Quick Homebirth

Baby's First Latch
I love catching this precious moment on film. Welcome Desiree!
Born on 8/9/10

We never know how birth will go. At classes we try to prepare first time parents for the idea that things can go very quickly, the 50 yard dash babies, or very slowly, the marathon babies. Accepting whatever you are experiencing and going with the flow is the important thing. If a couple is having a fast birth the dads are often left one step behind because they were mentally preparing for a marathon. When the baby arrives they are astounded! It's done? The babies here? How can that be?

Desiree James was born at home one unassuming Monday morning. Daddy went off to work. I mentioned that I was feeling "A little uncomfortable". Two short hours later my water broke and I called him back. I laboured quickly. Like Superwoman, Jennifer arrived and gave us the leadership and support we needed. I was having surges so closely together that my partner was unsure of how to help me. Jennifer immediately helped us into a more suitable birthing position. She used her calming voice and loving hands to ease our labour and reassure our progress. What a magical day it was. We had our baby girl in our arms, and all in the comfort of our own home. Thank you Jennifer for your professional and loving care!


There is nothing sweeter than being able to tuck a mom, dad and baby into their own bed after the birth is done. Leaving the house cleaned up, food available and supportive family at the ready feels just right. I'm a believer in what Dorothy said, "There's no place like home. There's no place like home. There's no place like home."

The Challenges of Being in Labor While Being a Mommy

I love this humorous account of a local homebirth. The humor comes from her no nonsense down to earth truth telling about the challenges of laboring and mothering at the same time. This is one of the difficult parts of having another baby. Women don't get the luxury of stopping motherhood while pregnant, birthing or recovering. No matter how many times I tell my experienced moms to have things arranged so you can drop everything, including your older child/children and zoom to the hospital I always arrive there before them! And then there is the issue of assuming this birth will be like the last birth; right? Enjoy Kelly's story!

Our little Alubia (bean in Spanish) was born on Aug.27, 2010; weighing 6 lbs 14 oz and measuring only 18 ¾ inches. She’s soooo small, but so cute. She has a full head of black hair and adorable chubby cheeks. We have named her Maui (Maria Luisa) and sometimes manage to NOT call her Alubia. Thanks, Maui, for the name.

Her birth story is very different than I imagined it would be, but it is still perfect (well, mostly). It turns out this labor stuff is complicated and having had a child only makes it more complicated. Who knew? This is the way things are supposed to be with a second birth: 1) The mother should know when labor starts. 2) The mother should remain calm during labor, because after all, she’s done this before and should be able to relax and breathe correctly. 3) The first child is NOT supposed to randomly start vomiting once labor starts and need his daddy. 4) The mother should be able to handle labor just fine if the father is temporarily needed by the older child. You know, the !Kung women only have birth attendants with their first child. After that, they go into nature and give birth alone and walk back to the village. So what’s a few contractions with no hubby, right? Well, none of that worked out well for me. And, I’ve also found out that the fact that everybody says that second labors can progress rapidly once they actually begin actually has a bit of a negative spin. They can take forever to “actually begin” and you should probably simply store your birth personnel (midwives, doulas, babysitters) in the garage or office or something so that everyone is ready to go right when you need them.

So here’s how it started. Wednesday at noon, I went to put Xavi down for his nap, but just couldn’t. I had absolutely no way of keeping my eyes open. So I pulled out a comforter and pillow and lay down on the floor and tried to convince him to nap with me. No such luck. Under those circumstances, he wants to lay on top of you with you on your back and I just couldn’t do it while pregnant. Finally, I texted Eneko to come and put Xavi down for his nap. He did and then returned to work while I went and laid down. And then started vomiting and having very continuous Braxton Hicks contractions and feeling like I was going to die. So he returned home and worked from home, watching Xavi while I made friends with the toilet (like we haven’t spent enough time together during this pregnancy). I felt so icky and wretched, way worse than with any stomach flu I’ve ever had, but a little like I was in labor, but not for any real definable reason. Kristi came over to check me and said not yet and drink the following liquids and we all went to bed (not together, she went home, obviously). A little later that night, the vomiting and ickiness went away and real contractions began. So that happened for most of the night and by morning, I was sure the baby was coming that same day, on Thursday. So when Eneko woke up, I told him the good news and we started getting the house ready for the baby and then I went to lay down to rest between contractions. It was wonderful. I let Laura, our doula, know what was happening and that we would call her when we needed her. Meredith, our babysitter, was able to get her in-laws to come care for her son until when her husband got off work and she kept me company until Megan could come check me and tell me… ehhh, maybe it will turn into active labor, but maybe not today since it was in the early stages. Stay hydrated, well-fed, rested and probably tonight, after Xavi was in bed.

