Mother-Baby Dyad: Snuggle to Heal, Grow & Thrive

27 Jul

We’re on the home stretch in our “11 Ways to Prepare for Your Best Birth” series and only have 2 left!

#10 Keep mother and baby together, with lots of skin-to-skin – it’s best for mother, baby, and breastfeeding

To clarify the title of today’s post: Think of the mother and baby as one unit in the first 3 months of baby’s life; we call it the “mother-baby dyad”. They need almost all the same things in the postpartum period — lots of snuggling, nourishment, rest, support, love.

I previously wrote a blog post on this topic after attending an all-day class with renowned perinatal neuroscientist and neonatologist Nils Bergman, so will refer you to it here: Snuggle with Your Baby: Benefits of Skin-to-Skin. The focus of that post was mostly about the benefits to the baby of skin-to-skin (aka “kangaroo care”).

I want to also detail a few benefits of this closeness for the mom (or non-postpartum/breastfeeding parent or family member, for select bullets):

  • Helps parent to bond and connect with baby
  • Helps parent get to know and understand their unique baby and baby’s more subtle signs in an acute and helpful way
  • The closer baby can stay to breastfeeding mom, the more restful it is and therefore the more conducive to healing from giving birth
  • Thanks to oxytocin (the “love” hormone) produced by skin-to-skin and, in even greater amounts, through breastfeeding helps mom feel happier and more relaxed, thereby reducing the chance of suffering from postpartum depression
  • The oxytocin is also helping your uterus heal, helping shrink your uterus (called “involution”) toward its pre-pregnant size each time you feed your baby in the first few weeks
  • The more mom can hold your baby skin-to-skin, the more frequently baby will tend to breastfeed, which bodes well for a healthy milk supply

I want to acknowledge that there are instances in which mom is not available to hold baby skin-to-skin, and absolutely it’s still helpful from a physiological perspective for dad, partner, or another family member or friend to hold baby skin-to-skin. So boost those endorphins and have fun snuggling away on your sweet baby!

More reading

Snuggle with Your Baby: Benefits of Skin-to-Skin (Birth Matters NYC)
7 Reasons To Be Skin-To-Skin With Your Baby After Birth
Skin-To-Skin Care After Birth: A Practical Guide (Mommypotamus)
Birthful podcast: Ep. 56, SylviaHouston, Skin-to-Skin
Video: Dr. Nils Bergman on Skin to Skin
Giving Birth with Confidence (Lamaze) – The Wonder of Mothers: Skin-to-Skin Care
Video: Keep Your Baby with You After Birth
Birthful podcast: Ep. 56, SylviaHouston, Skin-to-Skin



Push it, Girl, Push It Real Good: 2nd Stage of Labor

20 Jul

Okay, so I totally just revealed that I was product of the 80s and cheese out on that era of music (she says, referring to the post title’s nod to the 1987 Salt n Pepa song)! We’re up to #9 on our 11 Ways to Prepare for Your Best Birth series:

#9 Avoid giving birth on your back, and follow your body’s urges to push

Today we’ll talk about the 2nd stage of labor, in which our uterus is pushing the baby down and out and we get to meet our sweet baby.

Avoid giving birth on your back

First: Avoid giving birth on your back (also known as “dorsal lithotomy”). I’ve never worked with nor heard of a laboring woman who, if left to follow her body’s instincts, would choose to lie down on her back. Isn’t it kind of bogus that we tell women in pregnancy to stay off their backs for so many weeks and then in labor we order them to get on their backs to push a baby out? A woman should be allowed to have full freedom of movement and choose whatever positions she finds most instinctive and least uncomfortable throughout her labor, including the pushing stage. This will virtually never mean lying on her back.

Here are a few reasons lithotomy (either flat on your back or semi-reclined) doesn’t feel right to a laboring woman at any point in labor—especially during pushing:

  • In labor, we often have discomfort in our backs, and lying on our back only increases that uncomfortable sensation
  • Lying on the back is the most closed position for the pelvis; our wise instincts lead us more often to sit, squat, or get on all fours — significantly more open positions for the pelvis.
  • The vast majority of us, at least in our adult lives, have never passed a bowel movement while lying on our backs in bed. A laboring woman often pushes with the contractions very effectively while upright or sitting on the toilet because that’s where she’s used to coordinating her abdominal muscles and releasing the pelvic floor ones. Then if a care provider comes in and disrupts that process by ordering her patient on the bed, suddenly when she’s out of the familiar territory she feels totally disoriented. This is normal and to be expected, so I’d say, “just say no!”

