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Pre-Order The BIRTH WITHOUT FEAR Book Today!!!

Pre-Order The BIRTH WITHOUT FEAR Book Today!!!

In her first book, Birth Without Fear: The Judgement-Free Guide to Taking Charge of Your Pregnancy, Birth, and Postpartum (Hachette Books; March 5 2019), January Harshe, mom of six and founder of the Birth Without Fear website, delivers an inclusive, non-judgmental, and empowering guide to pregnancy, birth, and postpartum life.

Each chapter provides you with the all the necessary information, options, and tools to help you take charge of the experience of welcoming your child into the world.

Unlike other pregnancy, birth, and postpartum books, Birth Without Fear will also help partners understand what mothers are going through, as well as discuss the challenges that they, too, will face—and how they can navigate them.

Shattering long-held myths and beliefs surrounding pregnancy, birth, and the postpartum experience, Birth Without Fear is an accessible, reassuring, and ultimately inspiring guide to taking charge of your pregnancy, birth, and beyond.

The Birth Without Fear movement began as a voice for change in the standard of care in today’s birthing world, and Birth Without Fear will empower YOU to be a voice for change in your own pregnancy, birth, and postpartum. Options, support, and respect should be the norm for every pregnant and birthing woman, and it can be if YOU, the Birth Without Fear community, vote for that change by pre-ordering your copy of Birth Without Fear today!

Pre-Order Now!

January Harshe knows firsthand how widely birth experiences can range. She has run the gamut from an affirming and joyful planned cesarean to a traumatic emergency cesarean, as well as a VBA2C (vaginal birth after two cesareans) in the hospital, and two home births. One of these home births was such a dramatic departure from the confusion, uncertainty, and fear of her other births that a beautiful idea was born — she would make it her life’s mission to promote a revolutionary birth and parenting message: you can have a birth without fear, no matter how you birth.

January is the founder of the Birth Without Fear community, as well as Take Back Postpartum, Don’t Forget Dads, and Mothering Without Fear under the Birth Without Fear tent—all of which today collectively represent a social media following of over 1 million and counting.

Within each chapter of Birth Without Fear is a Partner Point of View written by Brandon Harshe. Having been by January’s side for six pregnancies, births, and postpartum experiences, Brandon has learned a lot about what it takes to support the woman he loves through the biggest changes and experiences of her life. In Birth Without Fear, he’s shared some of that knowledge to help husbands and partners be the steadfast support person that all birthing people need and deserve!

Members of the Birth Without Fear community on social media are familiar with the conversation shifting regularly to postpartum, and Birth Without Fear is no different. The focus of so many pregnancy and birth books is on, well, pregnancy and birth. But what about after the birth? You have the entire rest of your life to live, only now with a new baby!

This is where Birth Without Fear comes in. With chapters on breastfeeding, self love, self care, mental health, and sex and intimacy, no stone is left unturned for those of you wondering “what next?” after the baby has arrived.

When January Harshe created the Birth Without Fear community in 2010, she wanted options, support, and respect to be the standard of care for every pregnancy, every birth, and every postpartum experience. Individually, we all have a voice. As a united community, we can affect real change in the conversation about pregnancy, birth, and postpartum in our culture. Pre-ordering Birth Without Fear is a vote for real change. Order your copy today!

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PPD, PTSD and Antenatal Depression: Nutrition and Research…What Helps?

PPD, PTSD and Antenatal Depression: Nutrition and Research…What Helps?

Postpartum depression, antenatal depression, and post-traumatic stress disorder related to birth are multi-faceted, complicated illnesses that can be caused by a number of different things.  While some experts propose that these things have physical causes, others report psychological factors as the main cause.  And others, like myself (although I would not consider myself an expert), believe it could be a little of each.

Either way, all of us agree that the effects of these conditions are detrimental and should be prevented as much as possible. One research team noted that postpartum depression “is a serious mental health problem for women” and that “it’s consequences have serious implications for the welfare of the family and the development of the child.” (O’Hara and Swain,1996, p. 37)

In another report:

“Postpartum depression has a long term effect on mental health since it may increase the risk of continuing or recurrent depression. Postpartum depression has also been associated with adverse effects on early infant development, especially among socially disadvantaged children. Serious consequences for the child include increased risk of accidents, sudden infant death syndrome, and an overall higher frequency of hospital admissions.”

PPD has far-reaching effects on not just a woman but her entire family and society in general.  And even worse, 1 to 2 of every 1000 women experience postpartum psychosis.  (Stanton & Gallant, 1995; Noncas & Cohen, 1998)

While numbers differ, most studies indicate the number of PPD cases is between 8 and 15%.  However, a study by researchers Stanton & Gallant showed at least 26% of moms experience at least mild depression.

The percentage of women experiencing postpartum depression can differ dramatically by country as well.  That is why studies show rates of postnatal depression that are much larger and much smaller.  Either way, we know this is sadly a growing trend.

Because no one knows a woman’s body as well as she knows it herself, I think it is best to present as much of the scientific evidence available on this topic to women and let them pinpoint, prevent, and even possibly reverse the triggers that led to their own experiences with postpartum depression.

Consequently, the following information is a collection of strictly unbiased scientific studies and their outcomes.  I encourage every mom to consider each one and how it might help her and her family’s health during pregnancy, birth, and beyond, as well as other women in her community.

Essential Fatty Acid Deficiency

According to one study, women with low DHA levels are 6 times more likely to suffer from postpartum depression.  “Study results quantified women with lower omega-3 PUFA levels as being six times more likely to be depressed antenatally, compared to women who had higher omega-3 PUFA levels.”

As a nutrition counselor, I often see the effects of essential fatty acid deficiencies.  Most common is a deficiency of omega 3 fatty acids related to the improper ratio of omega 6 to omega 3 in our food supply, which is what the study above showed.  For instance, vegetable oils (corn, canola, soybean, etc.) are very high in omega 6 and low in omega 3’s, leading to a deficiency of omega 3’s.  At least 70% of our food supply contains one or more of these types of oils.

Sixty percent of our brain is made up of fats.  When a growing baby in utero does not obtain the necessary fats from mother’s diet for proper brain development, the necessary fats will come out of mother’s stores in the brain.  This is a common cause of not only PPD but also postpartum “brain fog” and children with ADHD.

EFA deficiency does not have to wait until delivery to affect a mother in the form of depression or brain fog, sometimes resulting in antenatal depression as well.

To correct/prevent this, vegetable oils (and foods containing them) should be eliminated as much as possible and exchanged for healthy oils such olive oil and coconut oil.  Foods that are also high in these essential fatty acids are fish, walnuts, flaxseed, and chia seeds.  I recommend that pregnant women take a cod liver oil supplement for good brain health in both mom and baby.

Thyroid Health

Women with thyroid dysfunction had a higher incidence of depression.”

In this study, researchers found that the more severe the mother’s thyroid dysfunction, the more severe her postpartum depression was.  Like PPD, postpartum thyroiditis is a growing health concern and one that I often encounter in my profession.  Symptoms include low breastmilk production, extreme fatigue (more than from having a newborn baby!), and depression.

Pregnancy can have a taxing effect on a woman’s thryoid, the butterfly-shaped gland in the neck.  Coincidentally, so do things in our food and water supply.  Soy/soybean oil and fluoride in drinking water are two of the most damaging to our thyroid health.  Avoiding foods with soy/soybean oil in them and drinking non-fluoridated water, as well as eating 1-2 Brazil nuts/day for selenium (which has a protective effect on the thyroid), will go a long way in helping support a woman’s thyroid during pregnancy.

Labor & Delivery Circumstances

One particular study found that cesarean delivery increased the rate of postpartum depression or postpartum PTSD:

“A significantly higher incidence of postnatal depression was found among subjects who had undergone Caesarean section than in those who had a vaginal delivery. The excess of cases of postnatal depression among the Caesarean subjects appeared to consist of a milder illness which started sooner after delivery. Following Caesarean section, there was a significant association between postnatal depression and general, but not regional, anaesthesia.”

Alternately, a study by Missouri Western State University found that while women having home births and/or who were attended to by a midwife, the location and type (cesarean or vaginal) was not so much the factor leading to postpartum depression as was the amount of control and satisfaction a woman felt she had with her baby’s birth.  Overall, they found that the more support a woman had during labor and postpartum, as well as the more control she had over her own labor and delivery, the less likely she was to suffer from postpartum depression.

Bottle-Feeding

“According to a new theory being proposed by University of Albany evolutionary psychologist Gordon Gallup and his colleagues, the decision to bottle-feed is tantamount, in the mother’s psyche, to mourning the loss of the child. At least, that’s how a woman’s body seems to respond to the absence of a suckling infant at its breasts in the wake of a successful childbirth.”

The authors of this study believe that “the absence or early cessation of breastfeeding would have been occasioned by miscarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother’s decision to bottle feed unknowingly simulates child loss.”

Of course, not all women are able to breastfeed.  For those that are, this is good reason to avoid bottle-feeding strictly for ease.  For those that choose to bottle-feed or need to bottle-feed based on certain circumstances, we can still reap the benefits of frequent skin-to-skin contact with baby to increase psychological health of both mom and baby.

Lack of Postpartum Community Care

Traditional cultures took (and continue to take) a very different approach towards a woman’s postpartum period.  In a report from 1983, researchers Stern and Kruckman found that postpartum depression was virtually non-existent in traditional cultures.  These cultures had many practices to value new mothers and their babies by the way they took care of them and encouraged a period of rest and pampering.  While these cultures differed in the way they valued the postpartum period, they all shared five protective social structures.  They can be seen here (http://www.breastfeeding.com/helpme/cultures.html) and include a distinct postpartum period that is set aside and treated differently than any other time of life, social seclusion and mandated rest, and functional assistance.

In contrast, mothers in industrialized countries are encouraged to be as productive as possible and to entertain guests who come to see the baby.  There is an inherent expectation for mothers in America to get back to life as normal as quickly as possible.  Mother-focused support is extremely limited in industrialized countries and, according to Stern and Kruckman, is a main cause of postpartum depression.

Additional Factors

A very large study of  Scandanavian women and postpartum depression discovered additional factors leading to PPD:

-Psychological distress in late pregnancy
-Perceived social isolation during pregnancy
-Positive history of prepregnant psychiatric disease (either by family members or the mother herself)

This study shows the importance of avoiding any unnecessary stressful situations whenever possible during pregnancy.  It also confirms that women with either a family history or personal history of depression.  Correcting any underlying imbalances and/or nutritional deficiencies related to depression either before or during pregnancy will benefit both the mother and baby.

(For more information on some of the possible causes of depression and some natural remedies, go to Healthy Families for God’s article here.)

