Posts Tagged ‘Childbirth’

Gotta move, gotta rock, gotta sing! Comfort Measures and Coping Techniques for Labor

March 28, 2013

By Milon Nagi

At a recent Healthy Birth Choices Workshop, we gathered to hear three new moms share the comfort measures and techniques they used to cope with labor. We were also joined by Zoe Kogan, licensed acupuncturist, who took us through some acupressure points and massage techniques which can encourage labor. It was striking to hear, coming through the unique and individual nature of each story, the common themes that emerged as each woman found her way through to the birth of her baby.

Milon Nagi and Laure Sinnhuber-Giles, members of CiC's Program Committee, practice a sacrum massage used to help women cope during labor

Milon Nagi and Laure Sinnhuber-Giles, members of CiC’s Program Committee, practice a double hip squeeze used to help women cope during labor

When Vicki began to feel the sensations that led to her baby’s birth, she didn’t at first recognize them as labor – she thought it was heartburn. Having known for over a week that her cervix was already 3cm dilated, she had learned through experience that “that effacement, that dilation doesn’t mean anything until labor really happens.” She went about her day, downloading songs from iTunes for her birth playlist and, as her contractions grew closer, checking in with her midwife, who told her it didn’t sound like labor yet. “She told me, ‘Call me when you can’t stand it anymore’,” Vicki recalls.

To ease the discomfort, Vicki got into her tub. And, when the sensations became more intense, she asked her doula to come over. She remembers feeling “huge relief” when her doula arrived, thinking “I can finally relax, I’m just going to do whatever she tells me to.” Her doula, realizing that Vicki was experiencing a back labor, recommended that she stand in the shower with the hot water raining down on her back. It felt good and there was a possibility it could encourage her baby to change positions. She stayed there for 45 minutes and, in the meantime, her doula encouraged her husband to take a nap. Emerging from the shower, Vicki followed her urge to lean forward onto the bed through contractions. She moved to laboring on the birth ball to help her baby come down. Eventually, her doula suggested now may be a good time to go to the hospital. “I don’t know how she knew,” Vicki says, “she recognized from my face or something that I was ready – I didn’t even know that.”

Her doula helped her dress and they moved to the hospital. During the car ride, especially, Vicki’s music helped her to stay present and cope with her labor. She remembers laboring without a room for a while, until a nurse noticed her squatting and “corkscrew walking” through contractions in the hallway and she was finally checked and put into a labor room. Vicki recalls noticing that it was dark when they arrived (around 6am) and seeing more light as time went on. Having arrived pushing, she expected to have her baby before breakfast. Her baby’s unusual position, however (his head was tilted to one side and he was “sunny side up”) meant that it took a while for him to make his way out. With her midwife’s and doula’s support, Vicki pushed for several hours in different positions, fending off threats of a cesarean section from the attending OB (who later returned with students to observe her, impressed with her progress!) and at one point accepting some Pitocin to keep her contractions strong. Her birth team encouraged her and reminded her how strong she was, her doula massaging and shaking her tired legs between contractions. With their “incredible” support, she gave triumphant birth to her baby son, River, just as she had hoped to.

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“So Seamless” – Choosing to Birth at Home

February 8, 2013
Photo Credit: Nicole Heidbrederwww.gracefulfusion.com

Photo Credit: Nicole Heidbreder
www.gracefulfusion.com

We opened this year’s season of Healthy Birth Workshops with a full room of first and second time parents-to-be, gathered to learn more about home birth. While some were already planning to give birth at home, many more were there with questions, wondering whether home birth might be the right option for them. We were honored to be joined by four new moms who shared their birth stories and home birth midwife Kimm Sun, CNM who answered questions and shared her expertise with our expectant parents.

Since 2004, the number of home births nationwide has risen by almost a third, to just under 1% of all births in America. Research shows that women choose home birth for a variety of reasons. For some a close, trusting relationship with their midwife is a big draw. Home birth midwives often provide especially personalized care, with at least some prenatal visits taking place in your own home. Lying back on your own couch while listening to your baby’s heartbeat can be a magical experience. Other major factors include the desire to avoid unnecessary interventions and to be fully involved in decision making during labor.

When Natalie, the first speaker, was pregnant with her first baby, she and her husband decided to give birth at a freestanding birth center. At six months pregnant, however, Natalie experienced preterm labor, and was on bed rest for the rest of her pregnancy. Reflecting on her experience in the hospital, she realized how unsupported and afraid she had felt: “I felt really invisible that night.” As time passed, she began to realize how much she craved an intimate labor and birth, in which she and her wishes were honored. As she noted, “some of the things that come up during birth are really, really personal.” She was thrilled when she made it to full term and gave birth at home with her chosen midwife.

For her second baby, the decision to have another home birth “felt so natural.” She and her husband carefully prepared their home for birth, choosing candles and music to support the ambience they wanted. When her Braxton Hicks contractions started to feel different one night, she realized this was it. Her labor moved quickly – her contractions going from 10 to 4 minutes apart in the space of just 10 minutes.  However, she says, she felt calm and safe. “It was so seamless the way my doula and midwife came and honored the space that we had created in our home and the way that my husband was supporting me.”

An hour after her midwife’s arrival, Natalie gave birth on her hands and knees. Her midwife passed her new son between Natalie’s legs and placed him gently on the floor in front of her. It was their chance to meet their baby. “That stillness and that silence were so profound”, says Natalie. With no hospital staff rushing around and no distractions, “we were able to just really get lost in him and wrap him up in our attention. It was such a gift.”

