Posts Tagged ‘homebirth’

Lessons in Childbirth Education

July 6, 2012

Thank you again to Milon Nagi – writer, blogger, workshop facilitator and overall awesome volunteer for Choices in Childbirth!

At our latest Healthy Birth Choices workshop, three sets of new parents shared their experience of Childbirth Education and spoke of how their classes prepared them for labor and birth. Shara Frederick, doula and childbirth educator, gave us an introduction to some of the main schools of childbirth education – Lamaze, Bradley, CEAMNY and Birthing From Within. While the various schools have individual approaches, all are grounded in the idea that birth is a normal physiological process.  All aim to educate expectant parents about this process and help them prepare for their own experience of childbirth. We were also joined by Dr Charles Swencionis, psychologist and Hypnobirthing instructor, who led us through a sample self-hypnosis exercise. Hypnobirthing particularly emphasizes learning to relax and decondition from fear, he told us. Fear causes tension, which causes pain. If we can relax it can ease some of the physical sources of pain in childbirth.

Michelle was planning a home birth in Queens, but, on her midwife’s recommendation, she and her husband decided to take a Home Birth class based in Brooklyn. “It was good to be among others who were also preparing for home birth and who weren’t weirded out by it”, she said. They found their classmates had interesting perspectives and questions they themselves may not have thought of. The class gave her husband “the bullet points” of what to expect and helped him feel more comfortable with them. He felt the class brought him a kind of confidence about birth that he did not get from reading books.  Once the time arrived, he said, “I just felt like we kind of had this.”

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Celebrating a Father’s Birth Day

June 15, 2012

Thank you to Milon Nagi for once again so eloquently describing CiC’s free Healthy Birth Choices Workshop! HAPPY FATHER’S DAY!!!!

At this month’s special CIC workshop on Men and Birth, we were honored to hear four new dads share their moving stories of becoming fathers, supporting their partner’s labor and the birth of their new family.

When David’s first son was born three years ago, he and his wife Rachel chose to birth at a hospital based birth center. While they were generally happy with their experience, David felt that what he describes as “the woman’s process in labor” was not fully respected. They returned with their second pregnancy however, at a routine visit with midwives at 32 weeks, they discovered that Rachel had been “risked out” of the birth center due to a technicality of which their midwives had been aware throughout but had not until then informed them. Their trust in their midwives was shaken. Worse still, says David, “Rachel had had her trust in her own birth shaken.”

They decided to switch to home birth, and speaking to their new midwife “restored Rachel’s trust.” David feels this switch helped them harness both the medical and spiritual benefits of being where Rachel felt safest and most confident as she prepared for her birth. While at times it was hard for him to understand Rachel’s “psychic universe” at this time, he could see that she needed a lot of support. “I worked to swallow my own pride and feelings,” he says, to be there for her in the ways she needed.

Rachel woke up one morning to a speedy labor at home. “She needed me there,” says David, “but she was really doing it herself.” He supported her through touch and massage but she labored undisturbed – at one point even asking her doula and midwife to leave the room. As David watched his wife in her labor, an image recurred to him of her hang gliding over the sensations. “She was totally experiencing all the pain of childbirth but riding on top of it.”

After less than four hours, David and Rachel’s son was born in a pool in their bedroom.  “It made it magical”, says David, to welcome and hold him undisturbed in what was already his home.  And, despite the intensity of labor, “there was a real palpable tranquility that flowed through the experience.”

Patrick shared the story of supporting his wife’s natural childbirth in a hospital, fending off the pressure for interventions to hurry her labor along. He found himself applying the “double hip squeeze” to his wife’s hips throughout, and advises dads to be physically fit for labor support: “You try it some time – press on someone’s hips as hard as you can for two to three minutes; take a break for a minute; go back and do it again. Do that for twelve hours.”

For Micah, preparation was key to feeling able to support his wife fully in labor. They were planning to give birth in a hospital and he was nervous about dealing with unwanted interventions.  As their Childbirth Education class allowed him space to begin to work through his fears, he realized he would be strong enough to deal with this. “It’s great to think through all possibilities of what you might want to do,” he advises. “Prepare, prepare, prepare – and when the moment comes trust your instincts.”