Postpartum and/or antenatal depression, as well as PTSD related to childbirth, are definitely complicated illnesses.  Hopefully, with this information, moms will be able to experience more of the joy and excitement of bringing a new life into this world!  To support women in your community, share this article with them.  Together, we can work to create a more supportive postpartum period for mothers the way traditional cultures have done for centuries!

Sara Jo Poff is a personal nutrition counselor, wellness educator, and the founder of Healthy Families for God.  Her mission is to help people overcome health traps and the food habits that cause them in order to live an abundant, joyful life living out their God-given purpose.  Sara Jo also started Circle of Elephants, an effort to protect pregnant women from medical injustice in America.  But before these pursuits, her priority is as a wife, a homeschooling, cloth-diapering, extended breastfeeding, Jesus-seeking mom to five children, ages 2 to 16.  For more information, check her out at http://healthyfamiliesforgod.com/.

*Photography by Katsoulis Photography. He also has an extensive 200 page guide on the subject of Pregnancy Photography that has just been published for the iPad that can be found here.

 


Birth Of Elsie {Homebirth Story With Siblings}

Birth Of Elsie {Homebirth Story With Siblings}

We were just waiting for the Braxton Hicks contractions to turn into the real deal so we could get our daughter here.  Sunday morning was spent with the church family and then the afternoon was spent with Greg’s family celebrating his mom’s 55th birthday.

I was feeling pretty good and honestly didn’t feel like I’d see my daughter anytime in the next few days.  I was nervous that when it was finally time that Greg would be late getting home and I’d labor alone, that the midwife would barely get there in time, and that everything would happen so fast, I wouldn’t hardly remember the experience!  Needless to say, that was not what occurred.

Greg decided to go ahead and get the pool set up and ready. That way if I did start my labor before he got home, I could easily start filling the pool up on my own.  We all nestled into bed pretty early and I was sleeping pretty sound until 1:43 AM.

I was awakened by an uncomfortable contraction and spent the next hour and a half pacing about trying to be sure if I was really in pain before I bothered waking up Greg.  I got out a journal and start writing down times and lengths of contractions, and finally decided about 3:30 to wake him up and call in the midwife and my parents.

Everyone arrived about five that morning. Danette and Caroline, her sweet apprentice, began monitoring Elsie’s heartbeat and my blood pressure.  My BP was slightly raised, so after a homeopathic dose of calcium and magnesium, I returned to my left side to relax through some more contractions.  That all worked, as my blood pressure lowered, and the more relaxed I stayed, the more intense the contractions were.

My mom got to work fixing some biscuits and gravy from scratch, and my husband quickly decided we needed to do this more often if it meant eating my mom’s cooking for breakfast!  I got to enjoy the fruits of her labor and spent most of the morning just nestled into my room breathing through contractions.

(Remember me talking about The Sphincter Law before? I honestly wasn’t worried this would effect me in the privacy of my own home.  I pretty much figured I have enough control over my mind and body that once labor started, I would get in the zone and be good to go.  Well, that was not the case.)

By the afternoon, with contractions still 10 minutes apart, and losing intensity at times, we thought a walk around the neighborhood would help. It did not help at all.  In fact, I felt as though everything was being put on hold.  I stayed out in the kitchen chatting with everyone and went almost 30 minutes without anything happening.

So, with Danette’s encouragement I went back to my room with my headphones in, music up, and only the company of my husband, and at times Emma.  As long as no one else was around my body would allow contractions to come up to eight minutes apart and last over a minute.  However, oddly enough, even if my sweet mama would come into the room, everything would stop.  I really got to experience how little control I had over my body’s birthing plan.

Jamie Buckland 1-2

 So, with the afternoon turning into the evening, my body slowly worked on getting Elsie lined up for her big debut.  For years Greg and I had told Emma that if/when we ever had another baby, the new little one would be in between us instead of her, and she would have to be prepared for that.  So, with the last few hours of her being the baby dwindling away, she nestled in between us to make the most of it.  We chatted about what Elsie would look like as she drew pictures, and then Greg would hold her really still as I would hum through my contractions.

Jamie Buckland 2-2

Everyone was pretty tuckered out after an eventful, yet still uneventful day.  The kids camped out in the living room with my parents and Danette and Caroline made themselves at home in the kids’ beds.  And that is how it was, still and quiet, until around 12:30am on Tuesday morning.

Finally, the contractions were coming on nice and strong!  Hooray!  I was up pacing back and forth, and then every eight minutes or so, I would bend over the bed to hum through what was now what I would consider active labor.  I woke Greg up and Danette heard us stirring around.

It was time to start boiling water for the cooled off pool and a wardrobe change as I got ready to get in the water.  Danette had told me we would hold off on getting into the pool until I couldn’t get comfortable any other way. I was at that point.  I crawled into the birth pool around 1:15am Tuesday morning and prepared myself to crawl out of it when no longer pregnant.

As soon as I got in the water, a contraction came on super strong. Then about two minutes later, another one, and that was the pace for the next two hours. My body was so relaxed in the water that I was completely out of control and the human ejection process had begun!

The water definitely helped me handle the intensity of the pain, so I just hummed away as my mind kept repeating things like, ‘and this too shall pass’, over and over.  The last 30 minutes were totally overwhelming.  I felt completely out of control during the contractions and proclaimed I felt like I was suffocating and couldn’t catch my breath.  Danette reminded me to relax and not let my contractions get ahead of me, so back to the humming and focusing.

This entire 25 hours of labor, Danette did not “check me”.  We did not know how dilated I was at any point in time.  My body was completely in control of the process, and although I felt helpless for those last few minutes, the empowerment I felt when it was all over was totally worth it!

I threw up my yummy snacks from the long day of labor as I transitioned through those last few centimeters, and started shaking as my body prepared to deliver my beautiful little girl into her daddy’s awaiting hands.  Danette gave me some ginger candy to help with the nausea, and I was really thankful, even asking for another piece to get me through the end.

Danette had a pitcher and would pour water over my back through my contractions while my husband was sitting on a stool in front of me holding my hands, and I was bent over the edge of the pool on my knees.  My mom and Caroline were patiently awaiting the progression, and my dad and kids were still fast asleep.

I remember looking over my shoulder once and finding my mother shedding big tears as she tried to deal with her baby girl being in so much pain, but the midwife was quick to comfort her and assure her all was well.

With all the controversy surrounding our decision to birth at home, I want to make it clear that I never once had any worry about my health, or the well being of my baby through the entire process.  My mind never once wandered into those dark thoughts, and I praise the good Lord for bathing the entire ordeal with His wonderful grace.

About 10 minutes before Elsie found her way to daddy’s hands, Danette told me I could check to see if I felt her head.  My water still hadn’t ruptured, and it was obvious I was feeling her sac cushioning her head in it’s descent.  With the next contraction I exclaimed that I felt like I could push.  So, I did.

On the second push, I felt my water break. Seconds later ,I announced her head was out.  Greg was scurrying around from being in front of me to getting behind me and Danette was getting the flashlight on so they could indeed see if she was on her way out!  Her head had been delivered, and with ease her little body followed just in time for Greg to reach down and lift her up out of the water.

They carefully helped me roll over onto my bottom where I stayed for the next hour.  Greg laid my sweet Elsie right onto my chest as I expressed my sheer delight that my baby girl and I had worked so hard together, and now here she was!  She immediately began to root and kick, lifting her head and bobbing around to begin suckling.  My sweet girl latched right on and has been an expert nurser from the beginning.

The after pains were pretty harsh. We waited 45 minutes for the cord to finish its beautifully engineered job, and then Danette clamped it for Greg to cut it.  Then miss Elsie got to go cuddle with her papa as they helped me get out of the pool and into my robe so I could get in the bed to rest.

Jamie Buckland 3-2

Moments later, it happened. As Emma looked on from her daddy’s chest, little Elsie took her place in between mommy and daddy.  And like that, the process I had anticipated for so long was over. My little babe who I’d dreamt about for years was finally lying here in her home, in my bed, in the blankets I had washed just weeks before.  We were complete.

And now Emma seemed so much older and much more mature.

 Jamie Buckland 4-2

The Big “E” seemed much bigger as he nestled the new little “E”.

Jamie Buckland 5-2

Elsie will be a few weeks old in just a few hours, and I’ve gotten to share our experience with some of our close friends and family. Some have been curious about how I felt afterwards.  I can honestly say it was a much easier recovery than with Ethan or Emma.  I’ve been pleasantly surprised at just how good I have felt.  I did have a small tear, but never had any discomfort from it whatsoever.  Danette had made me a brew up of some comfrey root, which worked wonderfully.

Some have asked now that it is all over, will we be trying to conceive again, and if so, will I birth at home again? The answers are yes, and yes. We plan on trying for #4 when Elsie is a little over a year old, and yes, I plan on inviting my new favorite midwife, Danette, back into my home to attend the birth of our next child.  Looking back, I am so thankful everything went just as it was.  Even with labor lasting just over a day, I feel so blessed Greg and I got to spend that time together as we waited for her arrival.

A big thanks to all of you who have supported us through this journey! And of course a huge thank you to BIRTH WITHOUT FEAR for all the information and stories that helped me along this journey.  If you want to read more about why we chose a home birth, you can read about my first two pregnancies and why I felt so passionate about sharing this experience.

{By Jamie Buckland}

The Birth of Sicily Rose {Postpartum Hemorrhage, Vanishing Twin Syndrome}

The Birth of Sicily Rose {Postpartum Hemorrhage, Vanishing Twin Syndrome}

Had it not been for your blog and all the  amazing women behind the stories you share, I might not of had the courage to go through what I endured. But, looking back now, I made and I’m a stronger mother and women for it.

This past February, we welcomed our second daughter, Sicily Rose to the world. I didn’t know it at the time of writing her birth story, but we found out a short time later that she was a twin. In my blog post, I write about hemorrhaging during our home birth, but I didn’t find out until I was 4 weeks postpartum it was because her twin was left inside of me. I hemorrhaged again at 4 weeks postpartum and almost lost my life. After being rushed by ambulance, getting a D&C, and a blood transfusion, we learned that our princess wasn’t alone in my womb.

(Side note, we thought our daughter was a twin at the beginning due to finding out about the pregnancy very early on and suffering from HG. I bled at 6 weeks pregnant and went into the emergency room. We again suspected twins when my HCG levels were off the charts but that was not confirmed nor denied by the hospital. During my D&C, they removed a 6 cm piece of placenta that was firmly attached to my womb. It was an entirely separate placenta from my daughters because I encapsulated her placenta. In the lab write up, we learned it was a vanishing twin. Vanishing Twin Syndrome occurs in 1 in 10 pregnancies on average. He or she may have “vanished from my womb”, but my baby has never vanished from my heart after learning about him or her.)

In my post, I write about dilating to a 10 twice. I dilated all the way to a 10 one week before our baby girl actually decided to arrive. And looking back now, I find it kind of symbolic. It was as if I was birthing the twin I would never hold or meet.

