Archive | June, 2016

Rosemary’s Birth Story

26 Jun

Today I have for you another one of my students’ birth stories, for your reading pleasure — mostly unedited.


New mama Lizz writes:

I had acupuncture Wednesday afternoon, which my practitioner said would be “more aggressive” as we approached my date. Later that night, dropped a bit of my mucus plug but didn’t think too much of it since it can still be weeks. Having crazy Braxton Hicks though! Around 1:30 AM my back started aching in conjunction and I suspected labor was starting but wasn’t totally sure. Around 2:30 AM told John to start timing and we were already 3 mins apart. They were intense but I could talk through. Called my doula and had her head over. John was packing the last few hospital bag items (I had left a detailed checklist!) as things progressed to be pretty intense and around 2 mins apart. We wanted to avoid rush hour traffic so left right at 6:30 AM for NYU and got there without much delay (though I had to asks the chatty uber driver to stop talking – which I somehow managed to do nicely!).

lizz triageGot to NYU and they were full in triage and labor and delivery so they put is in a TINY consult room which it turns out is where I labored for the duration! (Unexpected to say the least – photo attached after they’d cleaned it up again)

I was 5cm upon arrival, and went back and forth to the shared triage bathroom to labor on the toilet (absolutely the best spot other than the birth ball!) but since it was shared had to leave anytime someone needed to use it. Yes, really. I was making A LOT of noise at that point too, so I am sure I was freaking everyone out but I wasn’t too concerned at the time 🙂

We had requested a nurse who was experienced with natural birth and got the amazing Gina, who worked with John and our doula (Abby) to setup the room to fit all 5 of us (me, John, Abby, Gina, and Dr. Min – who was much more present than I expected!) plus to give me some privacy and variation in position. We kept the lights off almost entirely, intermittent monitoring which wasn’t restrictive since the room was so small anyway. I had been GBS positive, but my water didn’t break until after 6cm so it wasn’t much of a factor (PROM was a big concern of mine going in). I clung to both John and Abby every wave, so there was literally no time or space to use a lot of the props, snacks or distractions we brought. I was able to stay with my breath only because of CONSTANT reminders from Abby and helpful physical presence and loving encouragement from both her and John. Trying not to fight the contractions was SO HARD. Especially since changing positions made everything SO MUCH more intense!!! Don’t think I realized that would happen. I had no sense of time and just took each contraction at a time. I felt that things were moving and that the pain had a purpose, though it was really effing painful.

After Gina had turned the chair in the room into as much of a bed as it could possibly be so I could lay and save some energy I just couldn’t hold back what John described as primal animal noises.

I heard Gina make a call that I was 9cm and very transitional and asking for status on L&D room. They were also prepping an OR for me to push in just in case since I couldn’t do it there (Dr. Min later told me that they literally couldn’t have done any type of intervention in the tiny room so it was actually a safe zone for some of my concerns ironically – and we all agreed later the intimacy was actually kind of special). I was definitely bearing down at that point which was around 2:00 PM, and they were thankfully able to wheel me in place on the makeshift chair bed to the L&D room which was SO BRIGHT with sunlight.

I couldn’t believe how big the room was but also kept my eyes closed almost entirely. They told us that the baby had passed meconium in utero so the pediatrician would have to take her upon arrival. I asked that they keep her in the room which they agreed to do unless there was a major issue.

When I hit 10cm the contractions were still intense but much different so it felt like time slowed down a bit. I asked what was going on. Abby told me that they suspected the baby was posterior and Dr. Min was checking on another patient while we tried a few things. What she did, which I believe was called “shaking the apples” or something was get me chest down on the bed, butt up in the air and then she literally shook my hips with her rebozo. It was the most insane and uncomfortable experience and I yelled the entire time. She was able to back the baby out from her -1 station, turn her somehow, and then when I sat straight up afterwards she went down to -2 and I was able to start pushing.

I tried pushing in a number of positions but was just so tired I did wind up on my side and back mostly. Dr. Min said I was also making the most progress that way and I just had to believe it and that this would be over soon!

I wanted to ask how long I’d been pushing because it felt like forever but I decided I didn’t want to know! Was trying to keep myself in it mentally because my body was just so tired.