As his wife’s pregnancy progressed past 41 weeks she was automatically risked out of the birth center where they had planned to have their baby. Knowing they’d be heading for the Labor and Delivery floor, they labored at home as long as they could before heading to the hospital. Once they arrived, however, their midwife created the environment they wanted, while their doula, says Micah, was “badass”. They safeguarded the space and energy they wished to have present for their birth, even asking an unpleasant nurse to leave the room. “My role was to be here for my wife,” Micah notes, “to have her back and protect her.”

After a challenging “back labor”, his wife’s water broke and their son was born in just three pushes.  “It was an amazing experience”, says Micah. “The magic of having this human being in our life is so wonderful and the fact that we could have a delivery that went the way we wanted is a bonus.” He too describes the awe and power of witnessing his wife’s labor: “Watching my wife do that… I’m an artist and filmmaker – whenever someone I’m working with says they’re giving birth to their art project I say ‘No, you’re not giving birth. That’s disrespectful to women’.”

Rowan’s wife Emily is a medical student who came out of her Obstetrics rotation knowing she wanted to consider home birth. Waking early on Easter Sunday with strong contractions, Rowan and Emily decided to go for a walk. They bumped into friends they had been planning to have brunch with and invited them over. A day they had pictured as quiet and intimate ended up more of a community event, involving four other friends, home made ice cream sandwiches and a last minute plaster cast of Emily’s pregnant belly!

By the time evening came and some friends left, Emily’s contractions were around 6 minutes apart and they called their doula to come over. As Emily labored on all fours in their living room, Rowan found himself surprised by the amount of back pressure she needed him to apply through contractions. By the early hours of the morning Emily felt ready to push and they called their midwife to come over. Emily got into a tub of water and, for the first time, was able to really rest between contractions.

Their midwife arrived, bringing “the power and reassurance of someone who is practiced coming in and saying ‘everything is alright’.” Rowan reassured Emily that her body was doing exactly what it needed to be doing; that this was the natural process. The last ten minutes of Emily’s labor were “utterly overwhelming.” Rowan remembers shaking and crying. “It was so powerful to hear someone you love so much in pain and vocalizing in that way.” And then, at 5.06am, their baby girl was born. “Emily went from all this pain to looking like she’d just gone for a nice jog and had a shower!” Their midwife and doula stayed a few hours, then left Rowan, Emily and their new baby snuggled up in bed together and ready for a long sleep. “It felt really, really good.”

All four dads spoke about the importance of having additional support during labor. As Micah put it: “the birth is the woman’s work but there is a team in it.” He described their doula as “essential to our having the experience we had.” From continuous back pressure; position suggestions; taking photos; reminders to stay hydrated; running out for snacks; bringing fresh ideas and tools – each speaker described their doula as an invaluable support for him as well as his partner during labor.

They also spoke to the importance of support in the weeks following the birth. Both Micah’s and Rowan’s families had some difficulties with breastfeeding and advised others to seek help early if nursing does not go as planned and have a lactation consultant lined up before the birth if possible. The help of friends, family or a postpartum doula was also invaluable, whether with cooking, cleaning, doing laundry or simply giving the new parents time to nap. In other times and cultures, as Micah pointed out, new families would be surrounded with community support. Rowan found it helpful to have a paid postpartum doula so that they didn’t feel bad about asking friends for help.

They talked about the first weeks as a time during which visitors (particularly family who may be staying) need to be there to support and take care of the new family – especially mom – not just to meet the baby or be taken care of themselves. This can make for some difficult but important conversations with family members as new boundaries are established during this tender time. At the same time, says David: “I can’t overemphasize how blessed you are to do anything for yourself in those first days. Whatever anyone will do for you, take it.”

As each new father shared his story, it was striking to see him feel again the power of this transformative, intimate experience of both becoming a parent and of watching and supporting his partner in her labor.  The joy and reverence on David’s face as he spoke of his wife’s strength in labor and of welcoming his new son into the world just nine days previously said it all: “I got to see a side of Rachel that I never would have seen if she hadn’t given birth and become a mother.  And that is an amazing thing.”

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.