Birth Story #15

This is one of my Ohio apprenticing stories…

When we got the call we knew we had to hurry. Dad had ridden his horse to the nearest phone to make the call and it was the early evening and slick and icy outside. As we quickly pull on clothes and coats we grabbed a jar of peanut butter, a knife and a few apples along with a cup of water and head to the car. I became quite fond of peanut butter and apples on that trip!

We pulled up to find an extra buggy in their driveway and lots of lanterns burning in the house. As we walked in through the kitchen door the warmth and cheeriness seemed to explode! The couple’s dozen children and their oldest daughter’s beau were at the kitchen table playing games.

As delightful as it was, we hurried on to the upstairs to find Mom close to the end of her laboring process on a magnificent bed that was handmade by her husband. The furniture in that room was magnificent, but that bed was beautiful and massive, headboard and footboard all wood and carved ornately. I take care to explain this because of the situation. As Mom neared her second stage of labor she decided that she wanted to move to a position she had used successfully before – holding onto the headboard as she squatted. Wow – the headboard is up against the wall and her husband has left the room to check something else. The midwife and I look at each other and see the doubt in each other’s eyes as to the possibility of moving that big bed in time when, lo and behold, Mom gets up, walks around to the head of the bed, takes hold of it, shoves it away from the wall, holds onto it to squat and starts pushing! Amazed and scrambling, we both grab our equipment and rush around to where she was barely in time to attend her birth!

As we clean up and assess Mom and Baby and get them back INTO the bed, Mom starts to tell us one of her stories. They had a little boy born at home, all the children were, who was not born with all his facilities. He was dear to them and cherished by the whole family. The newborn assessment was very important to her in light of that and she was happy to hear her baby was fine.

It was hard for her to admit that every time she was pregnant she would wonder if this baby would be okay. Bless her heart; she did not know that practically every pregnant woman in the world has wondered that same thing at some time during their pregnancy. It is not a shame or wrong – it is just not knowing a certain outcome for a given event/happening. I have known some of my moms to have a “feeling” about their birth or pregnancy that the Lord has given to prepare them ahead of time. But this is a different thought process than the one where Mom just wonders if the baby will be alright. I’ve learned to trust Moms with their input about their pregnancy and feelings about how things are going. How can we dare not? What a connection there is between two lives that will never be as close as mother and child in the womb. Then add to that the Christian woman who hears from and trust the Lord and there is an amazing thing that happens … words fail to describe.

So, if you are in labor and can walk around to the head of your bed and move it when you are ready to push, I’d say you could expect a fine birth.

Birth Story 14

The urge to push is a blessing for a pregnant woman. It not only signals that she is about at the end of her labor and ready to see the little surprise she’s been carrying for nine months, but is also the mechanism by which that little surprise arrives! That pushing urge is necessary and critical and a wondrous thing that God planned into the whole birth process.

When a woman labors she often feels each contraction, like a wave, as it starts slowly, peaks and then subsides. Some are slow, some are fast. Some are intense and painful and some are more moderated and less painful. Towards the end of the first stage of labor they start coming closer and harder. The body is getting ready to “expel” its little passenger. When Mom is dilated completely and ready to push, second stage begins, although the urge to push may not present strongly until the baby has descended a little more into the birth canal. After baby arrives and until the placenta is delivered is the third stage of labor. To not give you the wrong idea, know that rarely (as in “don’t expect it to happen”) does the body “expel” the baby without the pushing efforts of Mom just as Mom’s pushing efforts are hardly efficient to bring the baby without the strong pushing urge from the contractions.

I have done a few births where the mother had no urge to push. This is very hard for Mom as the mental decision and determination to push a child out is much harder than working with your body when “it’s gonna push no matter what you do and you can’t help yourself”! One of these moms was able to complete the birth at home with much assistance, fundal pressure, extreme positioning and actual deliver of the baby by the midwife; the other transported and Baby was vacuumed out. Both babies and mothers were fine. Both moms were hypothyroid and on medication under doctor supervision. Both had been told they could have natural/normal childbirth. Neither was a first birth, meaning they both had “tried” pelvises.

One of the women pushed and pushed and pushed and Baby did not come down the birth canal. After transporting – the doctor put her on pit and she still worked and worked to get the baby close enough for the doctor to get the device in place to suction him on out. She would push and bring him down to where we could see him and then when the contraction was over he went right back up out of site. C-section was being considered but with some amazing encouragement for Mom and some physical manipulations for Baby, he was vacuum extracted. We agreed that Mom would have her subsequent babies at the hospital.

