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I Am Strong – Cesarean Birth After Neonatal Loss

I Am Strong – Cesarean Birth After Neonatal Loss

*trigger warning*

I am strong because in April of 2012, I gave birth to a precious baby girl named Evelyn, prematurely at 24 weeks due to incompetent cervix, premature labor, and infection.

I am strong because I endured a frightening classical c-section 4 hours after entering the hospital with a smile on my face, knowing it was the best chance my baby had to survive.

I am strong because I was told I will never have a future vaginal birth due to my vertical incision, and I would never be allowed to go into labor for fear of rupturing my uterus.

I am strong because I spent every single night in the NICU watching my tiny 1 pound 5 ounce, 11.75 inch long daughter through a plastic window, unable to hold her.

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I am strong because I pumped breast milk for her every 3 hours.

I am strong because at 5 weeks and 3 days old my little girl developed an infection called NEC, and within hours of its discovery, it took her life.

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I am strong because I held her for the first and only time as she was passing away.

I am strong because throughout the most horrifying time of my life I was able to plan a beautiful funeral for my baby, something no mother should ever have to do.

I am strong because 4 weeks after she died, I donated all of my pumped breast milk, roughly 600 ounces, to a milk bank  to help babies like her.

I am strong because 1 year and 9 months later I discovered that I was again pregnant, I was elated.

I am strong because I was considered high risk and went to many, many extra appointments.

I am strong because at 13 weeks and 5 days I went into the hospital to have a preventative cerclage placed in the hopes of getting me to full term.

I am strong because I was placed on modified bed rest for over a month, but I took it upon myself to continue bed rest as much as I could throughout the entire pregnancy.

I am strong because I was given weekly progesterone shots.

I am strong because despite the constant fear of losing another baby I decorated a beautiful nursery for our second daughter.

I am strong because at 6 months I was diagnosed with gestational diabetes.

I am strong because I gave up all of my favorite foods, took medication, and drew blood up to 5 times a day to control it.

I am strong because I held my breath during more than 21 ultrasounds, expecting to hear the worst each time.

I am strong because at 37 weeks to the day, 3 days after my cerclage was removed,  I began having contractions that eventually were 2-4 minutes apart.

I am strong because I finally realized they were not Braxton Hicks and had my husband drive me to the hospital.

I am strong because I was given 4 pills of Procardia to help relax my uterus, but the contractions continued to get more intense.

I am strong because after 3 or so hours of contracting in the hospital I was told I would be having my cesarean that night.

I am strong because at 8:08pm, just one minute later than my first daughter’s birth, my second beautiful girl, Emily, came screaming into the world at 6 pounds 5 ounces and 19 inches long.

I am strong because during her birth my doctor discovered that my previous incision scar was thinning, and had I not gotten to the hospital when I did it would have eventually ruptured, and endangered both of our lives.

I am strong because I heard over the curtain the doctors exclaim that Emily had a true knot in her umbilical cord and her cord was wrapped around her neck, but thankfully neither affected her health.

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I am strong because my baby had to spend 5 days in the NICU, due to being slightly premature and having jaundice, a place I thought I would never have to visit again.

I am strong because I was finally able to bring our baby home from the hospital.

I am strong because I have two beautiful girls, one on Earth and one in my heart, to motivate me to be the absolute best mother that I can be.

From Katariina Shoemaker

A Mother Will Overcome {I Am Strong}

A Mother Will Overcome {I Am Strong}

A short and sweet story of a teenage mother, or just a mother, this is Jada’s story:

I am strong because I found out I was pregnant at 17, two months into a relationship, and decided then to keep the baby.

I am strong because I decided to end the relationship, because I wasn’t happy anymore.

I am strong because during my pregnancy, I went through the worst depression in my life a month before my son was born.

I am strong because I had my mother and my aunt in the birthing center room to support me while I went through with my natural birth, which showed me just how strong I was.

I am strong because I pushed for an hour (which felt like only five minutes) and gave birth to a 8 lb. 8 oz. healthy boy and picked the name of my son when I met him for the first time.

I am strong because despite the criticism on bed-sharing, I am proud to say I have slept beside my son every night since he was born, and have no plan to stop.

I am strong because I overcame my fear of breastfeeding in public despite my overwhelming social anxiety, and plan on weaning when he is ready.

I am strong because I suffer from postpartum depression and am raising my son, alone, the way I feel is right for the both of us.

I am strong because I am going through with getting my high school diploma so my son and I can have a good future.

I am strong because now, at 19 years of age, I am where I want to be and have great plans that I see myself accomplishing in the future.

Brandon

10 Tips to Plan a Mother’s Blessing

10 Tips to Plan a Mother’s Blessing

A Blessingway is a sacred pre-birth ceremony that has traditionally been performed by Navajo people, and celebrates a woman’s rite of passage into motherhood.

Today, a gathering known as a ‘Mother Blessing’ is gaining popularity in North America. Unlike a traditional baby shower where the focus is on gifts, a Mother Blessing puts the focus back on nurturing the woman. A woman’s closest girlfriends and family gather in love to build up her mind, body, and soul in preparation for her journey to motherhood. It is intended that the mother-to-be leaves bursting full of love, strength, confidence, and belief in the ability of her body to birth her baby.

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HOW TO PLAN A MOTHER BLESSING:
Keep the preferences of the mother-to-be in mind; after all this event is about her. Make her feel as comfortable as possible. Not all mothers will be into all the ideas below, so choose a few that best suit her.