Discouraging, but Eneko, Xavi and I decided to do those final things before the baby arrived. We ate lunch, went to Trader Joe’s to get some stuff, got Alubia’s birthday for Xavi present from Whiz Kids (love that store!!!), went to Doc Burstein’s one last time to get ice cream (I imagine I will be dairy-free with this little girl too so gotta eat the good stuff while I can) and then came home to rest while California Pizza Chicken (according to Eneko) was delivered. All this time, I was having fairly regular contractions that were pretty strong and I was doing a good job of relaxing during them, visualizing progress and all that good stuff. And on Thursday night, NOTHING! No baby snuggling in bed with us when we woke up in the morning on Friday.

So after a contractiony breakfast, the decision was made to send Eneko to work. Who knows when this labor will start so we’re going to have to go on with our lives, just pausing to breathe every little bit. Xavi and I went to gymnastics and the contractions were pretty controllable while we were there and then we came home, prepared dinner and had our naps and our lunch (staying rested and well-fueled like advised). I was pretty miserable by now, but didn’t want to waste my last days of one to one attention with Xavi, so we went to Avila Valley Barn to feed the animals, ride on the tractor and get some "I-sheem." That tractor ride almost killed me. When we got home it was close to five, so we finished dinner and then sat on the sofa to read (Xavi is in the phase where he loves to have marathon reading sessions, having you read a book to him over and over and over and then choosing another and having you read that one over and over and over. Up til now this had been great for pregnancy because how often do you get to sit with a toddler???). By now, I’m moaning through the contractions and trying to read to Xavi. “A cow says Moo, A sheep says Baaa. Three singing pigs say AHHHHHHHHHHHHHHHHHH” and Xavi is getting upset and crying because that isn’t how the book goes and Eneko sends me a message saying he’ll be staying a little late to finish some stuff and I’m about to cry… But we survived that extra half-hour with no daddy and when he got home, he took Xavi on a bike ride and I got to have a few contractions without someone crying through them and flailing on my lap. Things seemed bearable once again. Eneko would be home all weekend and hopefully we would have a baby. Then during dinner, Eneko tells me about all the stuff happening in the office that weekend and I start freaking out. If he needs to work, he needs to work. Life can’t stop because I’m having contractions. But SERIOUSLY, it is sooooo hard caring for a toddler and having contractions. Should I call Sabrina to watch Xavi Saturday? But she needs to move and it’s her day off and she has her own family to take care of. And what if this goes on for days? weeks? It’s getting reaaalllly hard to relax during the contractions since it was getting really hard to relax period! And when you’re tense, they hurt so much more. And I was getting to my mental breaking point.

So my poor husband is trying to help and he offers to call one of the midwives to examine me and I say no, we have to wait until we are actually in labor. He offers to examine me and I say, no. Then I change my mind and decide that once Xavi is in bed, that would be a good idea and then I went to moan my way through the contractions in bed while he put Xavi to bed. By the time Xavi was asleep, I was so restless, moving from the ball, to walking, to laying on my side and just not feeling too great anywhere, knowing it was my fault, if I could just relax I wouldn’t have a hard time. So Eneko, around 8:30, checks and he says, “Not a 2 or a 5. A 3 or 4.” And I almost cried. Or maybe I did. Can’t remember. If it’s a 3, that means NOTHING. But if it’s a 4, then we’re in labor. But what if it’s a 3 and I stay like this for weeks???? He calls Kristi, against my advice, and reports his findings and asks for someone to come. And says he will set up the birth pool. I’m dead set against this, because, what if I’m not in labor? He wants to call Laura and Meredith too and I say no! And then beg for the pool because I can’t take it anymore and I need something to help. So he sets up the pool and it was like heaven getting into the warm water, but I still couldn’t relax because now we had an inflatable pool set up in the dining room in a house with a toddler and a cat (what could possibly go wrong there?) and what if this wasn’t even labor and if you can’t relax the contractions hurt and aren’t as effective which causes you to tense up more, which causes them to hurt more.