The other mom was able to have another child at home. Seeing these wonderful women work so hard to birth their children gives me a deep appreciation of motherhood and their love of their children.

“Push with all you’ve got! You can do it! Push harder! This baby needs to be born! Push harder than you’ve ever pushed before!”
These are often met with, “I AM pushing as hard as I can. I don’t FEEL an urge to push. Is it okay to push NOW? I CAN’T push any harder. Just pull him out!”

These are countered with, “You’re doing a great job! It’s getting close, keep it up! Let’s try a different position to use gravity to our advantage. Put your chin down, take two deep breaths and start pushing at the beginning of the second one. Use long hard pushes and do not stop. Make the baby move. YOU move the baby!” and so forth.

Early labor may seem slow and somewhat laconic until we get to that last stage when Mom needs the input to make it through. The ideal is to be there but let the parents ‘attend’ their birth as you monitor and wait. The decision to intervene is for safety and need of Mom and/or Baby.

In my observations, most births do not need a lot of intervention. Attendants are there for the ones that do. If the birth goes quickly it is usually a good birth without needs. If it progresses more slowly the need for intervention seems to be higher. Remember that the passenger (baby) needs to come down the birth canal as gently as possible, so we want to be patient to give the child the time it needs to mold and descend. Once Baby has entered the birth canal we want to make sure heart tones remain good and He is not there so long that He becomes depressed (physically). There is a time to wait and a time to encourage a faster progression. This is the dance that requires balance to produce the journey of a lifetime!

Ecclesiastes 3:1-4

"To everything there is a season, and a time to every purpose under the heaven: A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted; A time to kill, and a time to heal; a time to break down, and a time to build up; A time to weep, and a time to laugh; a time to mourn, and a time to dance;"

Birth Story #13

It’s the why’s that make sense. No matter what or you are learning, understanding the why behind the fact makes it sink in.

Teaching = Pregnant women should not consume a lot of caffeine.

WHY? The unborn baby gets the caffeine she drinks and has a reaction that causes it to be jittery and overactive. It takes several days for the baby to get it out of its system because their liver will not break it down like a mature person’s will.

Teaching = Pregnant women should eat regularly throughout the day and not go long hours without input, whether for dieting or just because it is inconvenient.

WHY? Unborn babies get their nutrition through their mom’s blood. The nutrients carried in her bloodstream are what feeds the baby. If Mom’s blood sugar drops so does Baby’s. If Mom doesn’t consume the right nutrients Baby can have physical and mental problems. The nutrients in the bloodstream are derived from what we eat and drink.

Teaching = For out-of-hospital births, when you go into labor, be sure to keep your foods and fluids up.

WHY? Labor and delivery are the hardest work a woman’s body will do. It requires a lot of calories just like an extreme exercise. Women who do not maintain their foods and fluids during labor risk becoming fatigued to the point of not having the energy to finish the job and may need to transport just to get an IV when they could have had a normal, healthy birth without the intervention. By the way, this is the most common reason for not finishing a home birth I have seen. The laboring woman has a lot on her mind and having a partner that can give her the input she needs, which in this case includes food and fluids on a steady and regular basis, is very helpful

Teaching = Pregnant women need to have regular check-ups during pregnancy.

WHY? Regular checkups provide a baseline for a care provider, no matter who that is. How do you know if Baby’s heart tones are regular if you don’t know what his/her baseline has been. How do you know how much Mom’s blood pressure is going up or down if you don’t know what her normal is to compare? In order to know that things are proceeding within the field of normal, you have to know what normal is. During the nine months of pregnancy baby and mom both go through amazing changes and as those changes occur a picture emerges of their preferences, needs and weaknesses, if any. During the labor and delivery this picture can be used to determine if things are outside of that norm.

Birth Story #13

This birth takes place in the country – on a beautiful farm. The home was built by Dad and the grounds are like a garden. It was a delight to go to this home. Mom and Dad were as pleasant as their wonderful home and their hospitality made getting to know them truly a pleasure.

The call came in the afternoon and we did not go right away as we knew this was a first birth and the contractions were just beginning. Towards evening we did go out and check Mom and Baby. All was well and it was still quite early so we came back into town and left Mom and Dad to the early labor by themselves. After about four hours of sleep the call to come came and we drove back out to their home. We had stopped and bought cola’s on the way, knowing we would not get much more sleep.