Actually, that’s a little late for the communication. I would recommend doing that if you must, but it would be better for you to have conversations with your care provider now, prenatally, about this point in labor and get a sense of how flexible your care provider is for the moments of baby’s head crowning and for baby’s birth. In a hospital setting, most OBs/midwives aren’t there with the laboring woman for the earlier stages of pushing until the baby is very close to crowning, at which time they’d come to stay with you until an hour or so after the baby’s birth. For the early stages of pushing, one or more nurses would be the continuous support, monitoring the descent of baby through the birth canal and getting your care provider when it’s time. So, in an unmedicated birth there’s usually a good deal of freedom of movement until the OB/midwife comes. This is assuming, of course, that you get a natural-friendly nurse (tip: request this if you’re hoping for an unmedicated birth upon arrival at the hospital in labor).

Follow your body’s urges to push

When a woman’s labor progresses to the degree that her cervix reaches 10 cm dilation (=openness of the cervix) and 100% effaced (no lip/edge of the cervix in the way of the baby’s head), which we also call “complete”, it signifies the end of Labor Stage 1 and entering Labor Stage 2 (Pushing).

For many unmedicated women, around the same time she’ll get an uncontrollable, overwhelmingly strong urge to bear down and push. This urge can be hugely helpful for women, particularly when it’s our first time to experience labor. It takes the insecure feeling of, “how in the world do I do this?” out of the equation entirely because the urge is SO strong and helpful.

It’s equally normal for other unmedicated women’s urge to take a while to be triggered. If you find yourself in this latter camp, here are my tips for you:

  1. If hospital staff are pressuring you to push immediately, ask if there’s any reason you can’t wait to actively push until the urge is triggered. (In the mean time, your uterus will continue to do lots of that work for you.) That is, there’s no rush to start actively pushing just because you are “complete”—contrary to what hospital staff might make you think due to their being stuck in their ways of regular all-too-impatient protocols.
  2. Change positions. Often the simple act of changing position can trigger the urge. (It’s a good general rule of thumb in labor, in fact: When in doubt, change positions to encourage progress.)

In a hospital setting, the nurses are accustomed to the majority of women getting the epidural and therefore not feeling this natural, instinctive urge to push. Therefore, they are trained to default to a highly coached, loud method of the “valsalva maneuver”, aka “purple pushing” because women are encouraged to bear down vigorously and hold their breaths for unnaturally long periods of time. With this method, nurses loudly and slowly count to 10 while yelling, “harder, harder!…that’s good!…go, go, go!” and often scold the laboring woman if she lets her breath go before they reach 10. For most women, this coached method will really only be needed if a) we’re rushing things and not waiting for the natural urge to push comes (as is standard in most hospital settings), or b) a woman has the epidural and most likely won’t feel the urge and therefore may welcome some guidance (particularly if it’s her first time to give birth). It is far from the most likely non-breath-holding method you’d use with the physiologically organic urge to push and tends to lead to greater likelihood of fetal distress due to oxygen deprivation.

I would add that, in the 2014 ACOG report on things hospitals can do to reduce the unnecessarily high cesarean rate in the U.S., they ask hospitals, “Why are you putting women on a deadline in this stage of labor?” — that is, most hospitals have set a fairly arbitrary time limit on the 2nd/pushing stage of labor. Usually it’s a generous 3-4 hours, but there’s really no reason to move to a c-section solely because “time’s up” if a mom and baby are doing fine and are up for pushing longer. With this, keep in mind here that studies have revealed that hospitals take 15-17 years to adopt new recommendations, no matter how evidence-based, wise, or urgent they are to incorporate.

Here is the BEST article I’ve ever read on the topic of instinctive pushing.

If you’ve given birth before, or if you are a birth professional, I invite you to chime in with your experiences and insights! What worked for you? What didn’t work?

Further reading

2014 ACOG report summary (Choices in Childbirth; full report link found on this page as well)
Second Stage of Labor: You Don’t Have to Push by Nancy Tatje-Broussard
Supporting Women’s Instinctive Pushing Behaviour During Birth (Midwife Thinking)
The Anterior Cervical Lip: How to Ruin a Perfectly Good Birth (Midwife Thinking)

Patience is key: On Spontaneous Labor & Avoiding Unnecessary Induction

10 Jul

Did you think I forgot to finish the “11 Ways to Prepare for Your Best Birth” series? I promise I didn’t! I just went on vacation and decided to take a pause and post some birth stories written by my students so I could truly vacation. Now I’m back from Lake George and feeling refreshed.

So, let’s finish these last few points on the list over the next few weeks!

#8 Allow labor to begin on its own & avoid interventions that are not medically necessary

I admit, the first part of this one is hard. It’s so incredibly common to have a sense of wanting the pregnancy to be over and meet your baby already—largely because baby is getting uncomfortably cozy in there as he grows and is kicking you in the ribs, making it hard to get enough rest and the like. It’s quite common for one of these things to happen around or soon after passing the (estimated) due date:

  • A pregnant woman requests induction
  • A care provider simply says, “it’s time” (insinuating there’s a need to synthetically initiate labor, even in the absence of an evidence-based reason to induce).
  • Or, a care provider uses the words “getting big” in referring to the baby’s size—which undoubtedly instills a good deal of fear in any woman who ever hears this!