Poor Eneko is doing all of the last minute birth preparations for the house and wanting to call in reinforcements and I’m still saying no, not until we know for sure. Around 10, Megan and Edana arrive and begin unloading all the equipment for the birth and I am soooo frustrated because they might just have to pack all that stuff up and take it with them. I had thought one person would just come and do a quick exam. But, it turns out, surprise, it was labor. Finally Eneko gets to start calling help when Xavi wakes up. So Eneko is trying to call people and things aren’t working out. Meredith’s husband is working that night of all nights and Sabrina has to bring her little girl who is throwing up and he didn’t want that because it’s contagious. Turns out, I had understood that incorrectly. The reason Xavi kept waking was because HE was the one who was throwing up (probably what I had on Wednesday). So no babysitter. And I am freaking out again, because I really needed Eneko to help ME but it turns out it is hard to arrange for childcare via telephone while taking care of a vomiting child and massaging your wife’s back in the birthpool at the same time. Why isn’t there an app for that? Everything else seemed to happen in some kind of crazy blur. It seems like Laura, Meredith and Sabrina arrived about the same time, right when they were needed most and Eneko was able to focus on one thing, me, since Xavi was now in good hands :). Things were moving so fast at that time, or at least it seemed like it from my perspective. The contractions got crazy strong very suddenly and for two or three contractions it was really overwhelming and then we adjusted and the birth went on well. But certainly not gracefully. I was never really calm or centered or focused, even having to be reminded to breathe on way more than one occasion. I remember Xavi’s birth as being so peaceful but this one I think I will remember as more chaotic (entirely my own fault though). I think she was born just a little while later, totally covered in vernix, but adorable. And then we got those great moments you dream of in your pregnancy: time has stopped, you’re sitting in the pool, holding each other and your new baby, not feeling like pushing out the placenta, but knowing you will have to. And, yeah, after she was born, I was informed that it had indeed been labor :)

Anyhow, everything ended up perfect and everyone came through and then some, making our night exceptionally special. We got some amazing pictures, though all seem to have some kind of nudity, and it was great to see how my friends who had come to take care of Xavi ended up helping out with everything, as did our doula. It was so wonderful to birth our little Maui among friends.

Now I have a feeling that if we have any more kids, I will not be allowed to participate in any decisions about phone calls. So unfair! I only messed up one time. Like the one time (our first “date”) when the action movie we went to see ended up being a graphic (or pornographic depending on your definition) movie about gay bank robbers. And now I’m not allowed to choose movies for us to go see anymore. People should really get more chances in life.

A Woman’s Guide to VBAC

Wow!!! Great new site full of just the right info for women considering trying to go for a vaginal birth after a cesarean! Thanks to Megan Bochum, a local student midwife and member of our local ICAN, for posting this link on facebook.

A Woman’s Guide to VBAC

Weighing the Pros and Cons of Planned Vaginal Birth after Cesarean and Repeat Cesarean Section

VBAC Success Rates and Prediction Models: Understanding Your Chances of Important Outcomes

Putting Uterine Rupture into Perspective

Are You an “Ideal” Candidate for VBAC? What Are Your Choices If Not?

The “Immediately Available” Standard: Where It Came from, What It Means, and How to Move Forward with New Evidence and Guidelines

What We Don’t Know: Critical Gaps in Evidence and How to Make Informed Choices In Spite of Them

Discussing Your Options with Your Care Provider

Legal Rights and Protections for VBAC: Issues from the NIH Consensus Conference

Take Action!

If Your Baby's Breech

I have had several couples over the years who were planning natural births only to be told at the end of their pregnancy their baby was breech. This is a very upsetting situation. First the medical establishment doesn't give the parents much options or hope. Second they don't seem to understand why the mother is upset; surgical births are second nature to them. For them it is no big deal. For the moms it is a very big deal. They feel boxed in, frightened of a cesarean, frightened of a vaginal birth, the clock is ticking, they scramble about to educate themselves on ways to get the baby to turn, and they begin the grieving process for their dream birth before the birth has even begun. All of my moms have tried hard to get their babies to turn. So far none of them has been successful. I feel some of this is due to how late in the game they were told about the situation. Some have toyed with going ahead with a vaginal birth and what that would entail; finding a care provider in or out of the hospital willing and qualified to assist the mother, dealing with everyone else's opinions on the subject and facing down their fears. Some were completely demoralized by their cesarean experiences others were not. No matter what you decide here are some things you should know.

All of my moms seemed to intuitively know something wasn't right about what they were feeling in their uterus before anyone confirmed their suspicions. They would say, "this just doesn't feel like a butt to me" or "if this is his bottom why am I getting kicked way over here?" Most of these were first time moms but they just knew. If you think this might be your situation ask for an ultrasound to verify position earlier rather than later. Don't rely on the doctors skill in "feeling" baby positioning because they can be wrong. Don't let your doctor talk you into putting this off until 37 weeks. The best time to start natural turning methods is 35 to 36 weeks. The bigger your baby, the tighter the space, the more difficult she will be to turn!

