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Photo Credit: Etsy VivaDoula shop
One of my wonderful doula clients wrote this endearing poem. He gave me permission to share. So, without further ado, and for your reading pleasure…
Like a Mother: an Ode to Placenta
by Duncan, new father of Kiyotaka, Jan 2013
Oh Lady Placenta!
What a life you lived in magenta.
From progesterone to waste recycling,
Your service was superb and unrelenting.
Day and night without a rest,
For nine months you gave him your best.
Yet from placenta previa to GD,
You shouldered the blame for his malady.
“Oh! Oh! Oh!”
Your baby’s rockin’ and roll.
Forty some weeks of hard work,
All but for this one big hurt.
Push, breathe, hum and push,
His show ended with a yelp and a whoosh!
Ten minutes later you quietly slipped out,
Trying not to take away what it was all about.
Like an orderly sneaking out of backstage,
Your life concluded its last page.
Yet those in gloves inspected your corpse,
Scrutinize, so not to miss any odds.
But they’ll never find what’s actually missing,
For what’s missing, is a gentle “thanks-for-giving!”
But you of all knew that his every chuckle and every cry,
Shall be the result of your labor long after you die.
Fret not, mama. For after you’re gone,
Your baby still knows you like when he was born.
Because you, unsung hero, and his heart,
‘til his last breath shall never be apart.
Today I’m linking to another student’s great birth story. My favorite quote: I once read a quote that said “childbirth is the one shot you get at assisting God in a miracle” and I couldn’t agree more.
And, drumroll please…after taking a few weeks of vacation and sharing birth stories, we’re finally up to the last point in our “11 Ways to Prepare for Your Best Birth” series.
#11 Arm yourself with support and resources for postpartum (postpartum doula, lactation consultant, moms’ groups, etc.)
What are the resources you might need as you become a good parent? Smart idea to consider these things now. What follows is not an exhaustive list, but can start helping you to think through the possibilities.
First, rally any and all willing family and/or friends! This is the best time in your life to accept help if it’s being offered, or reach out and be proactive in asking if necessary. The biggest helps in early parenting are a) meals and b) housework. These are things you just don’t have time or energy for in the first few weeks. There are several great and free meal train websites (look here, here and here), so see if you have a friend, family member, or if someone at your church/temple/other religious community who can coordinate meals for the first few days or weeks after baby’s birth. (After my husband and I received the enormous blessing of meals upon both of our babies’ births, I “got” the power of it so much that I volunteered to be our church’s meals ministry coordinator.)
While breastfeeding is certainly natural and can feel instinctive, it’s also a learned skill. Any learned skill takes time and usually requires some working out of kinks. Therefore, it’s wise to have a few names of and contact info for lactation consultants on hand in the event you could benefit from the expert support. There are multiple kinds of certifications; the main ones in my geographic area are: International Board Certified Lactation Consultant (IBCLC) and Certified Lactation Counselor (CLC). According to the International Lactation Consultant Association, an IBCLC is, “a healthcare professional who specializes in the clinical management of breastfeeding.” An IBCLC is considered a clinical caregiver vs. CLC more an educator. Because of this distinction, you will see more of a possibility of getting insurance to cover/reimburse for an IBCLC than for a CLC.
Postpartum Support & Counseling
Sometimes a new parent doesn’t feel like oneself on the other side of birth. If the not-quite-rightness lasts beyond 2-3 weeks after the birth, it’s very important to reach out for help. Help is readily available and no one should suffer in silence!
The different routes a parent could go for this kind of support:
- Parent groups (generalized, or even better to seek out one specifically tailored to postpartum depression / perinatal mood & anxiety disorders)
- Therapist / counselor (who can refer to psychiatrist if appropriate)
A postpartum doula is a wonderful consideration, particularly for families who might not have family or friends who can support them through this major life transition. They are different from a baby nurse in that they are all about supporting the postpartum parent’s healing and helping the new parent(s) gain any tools, strategies, and skills they need to become more confident in parenting—as opposed to coming in and simply taking care of the baby. They are usually priced in a different way from a birth doula (who usually is a flat rate for her package) in that parents pay by the hour, often with a front-end minimum.