It was still just the 5 of us in the room, and they were guiding me where to push. I was able to rest my legs on the bed bar between contractions because putting them down was impossible.

Though I told them I didn’t want to be coached or hold my breath, I could just hear in their voices that it was making the most progress of the options I had tried. John and Abby were holding my legs and head and I was pushing with all my might, just hoping to hear that we were crowning. I could hear excitement build in the room and when they told me to reach down and feel the top of her head I did. I didn’t have my glasses on so couldn’t see in the mirror and just needed to keep focused. Eventually, I felt the BURN, and Dr. Min helping to stretch and hold strategically. More people started coming into the room, and I know this was it. I was just so tired! Every push I was just thinking Rosie Rosie Rosie, and of my mom (Marianna) and Grandma Rose who she’s named after. John started giving me updates since he knew I couldn’t see. Her head was out! What he didn’t tell me (and I’m glad he didn’t) was that her hand was also coming out and the cord was around her neck.

More pushes and finally felt THE ONE and she was OUT!

I WAS SO RELIEVED!

They had to cut the cord right away because of her neck and to suction for meconium immediately. I saw a blurry blob off to the side and heard her cry, while I basically let go a string of expletives and just couldn’t believe it was over and that she was here and that all of his had happened! I wanted to see her but was actually ok to have a beat to process this all.

lizz and family.jpgThe delivery of placenta was definitely  uncomfortable but better once over. I was lucky to have 1 small first degree tear with a few stitches.

When they finally handed Rosemary to me, John and I just bawled. And couldn’t really talk. The room got very quiet as all the people left and we just settled in. Abby fed me applesauce.

My sister was in the waiting room so she came in to be with us too, and then left to get us FOOD! Ha. So then it was just us with Abby and Gina and we started to recount the details of the day, which was just amazing.

It was really the most incredible experience of our lives…

[Our Birth Matters classes] prepared us for so much of this, and enhanced our confidence going in. [The role of the birth educator] is so important. Thank you!

lizz family photo

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Birdie’s birth story

19 Jun

From time to time, I will share my client’s birth stories, with their permission and unedited (unless they request certain edits such as changing names). Here is the first, entirely unedited.

Birdie’s Birth Story, as told by mama Emilie – Friday, May 20, 2016

Birdie

I woke up at 7:15 AM this morning to a tightening in my belly. It wasn’t painful in any way—just a sensation that I hadn’t felt before. After a second tightening, I wondered if these were contractions. But as they didn’t hurt, I decided they must be the mythic Braxton-Hicks ones. I had wondered before how I would be able to tell the difference between a false alarm and the real thing, but everything I’d read and had been told by friends was that when the real ones happen, you know it. Just to be safe, though, Josh and I decided to work from home for the morning until we knew more. After an hour, the tightening had subsided entirely, so we headed into Manhattan.

Once at work, the tightening continued, and I started tracking the hits on an app. Though they didn’t subside again, they also didn’t follow any sort of pattern in terms of duration, frequency, or intensity. Dr. Moritz had told me that real contractions might vary in length, but I would notice a pattern of increasing frequency and intensity—neither of which was happening. So I attended a meeting and then my “surprise” pizza party baby shower before heading to the doctor’s for my weekly appointment at 2:30 PM. On the walk from the subway to the doctor’s office, a tightening struck that was strong enough to cause me to stop walking for a moment and think that maybe I should call these things what they were—contractions.

When I was taken by the nurse at 3:00 PM, I told her what I’d been feeling, and she didn’t seem too concerned but asked if I wanted Dr. Moritz to examine me. I said yes, so after a regular appointment with fetal monitoring and whatnot, Dr. Moritz chatted with us and then seemed ready to let us go until next week. Josh mentioned again what I’d been feeling, and the doctor shrugged it off but got what he needed for the examination. After praising me for having “the pelvis of a goddess” (?) and saying that based on that I should be able to pull off my hope of delivering without drugs, Dr. Moritz suddenly had very wide eyes. “Uh, what were you planning on doing after this appointment?” I replied, “Just going back to work.” Dr. Moritz: “Yeah, you’re not going to be doing that. Did you see the look of surprise on my face? You’re five centimeters dilated. I’m not sure you’re human—only an alien could have made it this far along and just be sitting here chatting with me and not in any pain. You’re having this baby either today or tomorrow.”