There are many alternative things to try: acupuncture, homeopathy, slant board, Watsu massage, prenatal massage, chiropractic adjustment, headstands or somersaults in a pool, frozen peas on your belly, and more. Use this link to learn more: One Midwife's Collection of Breech Turning Techniques

If the natural methods don't work you can try an external version where your care provider tries to manipulate the baby into turning by pushing on your abdomen. If this is done by a doctor they will want you in the hospital. They will have an i.v. in place so they will be ready to do an immediate c-section if the process causes the baby fetal distress which can't be resolved any other way. This is one of the reasons they will try to put you off and tell you not to worry until 37 weeks. They have nothing else to offer you and they want the baby to be considered "term" in case it needs to come by emergency c-section. I have watched this done a few times now. For some moms it is quite uncomfortable and for others only mildly uncomfortable. I have to say the doctors all spent quite a bit of time and really tried hard to get the babies to turn. Here is a link to view a version.

If none of these methods turn your baby you will need to say to yourself, "now what?"

Consider going for a vaginal birth anyway. Some of you may think I am being reckless, too "radical", in even suggesting such a thing. But guess what? In Canada, that bastion of radical thinking the Society of Obstetricians and Gynecologists new guidelines say to NOT automatically go for the cesarean with a breech. Here is a study from Canada on which they are basing this new approach. For them the "wisdom" of doing a c-section depends upon what type of breech position the baby is in. Study.

Do your own research! Read the chapter on breech birth in The Thinking Woman's Guide to a Better Birth by Henci Goer. Then go more in depth with Breech Birth by Benna Waites. Watch this video of a breech homebirth: Aurora's beautiful and inspiring frank breech home birth. 

If you are going to go for a vaginal delivery of a breech baby who will be your care provider? Ask your doctor or midwife. Ask them if they know any doctors or midwives in your area who do breeches. It is very hard to find any doctor willing or skilled anymore in breech deliveries because with all breeches being automatic surgeries non of them have had much practice at it. This of course compounds their distrust of a vaginal delivery because they don't have the skill. Talk to the homebirth midwives in your area. Are any of them skilled in breeches? Will any of them do a planned breech baby at home? Ask yourself if you are comfortable with the idea of having a baby at home?

If you find a care provider and a place you will need to prepare yourself and anyone else who will be at your birth with positive images and stories of vaginal breech births. You can find this in the book, Breech Birth-Woman Wise by Maggie Banks. Find a copy of Birth Reborn, the movie, through your birth educator or a midwife. This video has some intense footage of a breech birth which made me hold my breath with fear the first time I watched it because it was so foreign to me. You and your partner need to get beyond that feeling.

So what do you do if you can't find a care provider willing to "let" you birth your baby vaginally? Well you can be really radical and just show up at the hospital in labor and then refuse to go to the operating room. Once they have informed you of the risk you are taking you have the legal right to refuse consent to any procedure. This is not an option I am advocating because for labor to go well the mother needs a peaceful and relaxing environment. This sounds far from peaceful to me. My point is you have this option; it is your right. Some women have chosen this path; it has been done before.

If you are still thinking you want to have a cesarean birth the next decision is whether or not to let labor spontaneously happen or to simply choose a day, book the O.R. and schedule your baby's birthday. Here are some things to think about. We know that labor is physiologically good for babies and for mothers. It stimulates the babies breathing, pumps the baby full of hormones that spring the brain into activity, and prepares the baby for life outside the womb and for bonding. The down side to this approach is not having control of the cesarean itself. If you schedule it you can have a meeting with the head nurse of your hospital's labor and delivery unit and make special requests. The number one thing to ask for is to have mom, dad and baby together continuously. In other words the baby and dad stay with mom in the O.R. throughout her repair and go with her into recovery. At most hospitals this is not the standard procedure. It may require special staffing or shuffling of staff at your hospital. It is much more likely to happen when it is arranged ahead of time. You can also arrange to have a lactation consultant be there to help with latching the baby on in the recovery room or perhaps even in the O.R. Of course your doctor may be concerned about "allowing" you to go into labor at all because your water could break. They have concern about "letting" the water break because of possible cord emergencies with a breech presentation. Again this comes down to presentation. If your baby is presenting their butt firmly down into your pelvis and not a foot or feet than common sense tells us the risk of cord prolapse is about the same as for a head. If not than you need to consider that about 30% of the time a woman's water breaks before any signs of labor and the risk of cord prolapse with a foot presentation is considerably higher.

If you are scheduling a cesarean consider asking your doctor to try to do the external version one more time after you have an epidural. Sometimes with the mother unable to feel anything her muscles will relax enough for a version to be successful. If you are successful you would have to decide to go forward with an immediate induction or risk having the baby slip back into breech position.