So in honor of our babies here is the birth story of Sicily Rose:

The Birth of Sicily Rose

Our Sicily Rose has finally arrived! She was indecisive about coming at first, but when she was ready, she was READY! On Sunday February 9th, we planned a birthday party for our Audrey Girl. She just turned 3 on the 7th so we all went to Dave and Buster’s to eat lunch and play some games. I had contractions start up that morning at about 10 am. By 11:30, we were at the party eating lunch and they were still coming on pretty strong. I couldn’t eat a whole lot, because they just kept growing in intensity. Christian and I decided to leave the party and head for home because it was snowing pretty hard and we didn’t know how fast I was progressing. Nana stayed behind so our Audrey Girl could finish up her games.

I called my midwife about 5 pm and just let her know I had been contracting all afternoon, they weren’t letting up, and that I felt like today was the day. She asked Christian to check my purple line for dilation, so she could get an estimate at how far along I was. (If you don’t know the purple line trick…Google it.)

We guessed I was about 5-6 cm dilated, so I told my midwife to just hold off on coming for right now. I kept contracting, tried to eat some good protein so I would be ready for what was to come, but I felt too nauseated and what I ate did not stay down. I called my midwife about 8 and gave her the green light to head this way. She got here and checked my dilation. She said I was at an 8. She listened to Sicily’s heartbeat and I went ahead and got in the birthing pool. My contractions weren’t horrible, but the water helped ease any discomfort that I had.

After an hour and a half, I got out of the water. My midwife wanted to see where I was with dilation. I was finally at a 10. I decided to rock on the birthing ball for a while to see if I could persuade Sicily to burrow down. She was right at the edge, to the point where I could feel her head, but she was getting hung up on my pubic bone on the right side. I did some stretching and then began feeling overwhelmed. 10pm turned into 3am and still nothing. My Midwife, Sarah, suggested I lay down and rest so when it was time to push, I would have the energy to do so.

I slept until 5am and woke up to find my contractions had died down. I got up and decided to just walk, walk, walk. I did circles in our living room around the birthing pool. Sarah told me I should eat something, so I had my mom cut up some deer sausage and I ate that. It was so good in that moment. I remember that being all I wanted to eat.

I was so flustered at this point, because I had been contracting and had progressed all the way to a 10 and then nothing. The contractions just stopped. The walking didn’t stir them back up again. I was so tired. At 7am, I found a pillow and laid down on the living room floor. Christian slept on couch beside me. At 8am on February 10th, I could hear Sarah tell Christian to get me into bed, so I could sleep more comfortably and that she was going to head home to do the same. She said she would come back over later to check on us.

I was so bummed. Here I thought “this is it”, made it all the way to 10cm, and then nothing. Everything just stopped. I slept a little while but when I woke up, all I could do was cry. My baby was supposed to be in my arms by now. Christian worked until noon that day and then came home to help comfort me. He called Sarah and had her come back over to talk with me. She came right over without hesitation and suggested I see our chiropractor. She thought that would help Sicily get in the right position and not get hung up on my pubic bone anymore. It was worth a shot to me, so off we went. I was glad I did because it really helped me settle down and relax.

After my adjustment, we went home and I fell back asleep. My mom took Audrey home with her so I could have a few day to myself to recuperate and see how things progressed. I woke up Tuesday morning to my phone ringing off the hook. Everyone wanted to know “is she here yet?” It was so hard for me. I think I cried most of that morning. Christian came home from work and told me to get dress because we were going out. He surprised me with dinner at BeerKitchen…my favorite place to eat chicken and waffles and then we rented Bad Grandpa from Redbox. It’s been a long time since I laughed that hard and it was a treat to get a last minute date night with him before we became a family of 4.

Audrey came back home Thursday night. I was more than ready to have my big girl in my arms. Nothing beats snuggles from your child when you’ve had a rough day…or week. Friday I went back to the chiropractor for another adjustment. She suggested acupuncture and I was all for it. I didn’t get anxious and told myself whatever happens…happens. Saturday was spent relaxing at home. I was tired and indulged in a nap or two. Sunday, Christian did some painting around the house, so I decided to get out and get a pedicure with my BFF, Mallory. I thoroughly enjoyed some much needed girl time. Little did I know, this would be our last day as a family of 3…

Monday morning I woke up about 4:45. I had the urge to pee but I didn’t want to get out of my nice and warm bed. I laid there for a few minutes, then I felt this wet, warm sensation. I didn’t know if I had just peed myself or if my water had finally broke. I got up, pants soaking wet, and went to the bathroom. Sarah told me that if I was ever unsure to just smell it. A broken water bag doesn’t have a smell, but urine does. Mine didn’t have a smell and I was able to then go pee so we were all good. 🙂

I changed my clothes and Christian rolled over to see why I was up making so much noise. “I’m pretty sure my water just broke,” I told him. I wasn’t having contractions at this point, so I got on my phone and googled to see how long I could possibly be waiting for my labor to really start….it said up to 3 days so after all I had just went through, I was expecting the worst. I texted Sarah around 5am and told her my water broke. Since my contractions hadn’t started up yet, we decided there was no need for her to come over. I texted our birth photographer, Rachel to give her a heads up too and then I laid back down.

By 6:00am, the contractions were coming. Christian got up and decided to make me some eggs so I could eat, set up the birthing pool, and see how things progressed. He brought my plate into our bedroom to me where I was standing over our bed rocking through the contractions. They were coming fast and strong. As much as I wanted to eat, I just couldn’t. The contractions were getting intense and I wanted to get in the water so bad. My birth pool wasn’t filled up all the way just yet so I went into the bathroom and kneeled by the bath tub. I had to tell myself to just keep breathing through it.

At this point, I knew this was the real deal and Sicily would probably be here sometime today. I told Christian to call Sarah and Rachel and tell them to get here now. I had called my mom when my water broke and I knew she would already be on her way. Sarah got here around 6:45am and just as soon as she listened to Sicily’s heart rate, I was in the birth pool. The warm water felt good and the contractions kept coming about 2-3 minutes apart. My mom got here soon after. She sat next to the pool on our chaise lounge and asked me what I needed her to do. At this point, there was nothing no one could do for me. It was just me and Sicily…working in sync with each other and trusting each other.

Sarah’s birth assistant walked in as I was laboring in the pool and I could vaguely hear Sarah tell her to get her gloves on and get ready because things were about to go fast. I smiled to myself when I heard this because that meant “this was it”…our girl would be in our arms today!

Rachel got here and then things went fast. I didn’t say a word to anyone as they arrived. I just kept breathing and focusing through the contractions. I remember thinking to myself, “When is it going to really hurt?” This pain was bareable to me. It was a good pain, because I knew in the end I would have my baby to hold. (Kidney stones hurt worse than child labor incase you wanted to know. I would birth 10 babies in a row before I would ever deal with another kidney stone.)

Audrey woke up and went to sit with Nana on the chaise lounge. She really impressed me that morning. She was so calm and spoke softly. She just laid in Nana’s lap and they watched me together. Christian came to the edge of the pool and held my arms as I sat in a squat in the water. I wanted him there. Right there holding me up. He was so cute. He kept giving me encouragement and telling me how strong I was. Sarah helped me remember to keep breathing. “The ring of fire” was felt just as Sicily was crowning and I knew we were getting close.

Sarah got behind me and put a mirror in the water to see where she was at. Feeling her head crown hurt. I was in the moment, I needed to bite something and Christian’s arm was there. He pulled back just as I realized what I was doing so I grabbed a towel and bit it instead. Just then, the ring of fire was over and out came her little head.

Sarah and Christian helped me lay back so I could push her the rest of the way out. I wasn’t in pain anymore. I was just breathing trying to muster up enough energy to get my girl here. Sarah’s assistant said, “it’s been two minutes. We need to move things along.” And just then I pushed and out into the water came our girl. I picked her up and brought her to my chest. She had inhaled a little bit of water and she wasn’t crying. Sarah told us to just keep talking to her as she patted her on her back. It worked because she let out the cutest little squeak. No crying. Just completely content laying on her mama’s chest in the water. All I could do is stare at her in awe and say, “I did it….I did it.”

Our story doesn’t end there, but how I wish it did. I wish I could tell you that I laid there in the birth pool holding my sweet girl and the rest of the day was just spent snuggling my little family of 4.

I felt the urge to push again and I knew it was my placenta coming. Sicily was still attached to her cord at this point and laying on my chest in the water. I told Sarah I needed to push and I did. Blood just shot out. The pool turned pitch black. Sarah, her assistant, and Christian helped lift me out of the pool and onto some towels on the floor. I remember Sarah sternly telling me, “Stop bleeding. You have got to stop bleeding.” And Christian told my mom to take Audrey into the other room.

Everything was happening so fast. I glanced down at Sicily still laying on my chest as I felt my placenta escape from me. The blood still flowing out much faster than it should have. I don’t really remember how but my birth team managed to get into our bed. Sarah examined me and said I had 2nd degree tearing in 3 different places. I was so glad I birthed in the water, because I can’t imagine how it would have felt if I didn’t.

My bleeding still hadn’t subsided. I was soaking the blue puppy pad looking sheets every few minutes. Sarah felt my uterus as we tried to get Sicily to latch on to eat. She examined my placenta that Sicily was still attached to, to make sure there wasn’t any leftover in my uterus. There wasn’t, thank God.

My options were running out, so Sarah did the last thing she could think of to stop my bleeding. She cut a piece of my placenta and told me to put it in my cheek and suck on it. I didn’t care. I would do anything at this point. I just wanted my bleeding to stop. I did not want to be rushed to the hospital. Christian turned white as a ghost. I’ve never seen him look so scared in all my life. The way he looked at me was terrifying. I asked him to leave the room and get himself something to eat.

Sarah’s little trick worked. My bleeding stopped and she was able to stitch me up. Her assistant fed me eggs and juice and mothers milk tea as Sicily laid on my chest still attached to the placenta. I kept trying to go to sleep but Sarah wouldn’t let me. She was afraid I would go unconscious and no one would know. Every time they moved me I started to faint. Christian came back in and helped feed me. Sicily latched on and Sarah gave us the green light to just snuggle skin to skin as we had been. Christian cut the cord and Sarah kept my placenta to encapsulate it. Another hour or two went by and Sarah continued to monitor me. She went over her concerns with Christian and came back in to tell me goodbye. She said she’d be back over later that evening to check on us again.

I spent the rest of the day laid up in bed snuggling with my babies. I was asked later if I regretted doing a homebirth because of the bleeding episode…I absolutely do not. I am glad I had a homebirth. If that had happened to me in the hospital, things would have gone a lot differently. Would I do it all over again? In a heartbeat. This was truly a once in a lifetime experience….and “I did it!”.