The most critical times to consider buffering with extra support: 1) the 1st couple of weeks after birth; 2) if/when one partner or helper leaves one parent home alone with baby for long stretches anytime in the first 3 months; 3) ~2 months after birth, when many babies’ amount that they cry every day peaks.
Helpful to equip yourself with plenty of local resources, but it’s also good to have some online/broader resources at the ready as well. Try to gather these resources before you give birth as you won’t have as much energy or time in postpartum to do research. There are several places you can gather these kinds of resources:
- Talk to local parents. Word of mouth is the best way to find stellar local parents groups as well as postpartum professionals. If you don’t know any parents, you can connect with them by attending your local La Leche League meeting, searching on Facebook by your town, visiting churches, temples, community centers, or libraries. One awesome midwifery group I know in NYC creates moms’ cohorts based on due time and neighborhood — how awesome is that?
- When you look for a birth class and/or doula, seek out a well-connected professional with a solid resource list available for clients. Often those professionals will have a resources page on their website plus a more expansive private resource list to support her clients
- Seek out local family-oriented retail or educational establishments (this is could be in the form of a baby wearing or breastfeeding boutique, a retail or consignment baby/maternity shop, etc.). These venues, and sometimes your local library, often have personal connections, a resource list, or a community bulletin board with local postpartum professionals’ business cards.
Sometimes our birth and/or healing doesn’t go as we expect. Occasionally we might have some physical issues to work out such as abdominal separation or pelvic floor muscle issues. In the event that this is a felt need for you on the other side, there are available resources such as pelvic floor specialists as well as other more general physical therapists who could work on abdominal issues. I would encourage seeking out a PT or other body worker who specializes in the perinatal phase of life.
A few of my favorite online resources:
Perinatal / Postpartum Counseling & Support
- Postpartum Support International, 800.944.4663 – find local support groups
- The Postpartum Stress Center – info on how to talk with care provider, spouse, etc.
- Postpartum Progress – peer-to-peer blog with 1st person stories
A few of my favorite NYC local resources:
- NY Lactation Consultant Association (find a local board-certified lactation consultant (IBCLC))
- La Leche League of NY
Postpartum Support & Counseling
- Postpartum Resource Center of New York, Inc. – Helpline: 855.631.0001
- Seleni Institute (Upper East Side) – Support Groups & Counseling
- Mommy Groove Therapy & Support, Olivia Bergeron, LCSW – In-home and in-office Prenatal & Postpartum Counseling
- Ellen Chuse Childbirth – Prenatal & Postpartum Counseling, New Moms’ Group, Home birth Classes (Park Slope)
- Babywearing International of NYC – Babywearing Meetups
- DiaperKind – cloth diaper service
- First Due CPR – CPR/AED/First Aid training (adults, children and infants)
- NYC Parent Groups (via Park Slope Parents) – a large listing of online groups, listed by borough
- NYC Dads Group
- MOMally, Andrea Scannell, Parenting Coach, New Moms Groups (Astoria)
- A Mother is Born, Meredith Lichtenberg, CCE, IBCLC, JD – New Moms Groups, Parenting Classes, Childbirth Education Classes (Manhattan)
- The Functional Pelvis, Lindsey Vestal – In-home Pelvic Floor Therapy
- Renew Physical Therapy, Isa Herrera (Manhattan)
- New Dimensions Physical Therapy, Lila Abbate (Manhasset, Long Island)
Today I have another student story for your reading pleasure!
I was due with my little one on July 29. At my 40 week check up, my OB informed me that – sigh – I was only about 2cm dilated and not effaced. She wanted to chat options and I asked her to do a membrane sweep. She doesn’t ‘love’ membrane sweeps because they can cause infection (her words) but she did a gentle one and also stretched out my cervix. That was Wednesday.