(1) Pampering
Make a foot soak, and offer her a hand massage, foot massage, or back massage. This can be a beautiful time for her to sit and relax and have her friends take turns laying hands on her and transferring as much loving energy to her as possible.

(2) Flower Crown
Make the mother-to-be a flower crown to celebrate her beauty. Ask each woman coming to bring a flower from their garden to contribute to the crown when they arrive or just have a selection of stems for each attendee to choose from when they arrive. If you want to celebrate all of your attendees, you might want to have everyone make themselves a flower crown when they arrive.

(2) Paint Her Belly
Painting her belly, henna, or a belly cast is a beautiful way to celebrate the life inside her. Let the art radiate the life she carries.

(3) Circle Time
Gather all the woman to share a blessing with the mother-to-be. It can be a time to share their best mothering wisdom, an inspirational verse, or a song. You can meditate together, belly dance together, or sit and laugh and tell your favourite birth stories.

(4) Leave Your Guests Thinking About the Mother-To-Be.
During circle time, a beautiful activity can be binding everyone’s hands together in ribbon. After praying over or blessing the mother, each attendant cuts herself a small piece of ribbon to wear on her hand until the mother-to-be goes into labour. Every time they glance at the ribbon on their hand, they can send up a prayer for their friend’s upcoming birth. Once the birth begins, someone texts out a message to the rest of the group and they all cut off their bracelets together in solidarity. Another send home gift could be a candle that all the friends light when they hear the birth has started.

(5) Bead Ceremony
Ask attendees to bring a special bead to create a necklace for the mother to wear in the last few weeks of pregnancy and during birth.  After each attendee offers their blessing, they can string their bead onto the mother’s necklace. She will be reminded of the love and support she has in her community of friends every time she looks at each individual bead.

(6) Birth Flags
Have some plain cloth banners for attendees to paint with encouraging words and phrases. The mother can string these in her home and have them be a reminder of her strength leading up to birth. This is a great option for women planning a home birth since she can decorate her birthing space with them. Some women who are planning a hospital birth and may also want to bring their birthing flags to hang in their hospital room.

(7) Stone Painting
Ask each attendee to bring a stone that you will paint with encouraging words for the mother. The mother can place the stones in various spots in her house (one by the bathroom sink, one by the kitchen sink, one by her alarm clock) or place them together in an encouragement altar. Seeing these stones will remind her of her strength leading into birth.

(8) Bring Gifts for a Birth Altar
A birth altar serves as a focal point for the labouring woman. Sometimes it can be difficult to stay focused on the positive affirmations you read and meditated on during pregnancy, so the woman can focus her attentions to her birth alter to give her visuals of her end goal- her baby. Items for a birth altar can include a birthing goddess, ultrasound pictures, positive words, aromatherapy, candles, and any imagery that you find beautiful and inspiring.

(9) Eat!
Of course, sharing a meal with friends is the best way to relax and enjoy each other’s company. Ask your guests to each bring a dish to contribute to a potluck meal.

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(10) Let The Emotions Flow
Be open and transparent with each other. Share your joys and your struggles. Don’t be scared to let the tears roll.

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After all of this love and attention, the guest of honour is sure to leave bursting at the seams with good birth mojo.

Written and Photographs by: Cradled Creations Birth Photography.

Also at www.CradledCreations.com

My Healing Hospital VBAC

My Healing Hospital VBAC

To tell Mel’s birth story, I have to say a few words about Katherine’s and Laeney’s birth stories.

Laeney’s birth was a hospital induction. At my final ultrasound, my doctor told me my placenta was failing and she was losing weight in the womb. They told me she would only be 4 lbs and might have to be transferred to a NICU 40 miles away. She was born, healthy, weighing 6 lbs 3 oz and although I didn’t suffer any adverse effects, I felt cheated. I didn’t even get to go into labor on my own and desperately wanted something different for my next baby.

Nearly 4 years later, during my pregnancy with Katherine, I knew I wanted a homebirth. I dreamed of bringing our baby earthside, surrounded by my friends and family, in the peace and love of our own home. Unfortunately, I ended up with a nightmare instead. My water broke at 25 weeks and we had a traumatic emergency c-section at 30 weeks due to an amniotic infection, followed by a 46 day NICU stay. My c-section was brutal. The spinal block was only effective on one side of my body and my daughter’s heart rate was dropping, so they cut me anyway, even though I could feel it. Once she was delivered into the hands of the NICU team, I completely lost my composure and started screaming uncontrollably and flailing on the operating table trying to escape from the pain. The anesthesiologist put me under and I woke up in recovery terrified for my baby. When I was finally able to see her, I could only hold her for a few minutes. I’ve never cried so much.

I grieved for my pregnancy. I grieved over my birth. I grieved for my child’s start in this life. I grieved over leaving her in the NICU and having to go home, 40 miles away. I hated my body for doing this to my child. For doing this to me. I agonized over what I could have done differently that would have kept her inside me even one day longer. I would break down sobbing when I saw other pregnant women in public. I felt jealous and cheated and angry.I suffered through PPD and PTSD and remember very little of my daughter’s first year on this earth.