Walking in we heard the familiar sounds of a laboring woman and knew she had progressed. Checking her and finding that she was not as far along as had expected, I started asking questions. Her stomach had been somewhat upset and she had not been eating or drinking. She was tired but wanting to stay at home for the birth. She did not think she could keep anything down. At this point her contractions were painful but not productive due to low blood sugar. I compare it to an engine trying to run with no gas. This is not normal…but since I had walked in with a large cola and had not drank from it yet, Mom agreed to drink it. Shortly after she began to drink it she was more alert and her contractions became more regular and progress was made.

Within another few hours she wanted to push and she was physically ready to begin. At this point the stomach usually does not digest whatever you put into it and it may likely even come back up. With this being a first time Mom and knowing that we could have a longer pushing stage, we went ahead and had her nibble on some cookies to guard from dropping the blood sugar – risking the chance that her tummy might not like it. It was good that she did, since the pushing took almost two hours. With regular monitoring of Baby and input for Mom, Baby arrived safely. The delight of a newborn is such a wonder and mystery! God’s design works.

We did baby number two for this couple also and you can believe that she ate and drank throughout her labor and did not have any problem with her energy levels for the second birth.

Birth Story #12 AKA You are What You Eat

Nutrition makes a huge difference in the outcome of a birth for the mom and baby both. Easily said and believed, but in reality I didn’t know how much of a difference it made until a few events proved it true.

Our family has always had pets. We like the added dimension it gives our home – and we love our pets too! We started out with cats. What amusement a kitten can provide – but more importantly here the lesson we learned was eye opening. My parents lived on an acreage and had a new batch of kittens when we visited one summer, many years ago and in which seems like a far away time. Long story short: we went home with a kitten from the batch. They were between 3 to 4 weeks old, as I recall, still small but past the newborn stage.

My parents fed their cats “scraps” as well as a generic cat food. There were also ample rodents around making them very useful and content cats. We got Science Diet cat food, as recommended by our vet. It is supposed to contain all the nutrients and vitamins as well as higher protein than most other pet foods. After about three months we realized that our cat was not “working” in our city home away from its family so we spoke to my folks and it was agreed that we would take it back to them. We were glad to know we could take her back and she would be in a good place.

What really shocked us was the difference between her and her siblings when we returned her. She was roughly twice their size. Her coat was fuller and shinier. That difference really stuck with me through the years and it was a huge factor in changing our diets in our own family as well as being concerned about pregnant women and their diets and the vitamins they use.

After observing so many women and the different diets and supplements that they use and their outcomes as far as childbirth and the babies, I have concluded that the nutrients not only make kittens bigger and healthier, but they also help women birth more easily and have healthy babies. Please don’t be offended by the comparison to cats – it is only the difference that good nutrition makes that is being compared. If it makes that much difference in a few months for a cat, imagine what we are doing to ourselves in a lifetime of good (or bad) eating habits.

My moms who exercised and took good supplements consistently had easier births. I saw this enough times to make that blanket statement. I’ve seen women who have had babies change their habits and start exercising and eating better and saw that it gave them an easier birth that time around. One case to finish off the point:

Mom had kind of difficult labors that were not extremely long, but were very intense. She did not exercise or take regular vitamins for the first few babies. After experiencing the intensity and difficulties of her births, she decided she had to get more serious about her health and condition. She started taking better nutrients, eating better in general (less sugar, more water, more fresh foods and regular protein) and she also started getting on the treadmill every other day. The next birth was her easiest hands-down! It was shorter and she recovered afterwards much more quickly. The baby was also very healthy. The next birth, following the same routine, was even better.

It is true that birth is easier after the first. And generally, as you have more children it becomes easier. This was not the typical difference we see in subsequent births. The pattern I’ve seen of the women who exercise and have excellent diets during their pregnancies (and throughout life) is more than coincidence. If you don’t believe me, find a farmer with a new batch of kittens…

4th of July

Happy 4th of July to all the dear families out there, and especially to the midwives who get very few holidays!

Birth Story #11 aka Birth Stool

“I’m taking castor oil. I can’t wait any longer and I know I am close.”

“You’re far enough along to do it but I don’t recommend it. It is not pleasant but it does work. Just let me know before you start so I can be prepared ahead of time, okay?”

“I’ll let you know if it works.”