(It should be noted, I was very over being pregnant after the two-weeks of an intense heat wave. I was miserable, unable to move and just ready to meet my baby.)
My OB and I decided we would schedule an induction for the following Wednesday, week 41. She would be out of town for week 42 if baby hadn’t arrived by then, so she would be there to deliver the baby. Also, she agreed to keep it low intervention as much as possible, to still allow me to have a natural birth.
On Wednesday night I noticed some baby movements and more frequent contractions, but nothing to cause alarm. My discharge was still the same. My best friend Cody was in town and came to visit, and we ate spicy Thai Food and relaxed. I had no idea what was to come in 24 hours.
Thursday morning I woke up bright and early and noticed that my mucus plug was starting to come out – hoorah! I woke up my husband in excitement and since it was finally a cool morning, we walked the length of Astoria Park
– I don’t remember what I was feeling physically, but mentally I knew I was coming to the finish line. I let my doula, Annie, know about the changes and her and my husband agreed they would both go to work that day and if I needed them, I would reach out.
Thursday afternoon I had a massage with my friend Anthony from The Giving Tree and by this time was having more contractions and much more discharge. (Annie said it was fine to get a massage at this point). I let him know I was starting to labor (I’ll never forget his face, he looked so shocked!), and asked he hit all major induction pressure points.
By Thursday night, during Hillary’s speech at the DNC, my contractions officially began. They were intense, frequent and the real deal. I had them all during the night, starting at every 12 minutes around 1am at one point, around 3am, they were 4 minutes apart, lasting about a minute. When I was active, they were frequent – but when I rested, they were tame – so would be about 9 minutes apart. I labored all during the night and had Brian sleep, so he would be ready for what was to come.
I stayed in bed and found that going on all fours or puppy pose was the best way to breathe through the contractions. After each contraction, I would have to go to the bathroom where liquid would just come out of me – I didn’t have to push or anything, it just naturally came out. I wasn’t sure if my water had broken or what – especially since i wasn’t sure what “water breaking” felt like.
Around 5am my contractions were much more intense so we called Annie, she advised us to relax since although intense, they were not frequent enough at this point and not consistent. She eventually came over around 9am and helped me through some more contractions, but we sent her home an hour or so later since the consistency wasn’t there. Again, she told me to relax and when I did, contractions were happening every 10-11 minutes.
We left a message late morning for my OB giving her an update, mainly wanting to let her know that when I was active, contractions were happening frequently, and when I was resting, they were every 10 minutes. Again, we also weren’t sure if my water broke since I still had a leak of fluid after each one.
Around 2pm or so, we heard from my OB who called just as my contractions were moving from every 6 minutes to every 5. I had just had a tough one that left me in tears and spoke to her as a new one was coming. She told us to get to the hospital immediately because she could hear the intensity in my voice.
We let Annie know and made it to Mt. Sinai West about an hour later. The car ride wasn’t as awful as I was expecting it to be. Because of my yoga background, I was able to go inward with the pain and Annie was able to time contractions based on my breathing.
We arrived at Mt. Sinai at 2:30 and had to wait in triage until 4:30 just for vitals. Everything was feeling a bit more intense, and I was more anxious at this point. At 6:30p I was finally taken in for a monitor read + cervical check. I was about 3cm dilated and the OB on call on the Triage floor wanted to send me home, but noticed my fluid was low, likely because of all the leaking. She called into the OB on call for my doctor, who wanted to admit me – hooray! There were talks about a possible induction, but by this point everything was getting pretty intense and I was just relieved that my pregnancy was at the finish line. This was the only time I slept – I probably slept about 20-30 minutes with the HR monitor on me.
Unfortunately, we came at a pretty busy night and had to wait in triage until 11p, which is when we were assigned a bed in L+D (Labor and Delivery). This was the worst of it – I was laboring up and down the hallway, in too much pain to eat and just wanted a bed. I was very self conscious to be laboring the way I was in the waiting room since there were other families there, so walking was the route we took. When we finally got into L+D, I felt like it was finally real.