Josh and I were stunned. Dr. Moritz suggested we walk around the neighborhood for 30 minutes or so and see how I was feeling, hopefully causing my water to break in the process. He said that if my water broke we might want to head over to the hospital, or we could come back to the office for him to check me again. Otherwise, we would want to head home until the contractions picked up steam. I was concerned about depending upon the contractions, as they had been so inconsistent thus far—how would I know when the time was right?

Josh and I went for the walk, and the pain was definitely apparent now, and I would often have to stop walking when a “big one” hit. We got back to the office around 4:30 PM, and Dr. Moritz examined me again. Though my water still hadn’t broken, he said I was between 7 and 8 centimeters dilated and that he was moving up the timeline—I was having the baby tonight. If we went to the hospital then, they’d force my water to break, so again Dr. Moritz suggested we walk so that it could happen naturally. But if we headed home to Astoria, we’d just have to turn around and come right back—but we could try to go home if we wanted. Dr. Moritz said that if we went home, as soon as I felt the urge to “take a big shit,” we needed to leave right away. I asked, “But given how quickly things are happening, would we have enough time for a 40 minute car ride from Astoria back here?” Dr. Moritz: “If you were a normal woman, yes. But with you, I’m not so sure.”

Josh and I decided we wouldn’t be going home, so we walked over to New York Presbyterian Lower Manhattan and hung around the patio area outside for a while. Josh took a conference call for work and then suggested we hit up a Duane Reade for some toiletries, since our “go bag” was at home. We walked a block and I asked Josh how far away the store was; he said another four blocks. I said that I wasn’t going to make it that far, and I pointed out an independent drugstore across the street. We got a few necessities and then walked back outside. A big contraction hit, and I wrapped my arms around Josh and buried my head in his shoulder. Then, whoosh, my water broke at 6:00 PM.

We rushed back to the hospital and got directions to Labor & Delivery. When we got to the sixth floor, we got directions again. Finally, we thought we were in the right place. It was 6:10 PM. Josh: “We’re looking for Labor & Delivery?” The woman behind the desk just stared at us. Josh again: “Labor & Delivery?” The woman: “Yes.” Me: “I would like to deliver my baby, please.” She seemed surprised by this request and also bored by it—she started handing us forms to fill out. Josh was attempting to convey urgency, letting them know that my water just broke, but who cares when there are forms at hand! I was signing things with a signature that I’m sure wouldn’t have held up in a court of law—it looked nothing like my handwriting. Then the woman handed us a bizarre form about designating someone to take care of me. Josh: “What does that even mean?” The woman: “You know, someone who will help take care of you … or walk your dog.” Me: “That’s what my husband is for.” The woman: “Well, you could designate him if you want.” Me: “Why would I need to designate him? He’s my husband. His job is to take care of me.” The woman: “Well, you still need to fill out the form, either designating your husband or rejecting coverage.” I tried to comply, but when a contraction hit, I dropped to a squat, clutching the edge of the desk. Josh started filling out the form for me, but the woman informed him he had written in a box that he wasn’t allowed to write in, and she pulled out a clean form for him to start again. Josh: “Okay, then we decline. DECLINED.” The woman: “Well, she still needs to sign the form saying she rejects it.” FINE. One last illegible signature it was! The woman said she’d get us into Triage and that we should take a seat. I looked around; there were no seats. Me: “Where exactly?” The woman: “In the waiting room.”

We walked back to the waiting room, but after sitting for mere moments, me squirming in pain and clutching the arms of the chair, I turned to Josh: “You need to go make them understand that I am having this baby now. Explain to them how dilated I am. Make them understand.” Josh headed back through the doors—apparently “8 centimeters dilated an hour and a half ago” were the magic words. Now they were ready to skip Triage and take me right away.