Birth of Sicily Birth of Sicily 2

Our birth photographer, Rachel was amazing. I can’t tell you what these images mean to me. I am so thankful to have been given the opportunity to have her there to capture these moments. I highly recommend Tripp Over Love Photography.
www.photosbyrtripp.com

A Midwifery Student’s Birth Without Fear {With Pictures}

A Midwifery Student’s Birth Without Fear {With Pictures}

I got pregnant with my first son when I was just about 18. I really wanted to give birth at the out of hospital birth center that a lot of my friends were giving birth at, but my mom and other friends convinced me it was best to have my first at the hospital, in case anything went wrong.

I got high blood pressure during my pregnancy and was constantly being tested for PIH. My labs kept coming back normal, but my blood pressure kept getting higher and higher. At 34 weeks I woke up with extremely swollen ankles and a terrible migraine. I went to the hospital and after being monitored for a while the nurse came into my hospital room and said “well… you’re gonna have a baby tonight.”

My doctor decided I needed to be induced. My blood pressure was up to 201/99. The nurse gave me a shot in my butt, and I apologized for wearing my ugly undies and asked if she has to use bigger needles for bigger butts. She said yes! HA! I loved my nurse. Her name was Wendy. She was so sweet!

I was given an IV, and while they were trying to insert it, I asked if that’s where I got the epidural. They said “nope, you’re not even in labor yet sweetie, you can get it when you feel like you really need it.”

They put me on Labetalol and magnesium, and some other stuff to keep my blood pressure down. The magnesium made me so loopy. I was cracking jokes left and right, and I think I may have even been hallucinating a tad, because Wendy was glowing at one point.

They induced me with the little pill that gets shoved up me (can’t think of the name!), and I sort of labored for about 8 hours. They came in and said my labor pattern wasn’t what they wanted to see, so they gave me the pitocin. The second they got the pitocin going, the contractions really started getting hard. Then the on call doctor broke my water and that made it even worse.

I labored for several hours, until about 8cm, and then the nurse asked me if I wanted the epidural because I had to get it now or never. I didn’t really feel like I needed it, but I got it anyways. I was able to sleep after getting it. Then, I felt like I had to pee. My nurse checked me and sure enough it was the baby’s head.

They rushed me to the operating room because I was only 34 weeks along and baby and I were both high risk, and the operating room was right next to the NICU. There wasn’t a doctor in the building at this point, so the nurses made me lie on my side and cross my legs and not push.

I had to push so bad, my body started convulsing and my teeth were chattering. My doctor finally got there after 20 minutes and said “sorry I missed it!” And the nurses said “You didn’t miss it! She needs to push!” So he got in his sterile outfit and told me to “bear down.”

I asked “WHAT IS BEAR DOWN!?” And everyone in the room screamed “PUSH!” My boyfriend at the time was holding one leg and my mom was holding the other. I gave one push and there was his head. My boyfriend said “he has hair!” and I started balling.

I pushed 1 or 2 more times and he was out. They put him on my chest, had dad cut the cord, and then rushed him off the NICU. I didn’t see him till 6 hours later, because of my epidural. They didn’t tell me that when I got it, I was so angry.

After he was home I started researching whether or not to vaccinate him, and during my research I learned a lot about out of hospital births and using midwives. Right then it clicked in my head “I’m supposed to be a midwife!” So I started an apprenticeship through the out of hospital birth center I originally wanted to have my baby at. Working there only 2 months, I got baby fever BAD! I soon got pregnant again.

This time around I used the midwife I had been apprenticing under and she helped me keep my blood pressure under control with diet and herbs. I had a fairly easy pregnancy till about 30 weeks when I started to have preterm labor. My midwife was able to stop it, but I was put on bedrest. It wasn’t easy with an almost 2 year old running around!

After about 4 weeks of bed rest I was able to slowly add more and more activity to my day. It was great being able to cook and clean again! At 36 weeks my husband (and baby daddy of first) and I got all the stuff we’d need for our homebirth. We rented a birth tub and got everything ready.

When I was 37 weeks I thought I was in labor, so my midwife came over and checked me and I was 4cm dilated. But my contractions would stop when I stopped moving. So she had me just rest and wait until they got real. I went 2 more weeks having these what I called “fake contractions.” However, they weren’t fake at all.

At my 39 week visit, I had my midwife check me, and I was 9cm dilated and 70% effaced. I asked her to strip my membranes and she did. As I was leaving my appointment around 5pm, I said to her and the other midwives that would be at my birth “I bet we’ll have a baby by 8 tonight.”

We left and went to Trader Joe’s to get some pizza dough to make calzones that night. We got home and I was cooking up some sausage and all of a sudden I got such a bad contraction, I hunched over and said a slew of swear words. Then my husband took over cooking.

I went to the bathroom and had bloody show. I texted my midwife and she said “your birth team is on the way!” And about 10 minutes later the photographer showed up! I knew the photographer never gets there until the last few hours, so I figured my midwife must have thought I was close.

Once the birth team got there I kept telling them that it was fake labor and it would stop, and that they should go home. But I kept having this weird pain in my butt. They got the tub filled and told me I could get in, so I did. But once I got in I had to go poop SO BAD.

My midwife told me to just poop in the tub, but I know how bad that can smell, so I told her I wanted to get on the toilet. But I was stuck. I literally was in such hard labor I couldn’t get out of the tub. I was pissed. And I was in denial that I was in labor. Then I just kept having this urge to poop. Then it clicked in my midwifery-student mind “I don’t have to poop, I have to push!!!” So I said “I’M PUSHING!” I pushed for about 10 minutes and then my water broke and I screamed “ring of fire! RING OF FIRE!”

My midwife had me stop pushing because she knew how badly I didn’t want to tear. She supported my perineum and had me breath and hum through the contractions. My body literally just so slowly pushed him out. My mom, midwife and fellow midwifery student helped to catch him. I was so awesome! I asked if it was a boy or girl and they couldn’t see, so I reached my hand down and felt a handful of balls and told everyone it was another boy! It was amazing!

My little sister, and my older son were also there. There were 3 midwives, a student midwife, and the photographer! It was so amazing. I still can’t believe I did it! Next time around I don’t think I’ll use the birth tub though! I hated that thing!

He was born at 8:32, 32 minutes after I guessed he’d be out. My labor lasted 2 hours! After baby was out, I delivered my placenta, and it was literally gigantic. We weighed it, it was 1.5lbs! Baby weighed 8.5lbs and was 22 ½ inches long. Much bigger than my preemie 6 lb baby!

I’m so grateful for the birth stories that BWF posts, it helped me to be more confident in myself. I am now 2 ½ months postpartum, exclusively breastfeeding and feel so strong for birthing without fear! I went into labor excited, not scared! Thank you, Birth Without Fear, for all you do!

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Maternal Death and the United States {Birth Without Fear}

Maternal Death and the United States {Birth Without Fear}

Maternal Death – the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. (WHO)

This is a subject no one really wants to talk about. Mothers die. Mothers die in pregnancy and childbirth and just after birth. The weight of that reality is just so heavy and heart breaking. In our current birth culture, fear reigns. However, fear reigns without reason or knowledge of what really needs fear. And of course – all of us hope to Birth Without Fear. And so, I approach this subject with a heavy heart but hope as well.

Samantha's Birth

Where Does It Happen?

In short, it happens everywhere. However, some areas are more prone than others. This can be due to lack of care – think of sub-Saharan Africa or rural villages in some undeveloped countries. Maternal death in those areas is an unfortunate fact of life (though organizations are striving to change this).

But apart from the “obvious” places, where do you suppose it happens? Perhaps war-stricken places, or those places without advanced medical facilities? Would it surprise you to know that the United States has one of the highest maternal mortality rates in the developed world?

Yes – you read that right. Our current maternal mortality rate is 21 deaths per 100,000 live births as of 2010 (WHO). This rate went up from 2005 (18/100,000). The 2010 “Healthy People” Goal for the United States was set at 4.3/100,000 – we grievously missed that by a large margin. The 2020 goal is 11.4/100,000, which would only be a 10% decrease from what the US considers to be its current statistic (the 12.7/100,000). I find it interesting that the government decided after they missed the 2010 goal that maybe they should try less to save mothers, since their efforts before had no effect and saw a rise in deaths.

The WHO number is adjusted from the number reported by the CDC (12.7/100,000) – this is because the United States does not have a universal system of reporting maternal deaths and the CDC admits that our numbers are drastically under reported due to this lack of uniformity in reporting (See this CDC publication, specifically page 20). Currently, only 25 states make it mandatory to state that a death was pregnancy related on the death certificate – and even this method is questionable due to lack of doctor training in filling out certificates and the great fear of litigation in the medical system. Ina May Gaskin writes about the lack of reporting here.

Other countries have much better standards of reporting. The “gold standard” is considered to the be reporting system in place in the United Kingdom. The UK ensures that not only is every death reported, but they also compile the deaths and reasons for them in a report every three years. This report is available to the public and the locations and names of the deaths remain confidential. This allows the nation and the nation’s health workers to look at the issues without fear of litigation – meaning they have no reason to hide maternal deaths.

To provide some perspective, here are the rates of some other countries:

  • Australia: 7/100,000
  • Brazil: 56/100,000
  • Denmark: 12/100,000
  • Germany: 7/100,000
  • Israel: 7/100,000
  • Japan: 5/100,000
  • Netherlands: 6/100,000 – note that about 30% of all births here are at home.
  • United Kingdom: 12/100,000

As you can see, we are rather behind many other countries – and don’t worry, I am going to come back to Brazil and why I included that statistic which is very high for an industrialized country (as is the USA’s number).

Why Are Mothers Dying?

This question is hard to answer since as mentioned above the reporting methods are varied and not always followed. We do know that some deaths are simply not preventable, this is just a fact of life. However, looking at the much lower numbers in other comparable nations we know that unpreventable deaths are not the reason for the very high numbers in the United States.

We know that it is not from lack of care in general – reports show that over 99% of all women in the United States receive prenatal care. However, we have to look at the level of care women are receiving. We have to ask, does a 5 minute rushed visit with your actual doctor count as adequate care? Does more diagnostic testing equal better care? Does spending more money equal quality care? (The numbers say no – we spend more than any other country in the world on birth).

We see a HUGE disparity in death rates in regards to ethnicity. An African-American woman is 3.3 times more likely to die in childbirth than a white woman. This is simply not acceptable in a country as advanced as ours, and one that is supposedly equal. Midwives such as Jennie Joseph are helping to implement ways to combat this disparity – her creation of The JJ Way is an example of how we can work to correct this travesty.

A big question that needs to be asked in the United States has to do with who is providing this care – care that is obviously not saving as many mothers as it should. In the United States women overwhelmingly see Obstetricians. While Obstetricians are amazing for complicated and high-risk pregnancies, they don’t have much training in plain old boring pregnancy and birth.