Fast forward three years and we found out we were pregnant with our third child. In my heart, I was terrified of going back to the hospital and desperately wanted a healing homebirth. But my husband was so traumatized by Katherine’s birth, he didn’t want to take the risk of staying home. So I found a midwife group that supported my decisions about my care and forged ahead, planning a hospital VBAC.

It was a terrifying, nerve wracking, healthy pregnancy. I had nightmares from the day I got that positive test result. PTSD is rough, and the triggers never really go away. We had lost two babies between Katherine and Mel, so I breathed a little easier at 12 weeks. We were out of the worst danger zone and baby was still hanging in there. When we passed 24 weeks (the age of viability), my fears eased even more. 25 weeks, 2 days, the day my water broke with Katherine,it seemed like I held my breath all day. Then 30 weeks came and went without a hiccup. (Well, with lots of in-utero, tickly baby hiccups, but you know what I mean.)

My husband and I both slept a little better once we passed that milestone. At that point, we were finally able to really embrace our pregnancy. We were having another little girl and it looked like she was going to go all the way and be big and healthy!!

I was beside myself when we made it to 36 weeks. I couldn’t believe my body was doing it! I was growing a big healthy baby and nothing was going to stop me from bringing this baby earthside, peacefully and naturally, with my husband and midwife. Yeah!

Until my 36 week appointment. I found out my insurance had dropped my coverage. So, at less than a month til my EDD and 3 days after Christmas, I was on the phone every day trying to get things straightened around. And every person that I talked to had a different reason to NOT put me back on my insurance. Without coverage, my midwife group dropped my care. I was terrified. What would happen when I showed up to the hospital in labor, with no midwife and no insurance? Would they force me into another c-section? Would they call child protective services on me for not having prenatal care for the last month? I decided to just show up at the hospital, basically ready to push this baby out. I would rather have her in the car on the way there, than be faced with another c-section.

Feeling pretty empowered, my pregnancy progressed past 39 weeks (woo hoo, FULL TERM!!!) I had gained 40 lbs and was so big, people (including my mother) insisted every single day that there must be twins, and one was just hiding on the ultrasound. The Saturday and Sunday after I hit 39 weeks just felt different. I was even more tired than usual. Having a lot of gross discharge. Only sleeping a couple hours at a time because my hips hurt so badly. Just being generally miserable. It was January and we had a winter weather warning, it was supposed to be -40 degrees F with the wind chill. My husband worked outside and requested that I have the baby on Monday so he wouldn’t have to go to work. He even talked to my belly and asked the baby to please come on Sunday night. HA! Ask and you shall receive, husband!

Saturday and Sunday I was having weak, lame-o contractions 10 minutes apart all day and all night. They were annoying, but not painful, but they were making my back really hurt. I bounced on the birth ball and walked around as much as I could in the house, but nothing really happened yet. So around 7 o’clock Sunday night, I broke out my breast pump and I power pumped for 40 minutes. I got 4 oz of colostrum (seriously, 4 oz before the baby is even born?! Who does that?), but no stronger contractions. They did pick up a little, going from 10 minutes apart to seven minutes apart. After the pumping, contractions spaced back out to 10 minutes again and I got discouraged, told my husband it wasn’t happening that night, and we went to sleep around 11.

3:34 am,WHOA! Umm, ouch! Calm down in there, baby. I thought you weren’t coming tonight? Since I felt like my bladder was about to burst, I got up, peed, and climbed back in bed. I had a mild contraction while I was up. As soon as I laid back down, another crazy one ripped through my body. Holy crap! This might be it! I started timing them. Two minutes later, another one hit and lasted a whole minute! 2 minutes later, another one! And another one after that! WOO! I woke my husband to tell him that I was in labor and he freaked out.

“What?! Is it time?! Are we going to the hospital now?!” I told him to calm down, that I wanted to labor at home until I felt it was time to go, and to go back to sleep. Honestly, I just wanted to be alone with my baby to center myself and power through those awesome contractions. I was beyond excited. I had never gone into labor on my own and I was really curious what it would be like.

I walked back and forth in the living room and swayed over a side table and hummed through each contraction. I got on Facebook and updated my private mom groups and I texted my best friend. I felt amazing and powerful and beautiful. I imagined my baby inside me, poised, ready to meet the world. In my mind’s eye, I saw my cervix glowing bright and hot as each contraction pulled it open a little more.

An hour passed like that. I called my sister down to make me a snack but couldn’t eat more than a couple bites. I ran a warm bath to try to take the edge off the intense back pain that was coming with each contraction. But I couldn’t stay in the tub longer than about 10 minutes. My body wanted me up and moving! Around 5:30 I woke my husband up and told him it was time. He ran around like a crazy person, grabbing all of our things I wanted to take with us. He went out to start the car since it was so cold and my mother called and wanted to talk to me. A contraction hit and I just yelled at the phone and threw it back at my sister. “She doesn’t really want to talk right now.” I heard her say. Then we got in the car.

That was the most painful drive ever. I couldn’t move through the contractions. I was vocalizing loudly and started to feel out of control. I felt pinned to the seat by the pain. And they were coming hard and fast, only a minute apart and a minute long. I wanted to climb out of the car and run away. We had just had an ice storm and the roads were AWFUL. The 15 minute drive to the hospital took 40 minutes and we arrived somewhere around 6:30. We parked in the garage and headed up to labor and delivery. My husband grabbed a wheelchair and wheeled me through the hospital between contractions. It was too painful to stay seated the entire time, so I got down on my hands and knees when each one hit. We checked into labor and delivery and they started monitoring me.