First they sent us to a bathroom for me to change into a gown and socks. Josh was shoving my clothes in a bag, and when I took off my underpants I told him just to throw them away. He hesitated. He later told me it was because we had nothing with us, and he was worried about getting rid of my only underwear. I just wanted them gone, and when you’re dealing with a crazy person, it’s best just to indulge her, so Josh did. I was then worried about making a mess of the bathroom with the blood coming out of me all over the floor, and I started making an effort to clean it up. Josh was trying to get me to stop, but I was very focused on it, so he said he’d clean it up and started doing so (again, crazy person). They then knocked on the door to make sure everything was okay, and we stopped cleaning and followed them into a birthing room.

They had me get in bed and asked me about my birth intentions. I’d spoken to the head nurse the previous week, but of course that didn’t matter at all. I explained that I didn’t want any drugs, and I didn’t want an IV. They said I’d have to have an IV. I said that they could put the pic line in, but I didn’t want them hooking it up to anything unless medically necessary. They then hooked me up to the fetal monitor. My wish had been for intermittent fetal monitoring, but I knew enough that it wasn’t going to be long, so who cared? They reminded me that even though I was on a bed, I had the option of moving around the room if I wanted. I thought they were nuts; there was no way I was going to have time to walk around!

Midwife Anne then arrived to introduce herself and let me know that Dr. Jew was on his way, but as I was progressing so quickly, if he didn’t make it in time, she would deliver my baby for me. Anne then examined me and said I was nine-and-a-half centimeters dilated and we wouldn’t be waiting for Dr. Jew. She said that if I felt the urge to push I should. I said, “I feel the urge to shit, not push.” She said, “That’s the same thing. It’s time to start pushing.”

Anne reminded me how to breathe, and I said, “Yes, I know. I just can’t seem to remember how to do it right now.” She sweetly said, “That’s why we’re here to help remind you.” Anne explained to me how to push, and even though I understood exactly what she was saying, I couldn’t seem to get it quite right. I focused on some little box thing on the wall (maybe a thermostat?) and tried to breathe in through my nose for four counts and out through my mouth for six. Josh was by my side the whole time, but I couldn’t look at him because I was focused on the box thing. Josh told me afterwards that he loved how I was myself the whole time, recalling a moment when I glanced up at him and rolled my eyes at something. The television was also on, though it was muted, and I thought how strange that it was on at all. With each contraction, I would push and push with Anne’s guidance. She reminded me not to push with my face, which I recalled being a tip from Lisa at our birthing class—yet I kept pushing with my face!

I saw Anne and the nurse share a “look” at one point, which scared me. The nurse told me that when I pushed, the baby’s heart rate slowed, so they were going to give me oxygen to help. No problem—they placed an oxygen mask over my nose and mouth. Anne asked me if I wanted to feel the baby’s head—I think as incentive to get me to push correctly—but I said, “No, thank you.” Josh was brave enough to look, though, watching our daughter make her entry into the world.

Finally, I was able to push in the way I understood Anne was telling me to do, and at 7:15 PM, after 25 minutes of pushing, I felt our baby girl slide out of me—65 minutes after we arrived at the hospital, 75 minutes after my water broke, and exactly twelve hours after labor started that morning (though I only knew it was labor for the last four hours of it!).

I don’t remember if Birdie cried, but I felt so peaceful and content as they placed her on my chest for skin-to-skin time. She was beautiful and perfect, and I was so happy to see the person who I’d been carrying around for nine months. Everything felt just as it should be. I could feel the umbilical cord pulled from inside me up my body, which was an odd sensation. Though I didn’t realize it at the time, Josh told me that the cord was around the baby’s neck. He didn’t see Anne loop it off her, but she did of course. Anne commented that the cord was especially long, and I recalled asking about the length of umbilical cords in our birthing class. Why were they so long, if that length meant they often got caught around babies’ necks? But as I was lying there holding my baby, I thought maybe this was why. I’m tall, but most of my length is in my torso, so perhaps my body produces a longer umbilical cord to make this moment possible of having my baby with me.

They asked if I was okay receiving Pitocin to help with the bleeding. Now that Birdie was safely out of me, I was fine with it. After the cord stopped pulsing, Anne instructed Josh that it was time to cut it, which he did so with help from the nurse. Meanwhile Anne was focused on me delivering the placenta, which happened rather quickly, and though I felt it happen, it wasn’t painful. Anne showed me the placenta—it was bigger than I thought it would be, and I asked Anne if she would examine it to make sure all of it had come out. She said that it looked great and that it had come out cleanly.