A majority of the time pregnancy will proceed in a normal fashion, and birth will follow in the normal fashion. When we use care providers who are trained to search for problems there tends to be a trend of finding problems whether they exist or not, or whether they are actually emergencies or not. As the saying goes, “Give a boy a hammer and he will find something which needs to be hammered.”

We can see that in countries were the majority of care is given by midwives (or that country’s equivalent care provider) the maternal mortality rate is lower (and the infant mortality rate is lower as well). The United Kingdom is a great example of this. They are comparable to us in many ways (general health and population structure), and yet consistently have better maternal outcomes. And they use the midwife model of care in which all women start with midwives and only transfer if problems arise. (Note that a woman can opt for an OB to start with, however most do not).

Now for the elephant in the room: the United States cesarean rate. Our current cesarean rate is 32.8% (CDC). Yes – basically 1/3 of all babies in the US are born through cesarean. So are 1/3 of all US women somehow “broken”? Unable to birth? Producing massive or stubborn babies? NO – of course not. If 1/3 of all women in the US were “broken” then those numbers would be reflected all over the world, and the statistics show this is not the case. In the same vein, we are not producing massive babies either – in fact the average birth weight has gone down as the cesarean rates have gone up (and is independent of that rise or that of induction).

Remember when I said I would come back to why I included Brazil? Brazil has a rather good medical system and is considered a developed country, so why the massive maternal death rate (56/100,000)? Take a look at their cesarean rate – 52.3%. Yes – over 50%. Brazil is an interesting case since most of these surgeries are elective, even for the first time mothers. The fear of childbirth is so deeply engrained in Brazilian culture that women jump at the opportunity to have a cesarean and avoid labor totally. A vaginal birth is seen, culturally, as something only poor women do because they can not afford a cesarean.

That mortality rate could be the United States’ future. We see a fear of birth in the US, and a huge cultural love of telling horror stories about labor and birth. We see more interest in elective cesareans (though elective first time cesareans are not significantly altering the rates). As VBACs are “allowed” in fewer and fewer places and malpractice issues continue to rise we see more and more women forced into surgeries they do not want or need. Our rates are heading right up to that of Brazil’s, and our maternal mortality rates will be sure to follow. A Cesarean increases the risk of death significantly in comparison to vaginal birth.

In comparison, the rate of cesarean in the UK is 25%, the Netherlands has a rate of 14%. As I stated before, the UK has 12/100,000 rate and the Netherlands 6/100,000 – rather interesting that as the rate of cesarean is almost half in the Netherlands and their rate of maternal death is also half that of the UK. While in some countries a higher cesarean rate does not correlate to a significantly higher mortality rate, those countries with very high rates of cesarean typically have higher (or rising) mortality rates.

We also cannot forget postnatal care. The postpartum period is one that needs care just as much as the prenatal time period. In the US, typically a woman is seen in the day or two after birth, at two weeks or so, and then at six weeks…and that is about it. This is simply not enough during this time of life when hormones are changing, the body is attempting to heal from creating another life, and things like retained placenta or clots can cause major issues. A much better plan of postpartum care must be put in place.

What Can We Do?

Be Educated. That is the number one thing you can do to not only help yourself have a safe pregnancy and birth, but also to help the women around you as well. When you learn, share the information. Break down the myths that pervade this culture – break down the assumption that VBACs are dangerous, or that “big babies” need surgical birth. Share the studies and articles you read.

Be Fearless. Help to eradicate fear of birth. Can birth end in tragedy? Yes. Unfortunately is does happen. But with proper and evidence-based care we give ourselves and our babies the best chance. Share the positive birth stories you hear. Share your positive birth. How does this help? It helps women to not fall into a fear based decision that increases her risks of complications – namely induction and cesarean. When a woman can start her pregnancy and birth journey from a positive place it gives her more space for growth and research. Absence of fear is not ignorance of risks – it is not being beholden to the fear of risk.

Those two things hand-in-hand – education and fearlessness – can go a long way towards helping this mortality rate go down. An educated woman is better able to avoid situations or care providers that increase her risks, and a fearless woman is better able to stand up for herself and decipher what is really in need of intervention and what is not without cultural fears clouding her view. Lets do our part to save mothers.

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Prepping for Your Home Birth Without Fear {The Ultimate List}

Prepping for Your Home Birth Without Fear {The Ultimate List}

One of the most common questions about homebirth from those considering it is, “What do you need?” While the list of supplies varies from midwife to midwife, there are some basic things that almost everyone is going to need to gather in preparation for the birth. There will also be things you will (probably) want to do for your comfort and peace of mind before “go time”. This is meant to be an Ultimate (I hope I thought of everything) List, but please don’t stress yourself to cover all the little extras. Birth really is pretty basic. This list is long and detailed so that you have a chance to consider everything you might want to do, not everything you have to do.

Early Prep

While not everyone plans a homebirth from the start, many women do. If you can get a head start on a few things it makes the final months much more peaceful. After you have lined up your midwife, get a head start on your prep.

One of the first things you can do is to create a peaceful space. (Right about now mothers of small children are laughing). If you know which room/area you plan to use then work in the early months to slowly declutter and create your space. Your nesting urge will come in handy with this as well.

If you have older children, you will want to decide if you want them at the birth or not. If you do there are things you can do to prep your child for the birth. Some things will depend on their age – for instance a one year old won’t need the same prep as a 5 year old. Older children may be interested in the mechanics of birth and understand more. You know your children best. Birth can be a beautiful family event if you decide to have your children there. And if you don’t think you want them there – no guilt! Everyone labors differently.

For younger children helpful prep includes books, videos, and role playing. There are a few children’s books out there that discuss homebirth, one of my favorites is called Hello Baby by Jenni Overend. It is beautifully illustrated and is great for little ones. Birth videos are also great for prepping kids. I previewed many, many homebirth videos on youtube and created a little playlist of those I thought my son could see. I included water births, “land” births, quiet moms, loud moms, and especially videos that included the whole family.

Speaking of “loud” moms – this is where the role playing comes in. While I was a very quiet laborer with my first born, I wasn’t sure if I would be again. We never know how labor will go (and I wasn’t quiet the second time, by the way). So we discussed as we watched the videos that mommy may “Roar”.

I talked about roaring like a dinosaur or a lion. We had a lot of fun roaring at each other and I explained that if mommy roars it is okay – I am not hurting and it just means the baby is coming soon. Apparently this worked really well since my two year old was not phased at all by my roaring at the birth – and I was loud!

Another opportunity for prep and role play with little ones can include your midwife visits. Many homebirth midwives do home visits for prenatals or have offices that are child friendly. I made my son a little midwife kit of his own, including a little plush placenta I whipped up with some felt. During my appointments in our home he “helped” my midwife and we talked about the baby. All of this helps children feel included in this life changing event.

plush placenta

Now whether you decide to have your children at the birth or not, I highly suggest lining up a support person for them. If they are going to be taken somewhere else for the birth be sure they are comfortable at the location and with the support person. Also try to pick someone with a flexible schedule who can be “on call” for the birth.

If they are going to be staying with you for the birth then you need to pick a special person. You need to pick a person who is there just for the child/children. This means that if they need to leave the house or room and miss the birth, they will be 100% okay with that. I would suggest clearing this specifically with them, since in some cases support people at home births might be signing up in the hopes of being a spectator. This isn’t the point of a support person for the older child. Be sure to acclimate them to your routines and places they can go with your kids. Discuss car seats if they need to drive the children anywhere. While this may seem over-kill it will give peace of mind in the last weeks and while in labor. It also clears up your support team to work just for you during the birth and not have to split their attention.

You will also want to consider if you want a doula for your home birth. Be sure to set up an interview and get someone who you feel is comfortable in your home and is preferably experienced or knowledgeable about home birth. Another part of your team to consider is a birth photographer. Again, interview them and be sure they make you feel comfortable. It also helps if they understand home birth or have shot one before, since they have different highlights and flow than a hospital birth.

Almost to the Finish Line!

Once you hit about 32 weeks, order your birth kit. This may seem a bit early, but some companies take a few weeks to ship. Or, if you are lucky like me, it will get lost in the mail because apparently your house is invisible to UPS. This also gives time to clear up any issues if the order is wrong or missing something. You don’t want to be stressed at the last minute!

There are many places to order birth kits and your midwife may have a custom kit set up with a particular company. You can also order kits of your own making or a basic kit from places such a In His Hands or Baby, Birth and Beyond. *

Basic Supplies Include:

Now that is just a starter list, and as I mentioned above some midwives will want more or less or different items. Some additional items might be an herbal after bath, different herbal items (for cord care or afterpains), Depends-type underwear, and a “birth certificate” and foot printing kit. You can also take off items from a premade kit on most sites, and substitute in your own items. For instance you may get your own postpartum pads and “depends” (hey, those are handy the first day or so!). The one thing I suggest not skimping on is the chux pads. Most births require a good amount of them, and they are handy after birth too. I tend to use them for a couple months under my sheets to protect the mattress from breastmilk leaks in the night.

Once you have ordered your birth kit it gets exciting! You have all these cool things ready to go, so what do you do with them until the big day? Enter the plastic tote.

boxes

I love “totes”. Really – my house is full of these lovely plastic boxes. It makes everything look organized, even if you really just threw stuff in there eight years ago when company was coming over. But I digress. Plastic totes are perfect for organizing your birth supplies. The above picture is actually my birth supplies from my second birth. The top tote has all the little stuff. Here was my personal list:

  • Everything from the basic list above, plus a few additional items from my midwife’s list
  • Several hair ties (in a small plastic baggie, taped to the inside of the box)
  • Chapstick (in the small plastic baggie as well)
  • A roll of paper towels
  • My heating pads, both the plug-in version and my rice heat pack
  • A bath robe

The bottom tote has all the linens I would need. For the bed I had a fitted sheet and flat sheet, a plastic bed protector (I actually scored that at the dollar store), and a really old holey fitted sheet. I gathered four or five old towels I didn’t mind getting dirty or stained (none of them ended up stained) as well as several wash cloths. I also threw in a few pairs of underwear and a pair of socks. This box wasn’t so much about needing things set aside for me, it was more about having it set aside for my birth team. This way I could just say “check the tote” instead of explaining where my sock drawer was.

A note about the bed, and more experienced homebirth moms will know this already – prepare the bed whether you want to birth there or not. Labor is a funny thing and may not go the way you planned (as I found out myself!). The most convenient way to prepare the bed in my opinion is to make what I think of as a bed sandwich. When you go into labor, have your partner strip the bed. Then put on a fitted sheet and flat sheet that are clean and nice. Over this, put the plastic mattress protector (or large plastic shower curtain liner). Then over this put the crappy/holey/old fitted sheet you don’t mind messing up.

If you birth on the bed or get anything on it, you simply strip off the old sheet and protector and VOILA you have a clean and ready made bed underneath! It may sound odd but this was one of the best things after the birth was over. I ran to shower off and when I came back the bed was totally ready with minimal effort for my birth team.