When the nurse checked me, I was 4 cm. My brain came out of my labor haze. “Only four?!”

“Four is great!” she said. “You’re doing amazing!”

A young doctor came in and told me that he would have to perform an ultrasound to make sure baby was head down. She was and he estimated her at 8 and a half pounds. He checked my chart. By some miracle, my surgical records had finally come through and I was cleared for my VBAC!!

The nurse came back, “We have to move to a delivery room, now. Here if you want to put this gown–“

“NO!! I don’t want to wear that!”

“Ok, well can we just wrap it around you?”

I guess the rest of the hospital didn’t appreciate a full term pregnant woman walking the halls naked. I made it to the delivery room with only a couple stops in the hall. A nurse came in and asked if I wanted the epidural. No, I can do this. My husband was my rock. He kept telling me how wonderful I was doing and how powerful I was. They checked me again. 6 cm. Okay, making progress.

My brain totally disengaged at this point. My nurse kept trying to talk to me, asking me questions, but I was just sitting on the edge of the bed, utterly focused on the contractions and my baby. It was like she was speaking another language.

I was hooked up the the monitor, trapped on the bed, and the pain was inescapable. I couldn’t even get down on all fours to get through the contractions. At this point, I was no longer vocalizing, I was screaming as each contraction peaked and felt totally out of control.

Another nurse came in right when a contraction hit and asked if I wanted the epidural again. “YES! Give me the epidural!!”

My husband rubbed my back. “No, honey, you don’t want it, remember? You can do this. You’re strong. You’re doing amazing. You can do this.”

“I can’t do it.”

“You can. I know you can.”

I started crying, “I can’t. Please. It hurts too much. I can’t do it. Please.”

He buckled under the tears. “Get her the epidural!”

A million years later, the anesthesiologist came in to do the epidural. He was great and it was very light. It only took the edge off the contractions and brought them down to a level that was bearable. I could still feel them all and even stand up. It was perfect. I relaxed and we waited.

As soon as the epidural took effect, the nurse checked me again and my husband walked down the hall to grab a snack (and try to sneak me something to eat as well). I was at 8 cm with a bulging bag. I couldn’t believe I made it to 8 cm on my own! I kind of felt like a wimp for caving in when I was so close. The doctor wanted to break my water but I asked her not to and she didn’t press the point. My baby was so close. I called my husband and he ran back upstairs without the food (sadly).

A little while later I felt something warm and wet on my thighs and reached down. My hand came back up covered in blood. I called my nurse and she brought in the doctor. I was 9 1/2 cm with an anterior lip. She asked again about breaking my water saying that the baby’s head against my cervix would help it finish opening and get rid of that lip. I agreed and she ruptured it. There was a little meconium in the water, but baby still looked good on the monitor. They left us alone so I could finish dilating.

A few more contractions and I started to feel pushy. I could feel her head descending through the birth canal and knew it was time. I called the nurse to “check me” and told her I was feeling pushy. She tried to check and only felt baby’s head. “OH! Baby!!” she said.

We were at a learning hospital so within seconds there were four OBs between my legs, four pediatricians by the warmer, about eight nurses scattered around, and three anesthesiologists in the back of the room. PUSH!

I pushed. And I pushed. And I pushed again. She crowned. One of the OBs said “Look at all that hair!”Really? Try to focus, Doctor. PUSH! Man, her head was so big!PUSH!Too big! PUSH! I can’t! She won’t fit! PUSH! NO, ouch!! PUSH! Just take her out! I can’t do it! PUSH!

“Her head is out! One more big push!” Her shoulders were born and then the rest of her.

And there she was. After nine months. Perfect, beautiful, healthy. And fat!! Whoah, fat, rolly baby! She was 8 lbs 10 oz (which is almost as much as my other two daughters’ birth weights combined). They put her on my chest and she just laid there. She never cried, she just snuggled on me and looked at my face. We hadn’t decided on a name yet and my husband looked at her and looked at me. “She’s definitely a Melanie.” After seeing her, he picked the name I had wanted. We just laid there skin to skin for what seemed like hours. She didn’t show any signs of wanting to nurse for quite awhile, so we just snuggled.

It was a perfect birth. Even though I had planned a natural birth, I don’t feel guilty about the epidural. It allowed me to relax and truly enjoy the perfect birth of my daughter. I was glowing with happiness. I did it. I grew a full term, healthy baby. I went into labor on my own and I pushed that baby out! But taking her home after only 24 hours in the hospital, only having left my side for 10 minutes to have her hearing test, was the truly healing part.

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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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The Fear and Anxiety of the Dad-to-Be

The Fear and Anxiety of the Dad-to-Be

No one reading this needs an explanation of how men and women are different. It’s generally accepted that men, for the most part, are logical fixers and women are, overall, emotional nurturers. Men like to see things from an empirical point of view, cut to the chase, and get to the root of the problem and fix it. Women like to talk it out and be heard and validated and make sure everyone else is happy first. Effective communication and understanding these differences make for successful relationships. No surprise there, right?

During a pregnancy, women experience the spectrum of changes, from up and down emotions to up and down physical wellbeing. It’s not easy growing a baby. Obviously I don’t know from personal experience, but I have witnessed it first hand. The growing baby and uterus shove organs up and back, energy decreases, nausea and the feeling to pee increase, hormones run wild, and tears flow intermittently while watching The Voice.