I was super impressed with the L+D rooms at the hospital as well – each bathroom had a decent sized shower and small jacuzzi tub. The room was large, a comfy recliner for Brian and a chair for Annie. We had the option to dim the lights and I just felt very much at home. It wasn’t hospital-esque as I was imagining. We met our nurse who was a bit intense, but I can’t complain too much about her.
11:45 came around and I met one of the OB’s on call – I was 4-4.5 dilated, 90% effaced and [baby was at] -2 station. This was an improvement since I was in triage, but I knew I still had a ways to go. The OB offered to stretch out my cervix and I happily obliged.
There was a concern with the baby’s tracings, so I was stuck on a heart rate monitor the whole time, which wasn’t my preference. Also, because my fluid was low, I was also on an IV. This also was not what I wanted, and to make it worse, I had to lay on my side to get a better read of the HR for the little babe. I tried to not let this get me down, despite the fact that I desperately wanted to walk around and take advantage of the jacuzzi, but I knew this was best for the baby. (I had taken a bath at home when I was having contractions and it felt so nice, so I was bummed to miss another option at a bath).
Around 1am my water broke! What an intense feeling – I felt a pop in my body and started freaking out, not knowing what it was, until I felt the rush of fluid coming out of me. Annie called our nurse and she came in, and I also met the OB who would deliver my baby, Dr. Jason Kanos – he was amazing and I instantly knew that despite I was hooked up to these machines, I would have the labor I wanted to have. He had a dry sense of humor and was straight to the point, which is something I took for in a doctor. At this time, I was about 6cm dilated, 100% effaced & -1 station. Hooray – some improvement!
He asked about pain management and I told him I only wanted an epidural if it was medically recommended (ie: if I was getting tired) or if I needed it. He offered me narcotics and nitrous oxide (laughing gas), which is new not just to NYC, but the US. Annie and I were so excited to have this option, so we took it!
As soon as he left and the nurses were setting up the Nitrous (it took them over 30 minutes to set this up since they had never used it before…) I threw up. This made Annie super excited, but this was the LAST thing I wanted/needed! Fun fact: Annie rinsed out my basin and put some peppermint essential oil in it, so when I threw up again, it was a much calmer experience – even the nurse took note of this tip!
After I threw up, I felt the baby dropping and knew I entered into transition – this was about 2:20am. The nitrous was finally ready and I must say, it didn’t do much for transition contractions! You have to hold the mask to your face, breathe it in as you’re getting a contraction and then breathe it out. It just felt like another hassle and thing I had to do, while trying to handle the intense contractions as well. I only felt “buzzed” once and that was early on in transition. Looking back at it now, it felt like it was just a distraction more so than pain management.
I also began to feel lots of intense pressure around this time as well – it felt like I had to poop and I had an urge to poop, but everyone was telling me not to push and that I didn’t have to poop, which was getting frustrating. I demanded a cervical check at this point, because I was convinced I was going to poop out this baby. At 2:50am I was about 6-7cm dilated and still in this -1 station! Dang!
I had 40 minutes of intense transition contractions – lots of yelling and trying to get on my back since being on my side really intensified it. I was still using nitrous at this point, but again, it was a pain and having someone hold the mask over my face was annoying. I just wanted to yell and push and remember saying “I don’t even know what noises I’m making or where they are coming from!”
I still had to poop and the nurse finally took me off all the machines around 330a to let me go to the bathroom to “poop”. Of course, nothing happened, but Annie told me to stay there for as long as I needed, since it helped quiet me down. Once I got into bed, I was allowed to lay on my back – finally. This was around 3:30am.
Once I got back into bed, I wanted to push and my body felt like it was just pushing itself. We didn’t have a nurse in the room and Annie urged me to not push (since we didn’t know how dilated I was) and I was beginning to lose hope. The contractions were so intense, I was on zero pain management and started to say “I can’t do this anymore” “I can’t!” which Annie + Brian knew were two things I didn’t want to be saying. Everything seemed to happen really fast this hour, but also felt like it took forever. A new nurse came in (mine was on break which is why I had gone an hour with no nurse) and by 4:30am Dr. Kanos arrived and said “You want to push? Let’s push!” He did a check and said everything was fine and scrubbed up.