Another great place to store your birth supplies for easy access is the pack-n-play or crib:

tamara birth supplies

Okay – so that is your supplies covered! That was easy.

The Last Weeks

Now there are just a few additional things you may want to do. One is a list. This list will be for your main birth partner. On this list include the steps you want them to take once labor starts. For me and my husband the list looked went something like this:

  • Call midwife (include number)
  • Call photographer (include number)
  • Call child care to give a “heads up” (include number)
  • Make bed
  • Empty washing machine
  • Hook up hose attachment for filling the birth tub, start to fill tub if in established labor

This list meant that I could concentrate on labor and not have to direct anything. I could get in “the zone”. I included the numbers on the paper just in case he couldn’t find them in my phone or his or if someone else was there doing the list instead. I didn’t include “call family” since we agreed we would not call family until the midwife had arrived and I gave the go-ahead. This was a lesson learned in our first birth that sometimes alerting family at the start of labor isn’t always the most peaceful thing to do if labor is long.

If you have a support person for your child, create a little cheat list for them of your child’s routine and favorite foods if they are not familiar with all of that. While the lists might seem over-kill, trust me that the less questions directed at you in labor the happier you will be. It also helps you avoid the little mini-panic that tends to happen in the last weeks when you realize that life is about change in a big way and you want to scream “I have no control” – yes, most pregnant mamas have been right there with you!

The next thing you will most likely want to do is a trial run on your birth tub, if you are using one. My friend and I both were very glad we did a dry run. For myself, we found out the tub had a slow leak and we created a plan for dealing with it. For my friend, she found this:

tamara tub hole

Yes – that is a giant hole. Apparently the plastic of the tub got brittle from the cold of the trunk it was stored in and it cracked. Since she looked at the tub around 36 weeks she had time to get a new tub from her midwife and do a dry run with that tub. Imagine if she had not inspected the tub until she was in labor! Doing a dry run also lets you see where you want to set it up and make space. Keep in mind you want room around the tub for your team to work and have access to you. Also figure out how you are going to fill the tub and think about how much hot water you will need. Some sinks may need an attachment to put a hose on it or may not have good water pressure. You can also fill your tub from the hot water heater or shower. If you are using your own built-in tub in your home, put some nesting skills to use and give it a good scrub down or have your partner do it (I vote for the partner).

tamara tub test

Another thing you may like to work on is affirmation cards. This would be a good activity for a quiet evening before baby comes or even as part of a baby shower or mother blessing. You can hang the cards around your birth space and even put some around the house where you will see them in the coming days (like on your bathroom mirror).

One of the final things you might want to do is be sure a space is clear for your midwife. Most midwives like to lay out their supplies if they have time before the birth is imminent. This can simply be a good patch of clean counter top or space on a bed in the birth area. If your kitchen looks like mine, a clear bit of counter space may mean moving your stand mixer under the cabinet or storing the blender or clearing the kitchen table (mine always ends up as a catch all). If you don’t have time to do this (or birth catches you by surprise) don’t worry, your midwife will find a good spot. Again, remember this is the Ultimate List – not the “stress about everything” list!

krystal midwife prep

You can also take a moment to set up all your postpartum supplies in the bathroom and by your bed. Myself and another friend I know created a breastfeeding station – nursing pads, nipple butter/lanolin, a good book, children’s books and small goodies (for the older child), and a nice water bottle. Some postpartum supplies you might like are a peri-bottle, pads in easy reach, herbal preparations (like those sold by Earth Mama Angel Baby), and over the counter pain medications for after pains (or herbal preparations). Always discuss medications or herbal options with your care provider.

krystal postpartum supplies

A small note about the cleaning that needs to be done. One midwife described it to me this way: “Clean like your Mother-in-Law is coming for a visit.” Basically, clean like you are having an overnight guest and then just take some extra care in a couple key places – your birth space and the tub/shower you may want to use. There is no need to over sanitize and totally tear apart your home in preparation for a home birth, just keep clean and neat. A great investment if you have it in the budget (or have an amazing friend) is to have someone come in and do a nice deep clean around 36 or 37 weeks.

Now you have all the preparation done. You have a peaceful birth space; you have your tub ready to blow up and know how you are going to fill it. You have your support team ready and affirmation cards made. Now you can relax and focus on that moment. That sweet, sweet moment when you hold your baby for the first time. Birth Blessings mamas! Did you do anything else to prep for your home birth? Let us know in the comments!

krystal home birth

*Please note Birth Without Fear does not have an affiliation with any birth supply companies and these are only suggestions.

**Last three photos credited to Aperture Grrl Photography.

Did you do anything else to prep for your home birth? Let us know in the comments!

VBAC: What ACOG Really Says {Birth Without Fear}

VBAC: What ACOG Really Says {Birth Without Fear}

VBAC – Vaginal Birth After Cesarean.

The term and action is wrought with political and emotional meaning in the birth world. Can  you have a VBAC? Does your doctor or hospital “allow” a VBAC? Under what conditions can you have a VBAC? Should it be called a TOLAC (trial of labor after cesarean)? What sort of prior birth history is preferred? Once I have one successful VBAC, will I still have to jump through hoops in subsequent pregnancies?

All these questions and more come up when we start to discuss the mine field that is VBAC in today’s world. But I wanted to know what ACOG really says. I am not talking about the public statements – which you can read HERE. I want to know what ACOG is saying to the doctors, what they put out in their practice guidelines.

vbacacog

The document I found is HERE. I encourage you to not only look at the document for yourself, but to also follow the many links I have scattered throughout this article.

At the opening of the document, ACOG has this to say:

Trial of labor after previous cesarean delivery (TOLAC)* provides women who desire a vaginal delivery with the possibility of achieving that goal––a vaginal birth after cesarean delivery (VBAC). In addition to fulfilling a patient’s preference for vaginal delivery, at an individual level VBAC is associated with decreased maternal morbidity and a decreased risk of complications in future pregnancies. At a population level, VBAC also is associated with a decrease in the overall cesarean delivery rate (1, 2). Although TOLAC is appropriate for many women with a history of a cesarean delivery, several factors increase the likelihood of a failed trial of labor, which compared with VBAC, is associated with increased maternal and perinatal morbidity (3–5). Assessment of individual risks and the likelihood of VBAC is, therefore, important in determining who are appropriate candidates for TOLAC. The purpose of this document is to review the risks and benefits of TOLAC in various clinical situations and provide practical guidelines for managing and counseling patients who will give birth after a previous cesarean delivery.

Lets start with noticing that ACOG automatically terms all VBACs as TOLACs first. If you complete the trial with a vaginal birth, then it is a VBAC. The issue with this sort of wording (and thought process) is that it sets women up with doubt and it sets the doctor on the defense against the failure of the trial. I will use the term interchangeably only because the document that I am citing uses the term so often. But moving past this unfortunate wording we do see that they know VBACs are beneficial. They state that VBACs lower the maternal morbidity rate and risk of complications in future pregnancies and that as a whole they lower the cesarean rate. They do also point out that there are certain factors that make a TOLAC less likely to succeed, and that when they do “fail” you are more likely to have morbidity (which makes sense, as a major surgery is considered a morbidity to begin with).

In the “Background” section at the start of the Practice Bulletin we see several points that seem to be denied in the general obstetric community. First they state that the cesarean rate has increased rapidly since the 1970s, from 5% to more than 31% in 2007. They blame this increase on the introduction of electronic fetal monitoring, and the decrease in breech births and forceps births. I put emphasis on the EFM use, since we are often told that it is needed for a safe birth, even though research proves that it does not lower fetal morbidity or mortality. Again and again, research also shows that it increases the chances of a cesarean, which in turn increases the risks to mother and baby. Yet, ACOG still insists on the use of EFM as standard care.

They also state in this section that after the 1970’s VBACs gained popularity. By the mid 1990’s the rates of VBAC (28.3%) were such that it was actually reversing the cesarean rates. However, this increase in VBACs seemed to come with an increase in uterine rupture – though the literature does not state what sort of uterine scars were common (since certain types are known to have more risk, such as classical), whether induction was used, or what type of rupture occurred (most ruptures are not catastrophic but are instead considered a “dehiscence”). Due to this increase in ruptures, the case for VBACs was again set back to “once a cesarean, always a cesarean” in many practices. They finish this section by stating that it is known that liability is a large part of why VBAC is not offered to many women who are actually good candidates.

Now we get into the nitty-gritty of what they say about VBAC. I am going to take questions and statements from the document to break this down. All noted pages are from the Practice Bulletin unless otherwise stated or linked.