So much to do. So much to learn. So much to think about. So many decisions to make. So little time and so little energy for any of it those last few weeks of pregnancy. This is why it feels so overwhelming. Of course the easy choice is to simply abdicate your authority and responsibility for your birth to your doctor and say yes to a cesarean without any further thought. Unfortunately abdicating your responsibility isn't what motherhood is all about. Whatever you decide make it your choice because you will have to live with this birth for the rest of your life. Your heart will heal better if you take the time, think it through and take up the role of mother. Parenting starts now!

Read one of my birth class client's breech birth story.

The Pendulum Swings

Can you feel it? The pendulum is beginning to swing the other way again. Last February I witnessed a doctor emotionally manipulating a woman, who was courageously working on pushing her baby out, into agreeing to a cesarean. I didn't know then that in that hospital room we were standing at the apogee of the pendulum's arc.

Apogee (Merriam Webster) Definition: 1. Farthest point on an orbit 2. final climactic stage, standing at the culmination

I only knew that in the past few years it had become a greater and greater struggle to keep my hospital doula clients out of the operating room. I didn't know that this was the final climatic stage in a hailstorm of surgeries.

Here is a simple physics lesson:
When a pendulum reaches it's apogee it holds its maximum potential energy. This energy is released as it begins to swing back the other way.

Can you feel it? In the past few months there has been a huge release of energy on a national and international scale against cesarean sections. On Tuesday I opened our local paper and saw more evidence of this phenomena; an article reprinted from the Los Angeles Times titled Study Finds Patience May Lower C-section Rates. That's right patience, not patients.

Here is a simple vocabulary lesson:
**Patient as a noun.
(Merriam Webster) Definition: 1.an individual awaiting or under medical care and treatment 2. one that is acted upon
**Patient as an adjective
(Merriam Webster) Definition: Patient 1.manifesting forbearance under provocation or strain 2. not hasty or impetuous 3. steadfast despite opposition, difficulty or adversity
**Patience is a singular noun
(Merriam Webster) Definition: the fact of being patient

Here is what this latest study done by the Eunice Kennedy Shriver National Institute of Child Health and Human Development said:

If doctors and their patients (women under their medical care) would have patience (forbearance under the strain of waiting out those last difficult weeks of pregnancy) and not go with an induction they have a much greater chance of not having a surgical birth. Of course for the woman remaining patient (steadfast) to the idea of waiting for spontaneous labor in spite of her doctors threats of placental disintegration, baby too large or blood pressure rising (opposition) can be a daunting (a great strain). In my experience getting a mom through these last prenatal visits is very difficult but well worth the effort. My own doula statistics bear this out with a 1% section rate for my first time moms who wait for labor to begin on its own.

If doctors would be patient (not hasty or impetuous) about the progress of their patients (women who they are acting upon) labors there could be many fewer c-sections. The authors of the study say doctors aren't acknowledging that labor takes time and doesn't follow a predictable pattern, especially in first time mothers. A high proportion of the surgical births reviewed were done after the patient (one who is acted upon) had been in active labor for only 2 to 3 hours! OMG!!! These women are being labeled as suffering from "failure to progress" which leaves them feeling defective the rest of their lives which leaves them much more open to being manipulated into repeat elective cesareans for all future babies. Most of the women I attend at births are in active labor for waaaaaaayyyy longer than that. I guide them, support them and explain that this is normal, babies take time and they are doing just fine. My cesarean rate even for mom's who agreed to an induction; 1%. The study showed that a major reason for having a cesarean was having had a cesarean. But my total cesarean rate with spontaneous labor, inductions and v-bac attempts is only 7%. There is no great mystery here. I am no wonder woman. Doulas and midwives support women whom they do not see as patients but instaed as healthy people in the process of a healthy physiologic act; like breathing or sex. Doulas and midwives having an abundance of patience is the key to good, safe, healthy births.

One final thought: Years ago I met the women who were spearheading our local International Cesarean Awareness Network at the time. One of them said, "There is no such thing as a 'failure to progress' only a 'failure to wait'. I have been calling it that ever since and now we are beginning to have the studies to prove who failed and what that failure has meant to women in america.

Can you feel it?

National Institute of Health panel strongly urges that steps be taken to reverse repeat cesarean sections.

Study in Journal of Obstetrics and Gynecology says v-bac is a reasonable and safe choice because the outcomes for repeat elective surgery and v-bac were basically the same.

New Guidelines from American College of Obstetricians and Gynecologists on repeat sections.

Study Finds Patience May Lower C-section Rates.