Photo Credit: Sarah Tewhttp://www.sarahtewphotography.com

Photo Credit: Sarah Tew
http://www.sarahtewphotography.com

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Choosing a Home Birth

February 10, 2012

Thank you to Milon Nagi, member of Choices in Childbirth’s volunteer Program Committee, who writes about last month’s free Healthy Birth Workshop. The next workshop Comfort Measures/Coping Mechanisms is Thursday, February 16th. Click here to register.

“There was Ricki Lake, up on the screen. Naked!” Erin’s first encounter with the documentary The Business of Being Born took place as she walked into her sister’s living room. It was the start of a series of events which changed the course of her pregnancy. Erin joined new moms Dina and Grace, doula Elanna Posner, and home birth midwife Cara Muhlhahn to speak to an audience of expectant parents at January’s CiC Healthy Birth Workshop on Choosing a Home Birth.

For Erin, the journey towards home birth began when her sister encouraged her to sign up for Bradley Childbirth Education classes.  The more she and her partner learned, the more they wished for a “blissful natural birth”. But they didn’t feel their OB was supportive. “Our first baby wasn’t even here yet”, she notes, “and it felt like he was going to miss out on the birth he deserved”. They had thought about having a home birth with a future baby. 30 weeks pregnant, Erin found a home birth midwife. She went on to give birth to her son in water in her own home with just her husband, doula and midwife present. “It was everything we wanted for our baby and so much more”.

Dina’s first baby was born in a hospital. “His birth was the main reason – the only reason – I had a home birth”, she says. She had wanted to give birth naturally, but alarm bells rang when her OB reacted to the suggestion of a birth plan by telling her not to bother as she’d be setting herself up for disappointment. She ended up receiving a cascade of unwanted interventions, including having her waters broken and an episiotomy, both without her prior knowledge or consent, and being separated from her baby for several days

By the time she was pregnant again, Dina had done more research and spoken with friends who had given birth at home. She knew she did not want to be separated from her baby and felt staying home was the best way to achieve the birth she wanted. One winter morning, she woke and told her husband, Paul, “I think we’re going to have a baby today”. As labor became more intense, she started to feel a sense of panic and loss of control which she remembered from her first labor. That time, she had responded by going to a hospital.  This time, she called her doula.  Her doula was able to come over and reassure her that labor was going just as it should.

Not long after, says Dina, “my body started to push”.  This sensation took her by surprise – at her first birth the staff had questioned her ability to push. She hadn’t known her body could do that all by itself.  She reached inside and felt her baby’s head. It was time to call the midwife. As Dina labored in the shower, rocking on all fours and “growling like crazy”, their older son woke and Paul and their doula took turns hanging out with him. Dina remembers hearing her midwife laugh when her baby began to cry before he was even quite out. Her second son was born into his father’s hands, while his big brother watched a movie in the next room with their doula.

Many of the expectant parents at January’s workshop were already planning home births, which made for an especially open and candid discussion. Some of the key questions on their minds centered around what may happen if things do not quite go according to plan. How do we ensure safety and what happens if we need a hospital transfer? Is there enough time to get to the hospital?

A small percentage of NYC home birth midwives’ clients transfer to hospitals.  In reality, emergency transfers are rare. If one is needed, you will go to the closest hospital – which in New York City will likely not be far. Home birth midwives bring with them equipment such as oxygen and IVs to deal with most situations which may arise during a birth.  They are also very good at identifying which moms and babies do need to move to a hospital, and ensuring that this happens in good time during labor.

For Grace, transferring to a hospital meant taking an hour’s drive into New Jersey, to a hospital-based midwifery practice which her home birth midwife especially recommended. While a long car ride in labor was not what she had hoped for, she had labored at home with her husband, David, and doula for over 30 hours but her baby remained high in her pelvis. She and her midwife felt an epidural may give her some rest and help labor move along. A doula herself, she was also concerned that hospitals closer to her home may be quick to move to cesarean section, especially given she was at 42 weeks, despite the fact that both she and her baby were doing fine. On arrival, she received an epidural and, on her new midwife’s suggestion, began pitocin.  After many more hours, however, her baby was still not descending. By now Grace had been in labor for almost two days and, concerned about the potential effects on the baby of continued exposure to the drugs, she and her midwife made a decision.

“We had a cesarean”, says Grace. “And it was an amazing experience”.  Grace’s midwife, doula and husband were with her in the OR as she gave birth to her beautiful daughter. Her doula massaged her head while her husband went with their newborn baby. She had never felt pressured into the decision to have surgery and, in addition, many aspects of her and her husband’s original birth plan were respected. They were able to keep their placenta for encapsulation. They had planned to delay cord clamping and, while this was not possible due to the surgery, the doctor did squeeze as much blood as possible from the cord into their baby before it was cut. David was able to announce their baby’s gender when she was born. And Grace was able to begin nursing within her baby’s first hour.

As Cara Muhlhahn noted, a woman’s level of satisfaction with her birth experience can vary according to whether or not she feels she had a chance to labor in the way she wished or felt railroaded into decisions. Whether with an OB, midwife or family doctor, at a hospital, birth center or at home, if we are treated with respect and our wishes honored as we labor, our birth experience becomes a different animal. But in order to do that, we first need to know what our wishes are. Read and learn about birth to figure out what you want for yourself and your baby, then interview potential care providers closely to find out whether their philosophy on birth is a good match for yours. Grace, for example, knew that her own comfort level was to labor for a maximum of around two days and she took care to find a home birth midwife whose approach matched her own needs. Wherever and with whomever we birth, the best thing we can do for ourselves and for our babies is to make educated decisions about which options are the right ones for us.