The spectrum of changes during pregnancy for the man is essentially nonexistent. Some men get excited about a new addition on its way, some are fearful about being an adequate father and provider. Others don’t really feel like anything different is taking place, and won’t feel like anything different is happening until that baby has entered the world. I have experienced all of the above, but I can identify with the last one the most. Simply put, a man doesn’t experience a change in hormones like his woman does, no increase in belly and breast size like his woman, and no tears during The Voice… In fact, what’s The Voice? Change the channel to ESPN, will ya!

However, there is one thing that men do experience that many of us tend to not discuss: Fear and anxiety.

Fear??? But this is Birth Without Fear! And anxiety??? Like the kind you need help for?

Let me clarify.

A pregnant mom-to-be is very focused on how her pregnancy will go, and especially how the labor and birth will go. The woman wants to know her baby will arrive safely. The baby and the health of the baby are the number one priority. And that’s exactly how it should be. You spend 10 months growing a fertilized egg into a full term baby that cries and eats and poops and sleeps, and you have no choice but to be invested in how that baby is doing. That’s what moms do.

But for the man? The number one priority is his woman. That’s the person he is attracted to, fell in love with, considers a best friend, enjoys seeing naked and having sex with, and the person he wants to have all to himself. When something is wrong with his woman, he’s jumping to her aid, doing whatever he can to make her feel more comfortable, essentially taking control of the situation and fixing it like he instinctually knows how to do.

But when it comes to labor and birth, the man is rendered helpless to aid the woman in giving birth to that baby. Sure he can give support and offer encouragement, even provide a hand that his woman will threaten to shatter during those transition contractions. But the man can’t take the pain away, can’t speed up the labor, or give birth to the baby himself. What if there’s a complication? What if things don’t go as planned? What if something happens to his woman? It is a helpless feeling to go from always being in control, ready and able to fix the problem to being a powerless bystander who can physically do nothing to affect the outcome of his woman birthing that baby. And that can be a hand-wringing, scary feeling.

unnamed-7But it’s okay. It doesn’t make us men any less capable or competent in supporting our ladies in birthing a new baby into the world. It just makes us human.

The trick, as I have learned, is supporting your woman during the ups and downs of pregnancy, during the uncertainty of labor, during the life-altering moments of the birth, and knowing that while you may not have the ability to affect the outcome of labor and birth, you can certainly control how much of a rock you can be for her during the most vulnerable, yet empowering moments of her life.

No, it’s not analyzing the problem and coming up with ideas on how to streamline a better solution. It’s not busting open the toolbox and looking for the appropriate tool to fix whatever is broken. In fact, it’s not even fixing something. It’s simply being there, being supportive, being her positive emotional strength when she feels she has none left. Yes, it is different than what we’re used to. Yes, it might be a foreign concept. And yes, that’s exactly what your role, as a man, is during that baby’s journey into the big, bright, cold world.

And that’s a logical fact that you can control.

Photo Credit: Leilani Rogers, Photographer

Birth Rights, Hyperemesis Gravidarum and More. {Guest Post by Jess Kroger}

Birth Rights, Hyperemesis Gravidarum and More. {Guest Post by Jess Kroger}

When you think of birth (in most cases, especially first time moms) the first thing that comes to mind isn’t that you have options – it’s that you’ll do what the doctor says to do and when they say to do it because they know best. For most women, this is fine, but then you get the group of mamas who step back and say, “wait, what the hell?” I truly wish we could all be like that, because our world would totally rock if we all came back to our natural roots and could take back what was ours. To all the mamas who do this – continue to be awesome and have control of your vaginas. For the rest of you (I was there once) listen well, because what I’m about to tell you is what birth is all about. This is what our bodies were made for, believe it or not.

Let me start out by telling you a little about myself. My name is Jess. I have been through the ringer of obstacles when it comes to life. But each one of them has made me the person I am today, and I honestly wouldn’t have it any other way. Some may trigger mamas, so I would just like to disclose that this will involve sexual abuse, loss, and depression. But you will also find triumph, hope, and love.

When I was in 2nd grade, a family member sexually abused me – this went on until I was in 8th grade. Rape, sexual actions, and emotional abuse were all involved. I didn’t come out to anyone about this until I was 21 years old. It’s taken me a really long time to get through this in my life, and continue to do so. When I was 14, I was driving and was run off the road by a semi-truck, I wasn’t wearing my seatbelt and my head hit the windshield. I now suffer from epilepsy because of it.

At the ripe age of 19, I was diagnosed with cervical cancer. I soon started radiation therapy, and had several small surgeries to remove the cancer spots. It would come back five times before my first living babe was born, and once more after, which all resulted in scar tissue on my cervix. In between all of the cervix issues, we found out that my left ovary had a spot of cancer on it. Small, but there. We radiated it and killed it, but did not remove the ovary. After my first was born, we soon found out that I had thyroid cancer. When she was only 8 months young I had my thyroid removed and did a round of radiation to kill any cells that may have traveled. I have been cancer free since March 29, 2011. In between all of the radiation we lost several babies.

I am a mother of 13 babies – 2 living and one on the way. Yes, you sure did read that right. I feel it’s important to acknowledge my angel babies when telling you about my children. Mamas who have lost, don’t be ashamed to claim your angel children, after all, they were real, and they were loved, for however short the amount of time you had with them.