Anne then examined me for tearing, and I needed just a few stitches. She put numbing gel (?) on me, but I still felt all three stitches go in. Somehow, the pain didn’t matter—perhaps because my amazing daughter was right there with me.

I asked about her Apgar, and she got a 9/9, which thrilled me. I then asked about her weight and length, and they said they’d have to take her away from me to tell me those things. The nurse carried her to an area that I could still see, and Josh went with Birdie, staying by her side. She was 7 pounds, 9 ounces and 20 inches long. After they cleaned her up a little bit, Josh got to snuggle with her, watching her watching him. After a little while longer, they said they had to take her to the nursery to clean her up for real and have the pediatrician look at her. I asked if Josh could go with her, please, and they said yes.

I missed Josh and Birdie while they were gone. There was a shift change, so a new nurse checked on me periodically and let me know when I should make my way to the bathroom to pee, which burned, but a urinary tract infection is much worse, so it wasn’t that bad. Twister was now on the muted TV, and I thought about how the first time I had jury duty, this was the movie that they had on in the waiting room. Why was it always Twister? The new nurse told me I should try to sleep. I wasn’t sleepy, though—just very, very happy. After some more time had passed—I don’t know how long—I was helped into a wheelchair and taken to a shared room. Wonderfully enough, I didn’t have to share the room that first night, so we had deluxe accommodations! Eventually, Birdie was wheeled back into the room in a plastic baby box atop a wooden cart and placed by the side of my bed. I was so happy to see her and Josh again.

3 Ways you Can Learn to Follow Your Body in Labor

12 Jun

Continuing our series on “11 Ways to Prepare for Your Best Birth”, we’re up to #7:

Listen to & trust your body – it will guide you

A lot of learning to trust this process has been covered in #5 here, so this post will be relatively brief.

Interesting thought to ponder from the childbirth classic Childbirth Without Fear: Veteran OB back in the early 20th century observed that, when women didn’t expect birth to be painful and perceived birth as a natural process to be trusted, their sensations were significantly less uncomfortable and more manageable. We cannot underestimate the power of the mind-body connection!

I want to reiterate the power of exposure to positive birth stories in this journey toward exploring your instincts and trusting the process. Ways to do this:

  • Read Ina May’s Guide to Childbirth  — about half of the book details many positive birth stories. When I was pregnant for the first time and took birth class, my birth teacher’s emphasis was, “Follow your instincts.” That all sounded great in theory, but when it’s the first time to go through the process, I was totally at a loss for having any clue of what those instincts might look like. This book
  • Watch lots of positive birth videos, many of which are natural births. I show some in class. Here are a few to get you started:
  • Check out a range of instinctive labor positions and instinctive coping tools and maybe even print them to have for reference for labor day — find these in various places:

Further reading:

Prepare your Mind & Body: Take a birth class

1 Jun

This week on our “11 Ways to Prepare for Your Best Birth”, we arrive at:

#6 Prepare your Mind & Body: Take a comprehensive childbirth education class that includes newborn care and breastfeeding

Why In-Person Classes? Why don’t I just read a book or take an online class?

In-person classes are ideal for many because you benefit from:

  1. Getting to know other expectant parents, which is immensely valuable as you enter parenthood. You need to find your “tribe” to develop your support network for a healthy and happy parenting journey!
  2. Learning about specifically relevant, local information on care providers and hospital protocols.
  3. The combination of various teaching methods such as lecture, video, powerpoint, posters, activities, discussions, and physical bodywork provides a more comprehensive, valuable learning experience than any video or book can ever provide.
  4. A conversational atmosphere. Class is a great launching pad for important conversations between you and your support partner(s) to process feelings, express concerns, ask each other questions. For those whose labor support is your committed spouse/life partner, this helps both to more intentionally strategize toward both a better birth and also to deepen and strengthen your relationship.
  5. Hearing others’ questions  in class—ones that might not have otherwise occurred to you or that provide deeper insights.
  6. Physical activities & bodywork. This is absolutely most helpful with a live teacher to instruct, adjust and advise on labor positions, massage & counterpressure techniques, and other tactile comfort measures for labor.