Now I find myself at a different birth and get a frantic call from my “castor oil” gal…

“Come fast!” Dad yells. “The contractions are getting closer together and I don’t think it will be very long. She isn’t talking and when she gets to this stage it’s always pretty soon!”

Leaving the birth we just did and driving “a little fast”, we arrive at their home not any too soon!

Okay, where did you plan to have the baby? Are you set up for it and do you have the birth stool out and ready?”

“Yes, it’s all ready and set up in the kitchen.”

“Mom, can you move that direction? Dad and I will support you. Just take one small step at a time and we can stop on the way when you have contractions. Lean on either one of us or just drop down on your knees if you need to get through the contraction on the way.”

We are almost to the kitchen/birth stool and Mom says she needs to push! Dad runs around in front of her to give her support. She stops to lean heavily on Dad as she pushes and we have a head! Dad is at the birth stool so he straddles it and sits down so Mom can lean in on him better and as she does so we have a brand new baby girl!

Well…they really wanted to use the birth stool.

Birth Story #10

When a woman has her first baby and she labors for a long time (average for first baby is around 24 hours) she is often exhausted when it is time to push. The things that we guard are intake for the mom. The excitement of knowing you are actually in labor and you will be seeing your baby soon is huge. Then there is the “unknown” factor, which I was at first tempted to call the “fear” factor but decided against it. You are so excited at first – some women shake and others literally seem like they are on a sugar high. Hormones are kicking in and your body is doing things you’ve only read about so far and you do not know how you will actually get through it all. Yep – it’s scary. That is why women need women to encourage and come alongside them during this time and it is also why a midwife is such a good choice for most women. I love it that midwife means “with woman”.

If a woman has another baby within a few years she usually finds that the second birth is shorter and easier than the first. Of course there are exceptions to every situation, but most of the time this is what I have seen. Once those muscles and ligaments have gone through labor they seem to be less resistant to the change the next time. However, if a mom waits five or seven years to have baby number two, she will likely have a similar birth experience to number one. During the long interval the body returns to its non-pregnant/pre-pregnant state. I do not know all the reasons, but Mom will usually be having a longer labor and it will be more work to open up again if the time between babies is that long.

Studies show that moms giving birth for the first time average a speed of dilatation of 1.25 hours per centimeter. Multipara moms will be closer to .75 hours per centimeter. These are all averages and it is not unusual to see births go faster or slower.

Unfortunately, in the hospital they use these as a standard to make the decision as to when mom is failing to progress, so these standards are in the forefront of their minds. Not being in the comfort of your own home, having strangers in and out of your room, ( sometimes doing very personal physical checks on you), not being able to eat and/or drink at will and being required to be hooked up to flashing and beeping instruments can make a mom tense up and slow down labor. (I’m sure I’ve left out some of the factors that can slow down labor, feel free to mentally fill in the blank here.)

At home we look at the health of mom and baby and try to determine if she needs to rest or needs more fluids or nutrients and what pressure points or other helps we can give to assist with her comfort. Perhaps we just need to leave her alone with her husband or let her try to nap for a bit. The idea is to remain low-key and yet keep alert enough to signs to know they are not outside the normal range for mom or baby. And the only way we know the normal range is by having done previous prenatals and charted what their normal is.
Sometimes moms have what we call a plateau. The labor progresses along nicely and then she hits maybe seven cm and contractions stretch way out (or even stop) and no progress occurs. If baby is sounding good and mom is feeling good with no warning signs, we have naps, play games or cook/eat…go on with life. One of my favorite birth stories included such an incident.

We knew mom was experienced and calm about her births and she was very much trusting the Lord as was her husband. So, at around seven cm we got out some dice and played a fun game around a table while we waited. Mom laughed with us and we all marveled as we had a great time playing. A little later her contractions started back up and she delivered an absolutely beautiful baby girl within a few hours. Was this failure to progress? I think God just wanted her and baby to have a time out, so we did. If baby was having depressive signs or mom was in any kind of trouble the situation would have been different, but it wasn’t. We see this in home births from time to time and it is not rare, but not the norm.

The wonderful moments of new birth, of that new little child in this world, of the look in its mother’s eyes as she sees him for the first time, of his alertness as he hears his father’s voice and turns his head to see where that familiar sound came from…what delights! Each child is a new beginning for us all as we can watch them grow and learn and experience anew the delights our creator has put all around us. I have been so blessed to be with so many families as they bring a new little one into this world. My heart will never be the same. I have truly seen the hand of God with women.