Not good reasons to induce, my friend.

I encourage you to resist the temptation to request or agree to an induction (solely based on dates or size) as you approach or pass your due date.

Here’s why. Did you know that baby initiates labor when she is done “cooking”, so to speak? There is a protein that is sent out from baby’s lungs when they are finished developing and ready to breathe the ex-uterine air (throughout the pregnancy, baby gets her oxygen through the umbilical cord). This triggers an inflammatory response in the pregnant parent that triggers labor. Additionally, March of Dimes says babies aren’t fully developed until at least 39 weeks, and also points out that important in-utero brain development happens between 35-40 weeks. Therefore, in the absence of any unusual medical indication to start labor, it seems logical and optimal to wait for baby to trigger labor rather than getting unnecessarily involved in ways that could put baby at risk.

Keep in mind a couple of other things:

  • The estimated due date is just that—an estimate. There is a 5-week window (37 weeks-42+ weeks) that falls within the (large) range of normal for baby being ready to be born. Dating is often inaccurate, unless you know exactly when you conceived.
  • Even if you have the accurate date of conception, also remember that both baby and mom are organic, unique beings who weren’t created according to nor behave in line strictly with textbook-rigid timing. Therefore, everyone’s optimal timing is different.
  • We live in a litigious environment, so care providers will often intervene (induction + many other interventions) because that is their best defense in the event of lawsuit from a bad outcome. There’s also just an unfortunate general sense of impatience in a clinical/hospital setting. It is therefore up to us to move through the perinatal period as informed consumers so as to know the difference between this scenario and legitimately wise uses of interventions.

So, the bottom line in a healthy pregnancy is: it’s best to wait for baby to initiate labor.

A bit more on the “avoid interventions that are not medically necessary”. Your best strategic tools along these lines are:

  • Labor at home as long as possible
  • Buying yourself time as many times as needed if/when interventions are suggested (assuming the suggestions are not emergencies; and never assume an urgent tone in your care provider’s voice equals emergency as it rarely does. Probe, ask questions!). In case you could use some clarity on what your rights are in childbirth, check out the Rights of Childbearing Women from Childbirth Connection.
  • Take birth classes in order to learn about the good vs. questionable reasons for the many interventions as well as the current state of your local birth environment and facilities. This way, you’ll know the questions to ask and how to make informed decisions

A little bit of patience goes a long way. You can then use that time, while waiting for baby, to study up or simply rest and enjoy the quiet in your last few pre-newborn weeks and days.

Further Reading

March of Dimes


Ned’s Birth Story

3 Jul

Another birth story for you today, this one told from a dad’s perspective and with my students’ permission. This one is VERY new, hot off the birth presses!

Our first sign that something was up was a little “bloody show” on Sunday night. About an hour later, a little more came out (we were at a Tony viewing party). An hour after that, D felt like we needed to go home as she was leaking more. At this point we were unsure if it was just mucus or if it was some of the bag of waters.

We Uber’d home and about 15 minutes after arriving home (thank goodness not in the Uber!) her water broke, an obvious “gush”. Fortunately she had put a pad in (since she was leaking) and we were able to clearly see that the fluid was yellow/green, obviously a warning sign. Still no contractions at this point.

We called our doctor and she asked us to come to the hospital to be checked. We arrived about 1:30am and after being examined (2 cm dilated estimated at that time) they admitted us and started a pitocin drip.

Thanks to our Birth Matters class we felt pretty informed about everything going on and understood the concerns with meconium (which is also why we were glad to go right to the hospital rather than trying to start laboring at home).

Contractions started in the next couple of hours and by 10:30am they were strong enough that D asked for her epidural (which was part of the plan all along).

We had a couple of hours of respite with contractions around 5 min apart on average but the epidural helping the pain a lot. By 1:30pm we were 5 cm dilated and 90% effaced. The next couple of hours were pretty difficult as D was feeling a lot of pressure and pain even after a “top off” on the epidural. At 4pm we were just about to explore some additional pain management when our attending doctor examined D again and determined she was fully dilated and it was time to push. D had had the urge to push with her last contraction. I don’t think we ever consistently had contractions closer than 4-5 min apart.

Pushing was about an hour (?) though of course it felt like forever. Our doctor did an amazing job and apart from the drugs there were no interventions, and the baby had a vaginal birth. D had no tearing, which was a delightful and welcome surprise! She was a real trooper during the birth, especially considering she hadn’t slept at all the previous night. She really kicked into another gear during the pushing, when it didn’t seem like she had another gear left!

Baby Ned
Born June 13, 2016 at 5:27pm (38 weeks)
6 pounds 6 ounces




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!


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

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


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:

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