My two little rainbow babies (babies born after losses) are now 3 1/2 & 21 months. They were atrocious pregnancies; from hyperemesis, seizures, hip and pubic bone issues, heartburn, and exhaustion. But, they are the most awesome little offspring anyone could ask for. From the tantrums to the kisses, I couldn’t imagine my life without them. I am currently 28 weeks with our third. I’m sure he/she will also be a poop head like the other two, but what’s not to love about a little personality, right?

Let me start with my first living pregnancy and birth. This is where my journey all began. Little did I know this birth would impact the rest of my life, and change who I was as a person.  In 2009, my husband and I found out we were expecting (again). We waited for that heartbeat to show up and then we shared with the world that we’d have a little nugget to hold in our arms. We were naive, new, and uneducated when it came to birth. I thought it was just like the movies, go into labor, get an epidural, and scream bloody murder while pushing out a baby. Little did I know.

Shortly after announcing our pregnancy, I started violently throwing up. It got to the point where I couldn’t even drink water without getting sick. I was soon diagnosed with Hyperemesis Gravidarum, which is where you are basically sick all day every day. I would spend most of my pregnancy in the hospital and on bed rest. At 28 weeks, I went into preterm labor. After a ton of medicine, the doctors were able to stop the labor.

After this, I was put on a short leash. My doctor made me come in every week for ultrasounds and other tests to make sure everything was ok. At this point, I also started having seizures. They put me on a medication that I now know actually made my seizures worse. At 35 weeks, the doctor finally told me that they needed to do an amniocentesis to see if the baby’s lungs were mature. This is where they stick a ginormous needle in your stomach and collect amniotic fluid, not in the least bit pleasant.

Earlier in my pregnancy I was told that I was unable to have a vaginal birth because I would die from an aneurism during the pushing stage, so I knew I would have having a cesarean section. I was ok with that, because I thought I would get to skip all the pain of labor and birth (haha, right). They also told me my baby was sideways, which meant I couldn’t have a vaginal birth either (keep in mind, they told me this before I was even full term). We went in on July 27 to have the amnio done, because – you know, what doctor says is what goes. After having to poke around several times, that of which even poked my poor babes bum and caused her to bleed (she still has a scar on her butt from it), they finally got a good amount of fluid to test.

A few hours later we would find out that her lungs were mature and they would be doing the cesarean. I was 35 weeks and not prepared for this major life event about to happen. We got to the hospital and they started prepping me, and then took me back to the operating room. My husband was left behind to wait. They administered the epidural and had me all ready to go on the table. The doctor started cutting and I screamed that I needed my husband in the room. They forgot to get him. I still to this day can’t imagine the pain that must have caused him. After he got there, they continued. It was all a blur for me, because I was so drugged up. But then I heard a cry. A cute, raspy baby’s cry. I remember wanting to hold her so bad, but at the same time I wanted to vomit because all I could smell was my burning flesh from the open wound on my stomach.

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I didn’t get to hold my sweet baby girl until I was in the recovery room. I suffered from horrible postpartum depression, I didn’t want to hold her, I hated the fact that I didn’t want to do anything with her. I only breastfed her for six weeks before giving up, we will say lack of support was a huge thing here. We gave her formula the day she was born, and honestly, she barely got any breast milk. The recovery from the cesarean was beyond anything I was ever prepared for. I couldn’t pick up my own child, stairs were impossible to go down, the pain was so unreal that I sometimes look back and wonder how I even got through it. It took a good year for my body to come back to life and not feel broken. I could go on about this birth story, but I feel I have more important things to cover.

Moving on, a year after Hazel was born, we found out that we were expecting again after a few losses in between. Excitement filled us, but at the same time, I feared having to go through what I did again, and with a toddler to take care of. Of course, another round of hyperemesis hit me. Harder than the first time. I was on IV fluids basically the whole 20 weeks of the pregnancy. I only gained 11 pounds my whole pregnancy. I knew that this time I wanted something different, what it was, I wasn’t sure.

That’s when a friend introduced me to ICAN. For those of you who don’t know what this is – it is International Cesarean Awareness Network. I highly recommend joining your local chapter for support. I soon discovered that I was able to vaginally birth after a cesarean. You know when they say once you have a cesarean, always a cesarean? What a load of crap. This is when I set out to find a doctor who would allow me to do so.

I live in Nebraska, so homebirth wasn’t really an option with me (unless I wanted to do an unassisted birth), and there weren’t a lot of hospitals that allowed VBACs. I ended up finding a doctor who was located an hour away from where we lived. My husband and I took a local hypnobabies class, and felt prepared for what was about to come. All was well; I was planning a hospital VBAC. The day before I went into labor, my doctor went out of town. The day I started having contractions was exciting for us. I was 36 weeks. After 24 hours of laboring, we went into the hospital where I found out I was still only 1cm. Let down, what a huge let down.

We headed back home to keep on keeping on. Things started to slow down, then they would pick up, and it became a pattern for 6 days. Finally I had enough and we went into the hospital again. My doctor was still out of town. I was at 7cm, and the backup doctor (who was new to the practice) told me that she did not want to do the VBAC for me because I was not her patient.