Why group over private?

There’s certainly no right or wrong here but here are considerations:

  1. #1 above, round 2. This benefit cannot be overemphasized. Unless you already have multiple friends who are in a similar life stage, I promise you that you NEED this. You need to have the support, community, opportunity to compare notes, sharing the woes and joys along the way that will lead to a healthier you and more thriving new family unit.
  2. With group classes, you’re getting a MUCH more comprehensive education for a significantly lower per-hour cost.

I acknowledge that, particularly where I live in NYC, people lead busy lives, and sometimes the group class schedule just doesn’t work. Private is certainly the next best thing. It can also be a good option for certain very specific situations, such as someone who has given birth before and just wants a refresher or has other reasons that the group setting wouldn’t be quite the right fit.

But the Cost! Babies are so expensive. Isn’t class expendable?

A once-in-a-lifetime, sacred experience such a birth requires a good deal of preparation, and is worth the investment. It goes a long way for reducing fears and helping equip expectant parents with tools and strategies they need. I want to reiterate that a good birth class will also foster deep conversations and interactions between expectant parent couples, which will not only help them have a more optimal, healthier labor and birth, but also can enrich and strengthen their relationship—books or online classes cannot do this. Priceless!

Also, I think you’ll find that your perspective of the cost will change dramatically once you have a toddler and start paying for various classes for them. In hindsight we can realize what a good deal most birth classes are! In NYC, for example, a really affordable price for kids’ classes breaks down to about $20/hr. When I break down my birth classes to a per person/per hour cost, my classes cost way less than that, and are significantly cheaper than the hourly cost of most NYC babysitters. It’s a steal when you consider it from these perspectives.

Why Comprehensive?

I recommend seeking out a class series that is not only going to equip you with information on and strategies for a healthy labor and birth, but also will equip you with newborn care skills, breastfeeding and postpartum self-care knowledge. I recommend this series be a minimum of 12-15 hours. Ideally you want to have the class to be spread out among 3-6 weeks and 6 classes, although 2- to 3-day intensives are very popular for many who have busy schedules. Intensives are not as ideal because so much information is packed into a small amount of time, and you don’t get to know your classmates as well, either, both because most intensives are less conversational and are fewer days and break times together.

A common question I get is: Do childbirth classes include infant CPR? CPR classes are an a la carte, separate class in almost all cases (ie in NYC I don’t know of any childbirth educators who incorporate CPR training into their series). I do highly recommend that expectant parents take a separate CPR class. Some popular options in NYC are:

Options & Methods

Here are some of the most popular certifications, methods or class types (first one is local to NYC):

Not considered comprehensive childbirth ed, so please do not consider these substitutes, but could be nicely complementary and supplemental:

  • Dancing for Birth
  • Some prenatal yoga teachers may offer some one-off childbirth specific classes such as breathing techniques or bodywork for labor that can be valuable

I caution expectant parents to steer away from any teaching that would teach or even insinuate that a completely natural, drug-free birth is the only way to go. What this all too often does is to set up parents for guilt and sometimes even trauma when the organic process of birth, which is unknowable and uncontrollable to a large degree, doesn’t go exactly according to “plan”. Better to choose a balanced class that acknowledges that, even if labor/birth doesn’t go as planned, it can still be a positive and beautiful experience when we plan for it with strong intention and purpose.

Size Matters

Look for a class that is small (or small-ish). An ideal class size is around 5-7 couples; definitely no more than 16 people in a class in order to get individualized attention and to foster connecting with each other and developing your parenting “tribe”.

How to Find

  • Ask your friends! If you don’t have any friend who’ve given birth, maybe you have friends who have friends who have recommendations.
  • Yelp – read reviews
  • Google Search
  • Websites below or above for specific methods; some have a by-location search/finder

More Reading

American Pregnancy – Childbirth Education Classes: Types & Benefits
Bradley Method
Childbirth and Postpartum Professional Association (CAPPA)
Childbirth Education Association of Metropolitan New York
Choices in Childbirth on Childbirth Education
Dancing for Birth
Hypnobirthing
Hypnobirthing Video
International Childbirth Education Association (ICEA)
Lamaze International
WebMD: Types of Childbirth Classes

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