  • What are the risks and benefits associated with TOLAC? (p2)
    • Neither an Elective Repeat Cesarean (ERC) or a TOLAC are without risks.
    • Most maternal morbidity that occurs during TOLAC is related to a failed attempt when a cesarean becomes necessary.
    • VBAC is associated with fewer complications than an ERC.
    • Thus, the risk of a VBAC really comes down to whether it is achieved. If it is a “failed” TOLAC it has more risk than an ERC, but if it succeeds, it has lower risk than a ERC.
    • The main risk of TOLAC/VBAC is a uterine rupture. However, as stated in the background, some studies do not give background information about what type of ruptures are occurring nor on what type of prior incision or induction methods.
    • They include a chart of maternal risk in this section and it is interesting to note that maternal death risk can be almost double (0.2%-0.4%) with a ERC compared to a TOLAC after one prior cesarean (0.2%), and that TOLAC with more than one prior cesarean had no death risk within those studies. It is also noted that a ERC also comes with the risk of uterine rupture (0.4%-0.5%).
    • It is noted that for families wanting several children a successful VBAC takes away the risks of multiple surgeries which includes hysterectomy, bowel or bladder injury, transfusion, infection, and abnormal placentation such as previa and accreta.
    • They include a chart of neonatal risk factors when comparing ERC to TOLAC. It should be noted that there is no significant increase in neonatal death or neonatal admission (NICU admission). We see a much higher rate of respiratory distress (1%-5% vs. 0.1%-1.8%), transient tachypnea (too much fluid in the lungs which causes breathing issues) (6.2% vs. 3.5%) and hyperbillirubinemia (jaundice) (5.8% vs. 2.2%) in babies who go through an ERC.
  • What is the vaginal delivery rate of women who have a TOLAC? (p3)
    • Most studies show a 60-80% success rate.
    • Studies show a decrease in success if the same circumstances happen again, such as stalled labor, which lead to the first cesarean  (however, I will note that the definition of “stalled labor” is more likely the issue than anything else).
    • The chances of success are increased if the mother has spontaneous labor with no augmentation.
    • One VERY interesting note is that being “non-white ethnicity” lowers your chances of success. This speaks to the huge disparity in maternity care in ethnic groups in this country. Simply taking one look at the maternal mortality rate in non-whites gives a clear and horrible picture of this undercurrent in our maternity care system.
  • Who is a candidate for VBAC? (p4)
    • The best candidate is one in whom the risks and benefits balance out in a way acceptable to the client and care provider, this may be different for each woman and there is no specific “formula” to come to this answer.
    • Decisions about the first VBAC should be considered with future pregnancies in mind. This is due to each subsequent cesarean increasing the risk for future pregnancies, and the inability in some areas to find care providers to attend a VBAC after multiple cesareans.
    • For most women with one prior cesarean and a low transverse incision VBAC is a good option and they should be counseled and offered a TOLAC. Women with other incisions (T-incision or classical) or with prior ruptures and surgeries of other sorts to the uterus should be evaluated more.
    • Individual factors should be considered in all cases (i.e. – no hard and fast decisions to ruling mothers out of VBAC), and in the case of women presenting in labor, VBAC should be strongly considered as spontaneous labor increases the success rate of a TOLAC.
    • More than One Prior Cesarean:
      • Studies addressing TOLAC in women with more than one prior cesarean find rupture rates ranging from o.9% to 3.7% – again, without specifying the type of prior incision or level of rupture. They also have not consistently compared these findings directly to women with only one prior cesarean.
      • One large study in particular found no significant increase in rupture between VBAC and VBAMC (vaginal birth after multiple cesarean) – o.7% vs. 0.9%. A second large study only found a slight increase – 0.9% vs. 1.8%. They also found no significant increase in morbidity.
      • The chances of success are similar to that of a VBAC after only one cesarean.
    • Macrosomia (Big Baby):
      • Some studies show a decreased chance of success with a baby larger than 4,000g, and posibily higher rupture rates. However, these studies are based on actual birth weights, and not the estimates given before birth. This is significant given the inability to accurately predict birth weight before the birth.
      • Suspected macrosomia alone should not rule out TOLAC.
    • Gestation of more than 40 weeks, according to the largest study done which looked at this factor, does not increase risk. There is evidence that after 40 weeks chances of success decrease but we must consider that induction of some sort may be common at that point (given current practice trends) and that lowers the chance of VBAC in general. Gestation of more than 40 weeks should not rule out TOLAC.
    • Previous Low Vertical Incision:
      • Studies show similar rates of success compared to low transverse incisions (the most common).
      • Studies do not show increased risk of rupture or morbidity for mother or baby.
      • Studies are limited, but a low vertical incision should not rule out VBAC given the current information.
    • “Unknown” previous uterine incision should not rule out VBAC. The two large studies done at large tertiary hospitals show that there is no increase in rupture rates or morbidity, and success rates are similar. Unless there is a high clinical suspicion of a complicated previous uterine incision TOLAC should not be ruled out.
    • Twins Gestation:
      • In all studies available it is shown that in women with a previous low transverse incision there is no increase in risk to VBAC a twin gestation.
      • Success rates are similar to those of singleton mothers. Twin gestation should not rule out TOLAC.
  • How does management of labor differ in a VBAC? (p5)
    • Induction of labor for maternal or fetal factors remains an option for TOLAC. However, the increased risk of rupture that comes with any induction and the decrease in success rates should be discussed.
    • One large study of over 20,000 women found that rupture rates increased slightly with induction. Spontaneous labor had a 0.52% rupture rate, non-prostaglandins induction with a 0.77% rate, and with prostaglandins a rate of 2.24%. However, again the types of rupture were not specified and the context of the inductions are not known (unfavorable cervix, need for multiple induction methods, etc).
    • Another study of over 33,000 women found a slight increase in rupture (o.4% for spontaneous labor, 0.9% for augmented labor, 1.1% for oxytocin alone, and 1.4% with the use of prostaglandins). An analysis of this same study noted an increase in rupture rates when the highest levels of pitocin were reached, however no upper level of dosing has been decided for VBACs.
    • Studies done on the risks of misoprostol (cytotec) show an increase risk of rupture and should not be used for TOLAC. (Actually, it increases risk of rupture in ANY mother so it should not be used for induction, period.)
    • Due to the small absolute risk found in several studies, ACOG notes that use of pitocin for labor augmentation is not ruled out for VBAC.
    • Mechanical cervical ripening (such as the foley bulb) are also considered acceptable for labor augmentation/induction in VBAC.
    • ECV (External Cephalic Version), such as to turn a breech baby, are not contraindicated in a woman who wishes to VBAC.
    • Epidural/Analgesia use is not contraindicated and studies show it does not effect success rates. However, epidural use in general is shown to increase the chances of cesarean in all mothers. (to view that study, right click and select “copy link location” and input into google)
    • Electronic Fetal Monitoring is suggested since the main sign of uterine rupture is abnormal fetal heart rate (up to 70% of cases). It is noted that internal monitoring does not help in diagnosing ruptures.
  • How should future pregnancies be managed after uterine ruptures? (p7)
    • If the rupture is in the lower segment of the uterus, the chance of another rupture is 6%. In the upper sections of the uterus it is around 32%.
    • ACOG suggests an elective cesarean for births after a rupture.
  • How should women be counseled about TOLAC/VBAC?
    • Each woman will weight the risks and benefits differently. Therefore, the options should be discussed at length and documented.
    • Counseling should always consider the future plans for more children and discuss the risks of multiple uterine surgeries. Women should also consider that family plans can change or there may be unexpected pregnancies.
    • After counseling the ultimate decision should be made by the client. Global mandates (aka – hospital wide) should not be made as they do not consider the individual factors and wishes of each client.
  • What resources should be available at a facility where a woman will VBAC?
    • The previous suggestion of ACOG was that VBAC should only be offered in facilities with “immediate” access to surgical facilities and staff. However, this severely limits the locations where women could VBAC.
    • ACOG now suggests that care providers and clients consider the facilities available, their individual risk factors, and the availability of other locations where more resources are available.
    • Health care providers and insurance companies should do all they can to facilitate women in achieving VBAC through transfer of care or co-management of care.
    • If there is no way to transfer care, a woman’s autonomy should be respected. If a woman wishes to VBAC in a hospital without immediate access to surgical facilities steps should be taken early in care to develop a plan of action in case of rupture.
    • It should be noted that coercion into a repeat cesarean is not appropriate. A policy of not allowing TOLAC at a facility should not be used to deny care or force a woman into a repeat cesarean. If appropriate, transfer of care should be arranged to a facility and care provider who is better able to support TOLAC.

Now I would like to take a moment to talk about the notion of only “allowing” VBACs in facilities with immediate access to surgical teams and facilities. Lets compare the risk of rupture, 0.7% in most studies, which is not always catastrophic, to the risk of other obstetric emergencies. Cord prolapse, a very dangerous situation in which the cord proceeds the baby down the birth canal and gets pinched, occurs in about 0.28% of births. This situation requires immediate access to a cesarean in most cases. Placental abruption, another very serious complication, occurs in about 0.7% of pregnancies. This also requires immediate access to cesarean in almost all cases. Notice that the risk of abruption and the risk of rupture are the same. The rate of shoulder dystocia, which is considered an emergency that may necessitate a cesarean (or an instrumental birth) is around 1.29% though some studies report it at higher rates in the current birth climate.

Now looking at the rates of these complications, which are on par with the risk level of rupture, we have to wonder why ALL hospitals offering birth services are not required to have immediate access to a cesarean. After all, placental abruption happens with the same frequency and can happen in any pregnancy and ACOG does not seem to be concerned that EVERY pregnant mother does not have access to immediate surgical care. At the end of the day, the risk/benefit analysis needs to be decided by the mother and what she feels comfortable with since the rate of rupture is comparable to the risks of any pregnancy and birth.

The point of this article is not to suggest any particular course of action for every mother. This is about giving you the facts to make your own decision. This is about looking at what ACOG really says about VBAC/TOLAC and not just what your doctor tells you they suggest. Arm yourself with information and consider your own personal factors and Birth Without Fear, no matter how you choose to birth.

Why Don’t You Write Your Birth Story? (Follow-up to Why Should I Write My Birth Story?)

Why Don’t You Write Your Birth Story? (Follow-up to Why Should I Write My Birth Story?)

About a month ago, I wrote a post about a topic near and dear to me: birth stories and the women who write them. I shared the words of BWF mamas who had written to me about some of the benefits of and their motivations for writing their stories. All so beautiful and insightful. These were women who had reached deep inside themselves to put into words one of the most intense and personal of human experiences. Many had already submitted their stories to Birth Without Fear. I couldn’t really share my own wisdom on this topic because, you see, I had nothing to share. Apparently, I’m the kind of person who would rather write about women writing their birth stories than actually, um, write my birth story.

Young writers are forever being told to ‘write what they know’ so here I am, doing just that. From the emails and Facebook comments of BWF mamas, from my own experience, and the words of Shani Raviv, writing coach (full disclosure: I just finished Shani’s awesome birth story writing workshop and am now convinced that I should spend the rest of my life in a Berkeley yurt), here are some of the reasons women don’t write their birth stories. And, at the end, a few tips and tricks for making the process just a little bit easier.

Josephine

When it comes to writing birth stories, what holds us back is…

1. Time – or a lack thereof.

“…[N]ew mothers get sucked up by the busy-ness of mamahood, of pacifiers and poop, sleep deprivation and breastfeeding, time management and care-taking and we all too easily dismiss or forget the life-changing, life-giving experience of birth … In my first few weeks postpartum I felt bruised and battered like my belly was disconnected from the rest of my body, like I had been hacked in half and there was a space where my belly used to be and I was wrapped in a halo, an aura of peace, of love, of endorphins, of fight or flight, of protecting my new cub while needing to be mothered myself by my doting husband. It was so full-on that I had to set an intention to create time to sit down and write my birth story.” Shani Raviv

“Ohhh I should write mine…if I ever get time.” – Laura P.

The post partum period. That time of new babies and new bodies (including your own), of steep learning curves and getting to know this little one you brought into the world. If you’ve been following my writing on Birth Without Fear, you’ll know that the post partum period is particularly hot topic for me (see Mothering the Mother: 40 Days of Rest) and I think women should get all the support they need throughout it. And, in fact, up through raising their children. It’s hard to find a moment to yourself when you’ve had a baby in the last ten years, and I think this was the biggest factor in my own avoidance. It seemed like a big task; I wanted to do it ‘right’; I wanted more than five minutes here or there to really sort through my feelings about the birth.

2. PPD.

“I don’t even remember writing mine. I was so deep in PPD. It sounds like a happy mommy sharing her birth story but at the time I wanted nothing more than to hide from motherhood.” – Brit M.

If you’re suffering from Post Partum Depression, it’s difficult to think about, express and relate any experience at all – never mind one that is so deeply connected to your depression. Sometimes women need time to recover from a stressful birth, or find that their memories have been intruded upon by other factors, such as medical interventions or pre-existing illness.