After fighting and fighting with her, we finally said screw it and went to a local hospital. I ended up with a repeat cesarean. The emotions that I went through after this birth were insane. I was angry; I felt like a bad mom, I felt like a piece of me was ripped away, I felt empty. This is when I decided I needed to better educate myself on pregnancy and birth. I was able to successfully breastfeed Harper for 10 months. In that time, my world turned upside down, or right side up, I suppose you would say. I became a childbirth educator, and a doula. I knew what I could do in birth, and I knew I wanted to help mothers around me avoid going through what I had gone through with my first two births. Again, I could go on about this, but my next pregnancy and birth is where I’d really like to focus.

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I hope everyone is still with me here; this is where I get to my initial point – taking control, and knowing your rights.

Here we are again, looking at that beautiful positive line on the pregnancy test. Being an educated person on birth, I knew that this wasn’t going to be easy, but I was ready to fight. At this point, I had been following the Birth Without Fear blog for a while. I found a lot of strength and hope from all of the birth stories there. I knew what I wanted – I wanted a natural, vaginal birth, without the doctors telling me what I could and could not do. Easy enough, right? So one would think.

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At 6 weeks, I once again began my hyperemesis journey. This time around I decided to be a little bit more proactive and take control of my medical care for it. I ended up finding a very supportive doctor that would do anything that she could to help me battle this horrible disease. I had a picc line placed at 8 weeks of pregnancy. I then spent most days going into the hospital with my kiddos and getting treatments so that I could live without throwing up every hour. It helped, but didn’t do the trick all the way.

At 14 weeks pregnant, I decided to take a leap and attend the first Birth Without Fear conference. I was scared out of my mind. What would everyone think of me with this thing stuck in my arm, puking all day, not being able to enjoy my time there? Little did I know that this weekend was going to change my life forever. Reading that, it probably sounds like a corny thing, but let me explain.

150 moms. 150 beautiful mamas who have been there, done that. 150 mamas to support me with my decisions, and to guide me through a difficult time. 3 amazing roommates who encouraged me (and even gave me shots in my butt to help my nausea, I will forever be grateful for that!) the whole weekend, and who never left my side. A roommate who herself, had suffered through hyperemesis, and could connect with my pain. A roommate who had suffered loss, and could connect with my pain. A roommate who had achieved a successful VBAC and could connect with my pain. SO many women who have been through what I have, in one way or another. So many mothers who constantly asked me if I needed anything, who made me feel like I was worth something.

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The speakers gave me hope; hope that I could do this, and that I wasn’t broken. A beautiful founder who herself had experienced loss, had experienced cesarean birth, and who had experienced vaginal births. A beautiful support team who had been through what I had. The support I received here was unbelievable. For the first time in my life, I didn’t feel alone. I felt like I had a voice. I didn’t get sick once the whole weekend, and for all my fellow HG mamas out there, you know how amazing that was. Truly amazing.

During the conference, we had this life changing session that was meant to release fears. This is really where a lot of things came out that I had no idea I was feeling. This little thing was so huge. This little session changed me. I was scared, and I didn’t know it. I was scared of feeling like a failure, I was scared of having flashbacks of rape when I started to transition or push during birth, I had fears that I would be letting myself down as a parent; I was scared of being judged by everyone around me.

It was when I wrote out the word ‘failure’ in the sand that I realized I had control. I had control of my birth, of my life. I could not let anyone get in the way of my dreams. I wiped the word away, and with that, I became a stronger woman. It was in this moment that I decided what I truly wanted. I wanted a homebirth. I wanted to have control of my birth. And that, I would do. I flew back to the good ol’ state of Nebraska a changed woman. I was ready to fight for what I believed in, and I would do anything in my power to make sure it happened.

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The obstacles that I have had to go through to make sure this birth is what I want have been unbelievable. I was expecting a few challenges, but nothing close to what I was about to face – from the lack of support, to the state laws, to being turned into CPS, to all the attacks and judgment. In the beginning, there were few people that supported my decisions to have a VBA2C, I hadn’t told many that I was planning a homebirth, as I wanted to look into all of my options first. It took a lot of convincing to get the people I loved on board. I’m sure some are still having reservations as it is.

In Nebraska, it is illegal to have a midwife attend your birth at home. This put a bit of a damper on some plans. We moved four hours away from a VBAC friendly hospital, so our options were limited if we did want a hospital birth. I began researching our different birth options. Hours and hours of research, talking in support groups, asking friends who had done homebirths anything I could think of, contacting the hospitals in regards to who would allow me to VBAC and who wouldn’t.

After carefully weighing all of our pros and cons, we decided on an unassisted birth. It was not easy deciding this. We changed our minds like we changed our underwear. But in the end, it is where my husband and I both felt safest, where we knew we would have the power to control our birth. We put together a kick butt birth team – consisting of a massage therapist, a chiropractor, two doulas, and a photographer, and of course my mom. Every laboring woman’s dream. Yes, you may be jealous.

I thought all was well, I thought I had everything in place, and this is when the attacks came, when the obstacles came. My doctor was suddenly unsupportive, telling me I was going to kill my baby. The ‘dead baby card’ is the worst thing that doctors can say to you. I was mad, I was hurt, and I wanted to fight back. I ranted back with scientific studies that showed VBACs were in fact safer than repeat cesarean sections. I even pulled out ACOGs guidelines for VBACs. (If you haven’t read the blog post on birth without fear regarding all of those guidelines, I highly suggest you read it).