I began pushing at 4:40am – Brian said it was about 4 pushes and at 5am Emma Sue was born! 8lb 4oz.
Since we didn’t know the gender, Dr. Kanos let Brian announce the gender, and he also cut the cord. I had a small second degree tear, so did need stitches, which hurt. (Don’t believe the books when they tell you that having a baby on your chest will distract you from stitches!). I also bruised my tailbone, which we realized the following day, which was a concern of my OB (who thought I would actually break it), because of how the baby was positioned in my body.
…& that’s it! 30 hours of laboring, very much worth it and seriously makes me feel like I can do ANYTHING in life!
Today I’m posting another birth class student’s happy birth story. Enjoy!
We have some happy news to report – Ryan was born last Sunday, August 28th, at 4:01pm. He weighed in at 6 lbs 14 oz and was 21.75″ long! I started feeling “Braxton Hicks contractions” at 9am Saturday, remarked to myself about their consistent timing (8-1-1) and went about my day shopping for nursing clothes and going to prenatal yoga.
After yoga my contractions started becoming painful and were happening more frequently but still I was convinced this was “false labor”. I set up multiple stations (shower, yoga mat in bedroom, bed) for managing the painful contractions. Tom was away at a bachelor party in Southampton and I deliberated whether to call him back home but after another hour realized regardless of what “this” was I was not going through an overnight of it without Tom.
When he arrived home four hours later he timed my contractions at 3-1-1, got the midwives on the phone, had them listen to one of my contractions and was promptly told to come in; he called the doula and let her know that we were passed the laboring at home phase and going to the hospital and she agreed to meet us there.
After 15 hours of laboring at home we arrived at the hospital; I was informed that while I was 80% effaced I was only 2 cm dilated and baby was in -3 position; only because of my currently high blood pressure was I admitted. It was another grueling 16 hours before baby was born and there were a series of fortunate events leading to us having the best possible team (highly experienced midwife happened to be on-call, L&D (ie Labor & Delivery) nurse was doula trained and studying to become a midwife, my mom was allowed in despite the two-person support limit).
In the end I was successful in having the natural birth I envisioned despite baby’s posterior position and extended time with baby’s head pressing significantly on my pelvis in the -3/-2 position. He came out looking like an Incan god (MAJOR cone head) and was treated “under the lights” for 42 hours due to jaundice caused by blood differences (I’m O+). We learned A LOT from the nurses in the nursery so were ultimately happy to have lost the privilege of “rooming in” that we had initially desired.
In the maternity suite there were a series of UNfortunate events that led to mass miscommunication between caregivers (pediatricians, nurses, midwives, doctors, etc.) and stress about when and if we would be discharged together. On Tuesday night we were both sent home, despite Ryan not getting the circumcision planned, with plans for follow-up blood work with our pediatrician for jaundice monitoring. We are exhausted but not overwhelmed and are happy that we had the opportunity to “study up” to advocate for ourselves and Ryan throughout our natural hospital birth.
Note about photos: This particular hospital’s protocol was for partner and doula to wear a mask for the pushing stage. This is not standard in most hospital settings in NYC at the time of posting.
I have energy and feel so elated his was the exact birth I wanted! I’m on a fetal monitor but all is well. I scream a little about how much it hurts, but she’s out! She comes out crying and we have immediate skin-to-skin and breastfeeding. More painful is the after birth stuff. Doc says I’m bleeding a lot and trying to get the placenta and everything out is not fun. They hook me up to oxytocin (aka pitocin) and I remember just questioning everything being so informed from class. (Lisa’s note: read more on active management of this 3rd stage of labor, which is standard in NYC hospitals)
Note: This is posted, as always, with permission from new mom Alyssa, with minimal edits.