“I didn’t write my first birth story because it was a negative uneducated experience. I forgot many details of it because of not writing it and being on pain medications.” – Melanie W.

3. Trauma.

“I wrote my daughter’s but still can’t bring myself to talk much or write about my son’s.” – Nichole F.

“I still haven’t been able to. I break down every time and I’m a sobbing mess… Still just too much. One day soon I hope!!” – Jennifer K.P.

In ‘Why Should I Write My Birth Story?‘ I wrote about the value of narrating a traumatic experience. Doing so helps us to gain control of the events in our minds, to order them and to see them as they were. But it’s not easy. Remembering the details of a traumatic birth and re-experiencing it can be terrifying and sometimes even damaging. For many women, the very thing that helps is also the last thing they want to do; if this is your situation, please know that it’s OK. You don’t have to write your birth story right now. Wait until you feel safe. Wait until you have found someone you trust to talk to while the memories resurface. Be as gentle with yourself as you are with your little one.

“It took me over five years to be able to write my first birth story without bursting into tears. My midwife for my second pregnancy helped me move past it, I knew I’d never birth the way I wanted to with my second if I didn’t.” – Jennifer B.

4. Reckoning.

“Writing mine was kind of disappointing, and reminded me of what I would like to be different next time around (which is pretty much everything).” – Mellysa N.

On  a similar note, the act of writing down one’s experience is tantamount to admitting that the experience happened. Even if the birth was not traumatic, writing it out can be discouraging if a mother hasn’t been honest with herself, or had expectations that were not met. For me this has most definitely been the case. Before giving birth to my son, I would get a little mad at people who talked about birth as a sacred experience. I thought things like, it’s just a thing you do, and women have been doing it forever, and stop making it something it’s not. While I was in labour, I worried about staining the sheets of the Birth Centre bed; in between pushes, I made jokes with my mom. It wasn’t until after the birth that I started to see how deeply I had been affected by it. I now believe that birth is a spiritual, sacred event. I’m all about it and – wowza! – I’m pregnant again. This time, I’m having a Mother’s Blessing, I do birth meditations, I have a birth altar, and all that jazz. Looking back at my first, almost mundane birth experience and putting it into words has been difficult. It’s like I’m writing the experience of another person. Because, in that time, I was.

5. Feeling the story is not important or valuable.

“I had an epidural, so it was nothing spectacular.” – Britany S.

“My son’s was a great experience… but there’s a lot I wish I’d have done differently, and more people are interested in a natural birth anyway.” – Briana G.

There is a persistent misconception about birth communities. This is that women interested in natural birth are only interested in natural birth. That they look down upon women who choose or accept medical interventions for themselves and their babies. I am sure that those jerks do exist. But I (practically an expert on jerks) am happy to say that although I am immersed in natural birth communities, I have never met one. Instead, I have met women with a range of experiences, all with these three things in common: they love babies, they love women, and they love birth.

Many women feel that because their birth was not what they expected, or not natural, or not vaginal, that it is not worth narrating or sharing. Nothing could be further from the truth. At Birth Without Fear, we believe that every woman’s birth story is valuable. Yes, you, the one reading this who thinks that her birth was kind of ‘meh’ and what would people say if they knew I wrote it all out, your birth experience is important! You can write it down! We want to read it!

6. Fear of others’ criticism:

“I was nervous how some would react to me posting my story for everyone to see, especially family. Birth is not something we talk about freely enough…Surprisingly, I’ve received nothing but positive feedback for posting my story. Friends (and strangers) have emailed me and told me what a blessing my story was to them.  What an encourragement it was to them to know that you can have peace with a labor gone awry.” – Kim G. (read more here)

“I worry that people will judge me for using natural induction methods at only 38 weeks, even though I had my reasons and in the end my water broke before labor started anyways. In my actual birth story, I forgot to include how far along I was, but since I’m worried what people will think of me I’m glad I left it out.” – Breanna

Birth is a deeply personal, emotionally intense experience. It remains a taboo topic for discussion in our society. And the internet is full of haters. So it is no wonder that women shy from writing and sharing their stories, anticipating the negative response that, unfortunately, some do receive. If this is a fear that’s stopping you, know that you do have some control of the path your story takes out into the world. In fact, you don’t have to share your story with anyone. Perhaps you’re writing it for your child – in that case, he/she is the only person who really needs to read it (and you can bet they’re not going to be too critical).

But if you want to share it online, consider what forum would feel the best for you. Anonymously, on your own blog? Privately, with only a few Facebook friends given permissions to read it? Or on a large-scale, by submitting it to a birth blog? Consider the atmosphere in which you are releasing your story. Some blogs and FB pages allow all comments to be posted, even those which are cruel and abusive. Others take a more moderate approach; Birth Without Fear lies on the other end of the spectrum. We only allow supportive comments and this, to me, is a kick-ass use of the delete button.

7. Fear that sharing one’s own story will shame or intimidate other women.

“The really crazy thing is I am beyond proud of my birth. I am extremely happy with it…and I think that is the big problem. For you see, I am not afraid of scaring other women with a horror story of a birth, but instead somehow shaming them or worse, giving them false hope with a story of what was in my mind a perfect birth. I know, I know it’s ridiculous.” – Patrice N.B. (read more here)

Some women feel that if they delve into the depths of their story and acknowledge how powerful or transformative it was, they might offend or inhibit other women from sharing their own. In the insecure and judgmental world that American motherhood has become (are you mom enough? or are you just, like, a regular mom?) this fear is understandable. But the truth is, there is room for all of us. And all of our stories.

Of the 352, 500 babies are born around the world each day (that’s one every eight seconds!), only a small fraction of births will be recorded and shared. By sharing your own you are not taking up space from someone else to share theirs. And as Ina May Gaskin has reportedly said, birth horror stories spread like wildfire; we should not be afraid to allow positive birth stories to spread like wildfire, too (from a comment on Patrice N.B.’s blog).

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As I read over this blog post, I realize that I have become ever more preachy while writing it. If that bothers you, stop reading because this next section is all advice. But, to be fair, some of it comes from you.

Here are some tips on how to write a birth story you love.

1. Don’t worry about getting it technically accurate. Write what matters to you.

“The details that women often don’t mention are those personal, colorful, emotional descriptions that make their birth story unique, personal and non-generic. It’s the same details that you would utilize for any creative writing: the five senses, metaphors, rhythm, color, description, detail, pace, show don’t tell etc. It’s these techniques that make writing come alive. And because one’s birth story really is such a deeply personal narrative it needs to be written in the teller’s authentic voice, to convey the emotions of the experience––the joy, pain, fear, elation––and be honest, vulnerable and real.” – Shani Raviv

Birth has been removed from its sacred, personal context and placed into the realm of science. As some believe, “Birth is a medical event”. Even if your birth experience was framed in this way, the way you write about it doesn’t have to be. Include your feelings. How you really felt. Birth is an intense experience whether it’s full of excitement and magic or pain and distress; don’t focus too much on the technical jargon or numbers, unless they are what is personally most meaningful to you. As Shani says, “Most people don’t even know what a contraction or dilation is. I had no clue what it was before I birthed or before my midwife educated me about my own body.” And I can tell you from my experience, a birth story that relates your own unique experience will definitely be more fun to write.

2. Don’t feel you need to tell everything in order.

“Everything was so intense and magnified in my mind, it was hard to put down!” – Martha F.

While a linear progression through time is the most obvious way to relate your birth story, it’s likely that you don’t remember it in that way at all. Time changes for women in birth as we go deep inside ourselves, the divine, or simply la-la-labourland. Your writing can reflect that.
3. Feel free to write about events other than the birth.
“Writing my birth story was a life-changing event, but it all started even before by birth.” – Anna Sawon (Editor of this Polish birth blog)

You can include things that happened outside of the birth in your birth story. If you start thinking about some other important event (say, how you met the baby’s father, or the things your mother said about her birth), consider including them. If they’re important to you, they will probably be interesting and valuable to the people who read your story. This is especially true for mothers whose babies had to spend time in the hospital, and who often feel that the birth story is incomplete without a recollection of those events as well. Birth does not take place in a vacuum.

4. Know that you have time.

“I was in such a rush to get it in writing afterwards, I’m now kind of embarrassed when I read it because it just doesn’t flow well. I’m usually a really good writer (IMHO) and my birth story just seems rushed and jumpy to me.” – Breanna.

You don’t have to write your whole birth story the day after it happens. After all, you probably have other things to worry about. Write down the small details you want to remember about the birth as soon as you can. Don’t worry so much about the biggest events because those you are more likely to remember. The little moments – the way your partner rubbed your back, the strange thought you had as they wheeled you off to the operating room – may disappear with time.

“It took me almost a year to write it!” – Amanda S. (read her story here)

5. Know that it doesn’t have to be perfect, in its first draft or ever.

“I actually wrote it 3 different times because I’d forget the little things that seemed so important that day and I just had to add them when I would remember.” – Jennifer C.

Don’t be afraid to write a little, leave it, and come back. This is how most writers work. And it’s also pretty much a necessity if you’re the primary caretaker of your little one.

“It took me about 2 months to write my birth story.  I exclusively breastfed my daughter, so feeding her was a very demanding part of my life.  Not to mention sleeping, diapers, showering, etc.  I took every chance I could to type, doing most of it one-handed!” – Debbie W.

6. Consider who you are writing the story for.

Is it for your child? Your partner? Other women? Or for yourself? This is an easy way to narrow down the focus of this unwieldy task, as it guides the language you use and the details you include.

7. Aak others what they remember.

“…[W]hat I love most is hearing of my births from someone else’s POV… it’s so strange to hear things you don’t remember, but awesome, too.” – Rachel H.

“…[A]s a birth doula I often write up a story for the couples I work with. I note times and major events in the birth, to give the mom a framework to insert her own memories and experiences… I also write down funny moments, jokes, or things that make their birth unique. And I describe from my perspective [the] moments of beauty or tenderness that stick out to me.” – Michelle H.L.

It can be interesting and valuable to hear what other people experienced while you were giving birth. You may want to ask your midwife, OB, or doula. Your partner themselves may want to write or contribute to the story of their child’s birth.

8. Let it go.

“I even printed it out and placed it in my daughter’s baby book so she can look back and read about the day she was born.” – Jennifer C. (read her birth story here)

When you have finished writing and editing your story, consider doing something to bring conclusion to the process. If your birth was traumatic, the concluding element is an important one. Burning, burying, and casting out into the sea are all ways to allow the story to leave your body. On a less cathartic note, some mothers find resolution through publishing their stories online; for others, printing and having it bound is a way to finish the task and preserve the story for future generations.

 

So, in the end, did I write my son’s birth story? Yes. Is it finished, perfected, in more than a piece-meal draft phase? No. But when it is, I’ll let you know.

 

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