After fighting with my provider and getting nowhere with them, I decided to fire them. Yes, you can fire your doctor! I decided that I needed to find someone who could just give me basic prenatal care, and help me survive living with hyperemesis. I wasn’t going to worry about telling them about my birth plans, because they were not going to be involved. This was my first action in taking control of my birth. Let me tell you, that felt good. After researching doctors in Nebraska, I decided to go back to the doctor that was supposed to deliver my second baby. I had a huge chip on my shoulder, but decided I should give it a shot. Maybe it would be good to have a backup plan with a VBAC friendly doctor just in case something happened that I was unable to do an unassisted birth.

I finally met with the doctor, got my care all in place, and was feeling really good about everything. We decided that I should have some ultrasounds done just to make sure baby was doing ok, because I had been malnourished most of my first trimester due to the HG. For the first ultrasound, we decided to have it done at a local hospital so that we did not have to travel four hours away. The doctor at the hospital told me that I had low amniotic fluid and my placenta was covering my cervix (placenta previa). For most doctors, ‘low amniotic fluid’ is measured at 5 or below. Mine was measuring at 12 – this was the second time the doctor had used some kind of scare tactic on me.

My placenta was also only partially covering my cervix, so little that it ended up moving up three weeks later. And this was the third scare tactic that the doctor had used on me. It was obvious that the doctor didn’t get my hint the first time when I came back with evidence-based research for them to go over. Yet again, I had to take control of my care, and tell the doctor that even though I respected their input on my birth, I would continue to plan for a VBA2C. We finally got to the point with our new doctor where he would let me do what I wanted, when I wanted. All was well in that department.

Next came the judgment and attacks. No one prepares you for how harsh words can be. You don’t expect them to hit so hard, but they do. The whole saying ‘sticks and stones may break my bones, but words will never hurt me’ – complete crap. Words are a powerful thing. There were people telling me that they hoped I failed at my birth; that they hoped my child died in my arms. The constant judgment from people saying ‘oh let me know how that works out for you.’ It got old, really fast. It was impacting my birth plans. It was making me feel like I was doing something wrong.

And then I realized that these people that were constantly attacking me were just validating their own feelings. They had to make me miserable for doing something amazing in my life because they wouldn’t be able to. Yes, that sounds wrong saying, but why else do we attack and judge each other? It’s a constant war out there, and if we stepped back to realize why we were doing it, we would all see that it was because we were missing that piece in our lives, that we so longed for what the other person has. It’s an honest thing that we all do as parents. But, how we choose to react to these words is all on us.

It was shortly after the verbal attacks that I found out someone had turned me into CPS (child protective services) for planning an unassisted birth. The feelings that I had about this could never be put into words, but I knew that this would just drive me to follow through with my plans even more. Obviously, CPS could not do anything about my birthing plans; after all, what I was planning was not illegal. After an interview with them, and handing them a printed version of my legal rights and the rights that I was not violating, they decided to drop the case.

It was after all of this that I decided to kill with kindness. I removed every single person from my life that had a negative impact on it. I created a bubble, where only people who were supportive of my decisions were allowed in. Sure, that bubble started out small, but it eventually turned into something much bigger than that. I started to take a stand in my life, to stick up for what I believed. To not let people push me around for the decisions I was making. I was going to birth this baby out of my vagina and into the arms of my husband like it was intended to happen. Anyone that got in my way would be pushed aside, and I would keep on keeping on. No one could tell me I was broken, or that I was being irresponsible.

We have a few weeks to go until we meet our newest sweet baby, and you can bet your bottom that we will be doing it how we want to do it. My body was meant for this, and I am going to carry out its purpose in life. My bubble is up, I know my rights as a woman, and I am educated on birth.

I refuse to become a victim. I refuse to dwell on what someone did not do for me. I refuse to dwell on what someone did to me. Instead, I dwell on what I can do. I can forgive, I can serve, I can love. I can demonstrate self-respect and say no to toxic people. I can live with joy inside. I can assume the best instead of the worst. I can kill with kindness. I can make this birth what I want it to be, no matter what someone else does or think.

Your birth will stay with you for the rest of your life. Make it matter. Remember every second of every moment, because you cannot get them back. Research your hospitals policies on childbirth. Know your options; know that you can sign AMAs (against medical advice) for anything you want. Remember that you are hiring your doctor to work for you, not the other way around. This goes for midwives and homebirths too.

In the end, you should have the final say in how your birth goes; no one should ever be able to take that away from you. Find a local childbirth educator and educate yourself on everything you need to know about birth. Learn about the values of a support team during pregnancy, birth, and postpartum. Doulas, postpartum doulas, breastfeeding counselors, even placenta encapsulators – research them. Invest your money in a good support team, they are worth every penny, and you will not regret it.

In the first year of my doula career, I attended 30 births. Each birth was different, unique, and beautiful in their own way – regardless of how the women birthed. But something that I realized along the way was that the moms who had educated themselves and taken control of their births had the best outcomes. They had a deep connection with themselves and their babies the instant they were born. The world would seem to stop in its place, and you could feel the triumph, the joy, the utter feeling of power fill the room.

It is in these moments that I realize how important it is to know your options, and to know that you are the owner of your body, and you can birth how you want. Regardless if these moms had epidurals, inducing medications, natural births, cesareans…the moms who owned their births were brought to life, and a new kind of respect surrounded them. And this, this is what birth is all about.

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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!

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