You work with babies...ah, how sweet !

I always find this statement very interesting. Yes, I love babies. I was a preschool directoress for many years, I love children. I am fascinated by them. But, what I really like is working with women!
Women are the most complex beings God created.

• We are strong and powerful, but like to be protected. (I am going to speak in generalities. I know this is not politically correct. If you don't agree with me, it's ok. I know there are exceptions to every rule.)
• We are tough when they have to be and incredibly gentle. Women have insecurities that may have began at very young age about the oddest things--"you would have been a tall girl if you didn't have so much turned under for feet" and we believe them!
• We hear and process everything around us as if it appied to us. We are protective of our children--I have seen women beat the *snot* out of their child, but you let a neighborhood child call them a name and the claws come out.
• Women can whine about a hangnail to the point you would have thought amputation was going to be necessary, and endure difficult long labors without a peep.
• We want independence at time, but love support-emotionally and physically.
• Women are highly emotional, but try to come across as cool and collected at all time.

I love working with women! There is always a delicate dance when women are together. We are intuitive, but miss the signs at times. We put out feelers to see what is going to be helpful and thrive on feedback. It gives me no greater thrill for an expectant woman to call me and express an interest in natural birth. We walk through the pregnancy together, week by week. We get to know each other. I learn likes and dislikes. I hear of insecurities and tried to provide wise counsel. We overcome fears and inhabitions. We process news reports, scarey stories, comments from the guy at WalMart, The Baby Story, and what aunt Susie's 2nd cousin once removed had to happen to her back in 1909. Sometimes we cry together at the end of pregnancy when the pregnancy just seems too long or when someone has dealt with just one too many negative comments about how "big" they are getting.

In labor the dance continues. What is working, what isn't. What helps, what makes it worse. The baby's heart beat gives delight...to both of us. I rub backs and talk moms through contractions when that seems needed or I stay completely out of the way and facilitate normacy. When women get ready to push their baby into my welcoming hands, I trust them to know when to push and how to push. I am watchful and expect everything to go just as it is planned because we are wonderfully created to give birth.

I receive their new baby as I would a gift, with a thankful heart. I rejoice that another young woman has been empowered with the knowledge and confidence that giving birth brings. I treat that newborn with all the love and respect possible holding them gently and welcoming them to this world. I want their first experience with people to be positive. I believe we can change the world by treating other like we want to be treated... this includes babies.

I love watching women become mothers. We are tender, warm and compassionate. We have an inborn ability to be responsive to our little ones. We have the ability to provide that newborn everything he/she needs just as we did when they were growing inside of our bodies.

Women are strong, amazing beings created in the image of God.

Have I told you how much I love working with women?

Wait Upon the Lord

As many know I had the awesome privilege of catching my beautiful granddaughter, Kensley. Jennifer and her husband Corey came to stay with us when she approached 40 weeks. We all thought baby would be here any day and the anticipation of her birth was on our minds constantly. Jennifer took all my advice to not be too consumed with a due date, after all most women when left alone, deliver around 41 weeks. She took walks daily, visited family, ate well, watched movies, relaxed in the hot tub and of course went shopping.

As the days wore on, tension grew, doubts crept in, fear took root and I worried. That is hard for me as a christian to admit as I am always the one who tells others that fear is of the devil and we are the trust in the Lord. One day, my Bible reading was in Psalms 27. In Verse 14, it says "wait on the Lord: be of good courage, and he shall strengthen thine heart: wait, I say, on the LORD. " The same God that David was speaking of is the same God we serve today. He still offers the same promises and gives the same comfort. That verse strengthened my heart in a difficult time. I still had anxiety, we still tried every trick known in the midwifery community to try to get labor started but in the end labor started on it's own and Jennifer's body, designed by God to work perfectly, did exactly what it needed to do to give birth naturally.

I was again tested when labor did start. Jennifer's labor was long and difficult. Watching your child suffer is heart wrenching even when you know it is the right thing to do. All the years of birth stories came back to me from my daughter as she never waivered from her goal of giving birth intervention free. Progress was very slow as she had to work hard to reposition Kensley so that she would come through the birth canal. Jennifer's strength and resolve were amazing. Again those words echoed in my mind...wait on the Lord.

Now lest anyone think I blindly sit back and do nothing in the face of crisis, let me assure you that we were constantly keeping track of warning signs that may indicate there was a problem. If there had been, action would have been taken immediately.

I am of the opinion that we go through events in our lives so that we can learn of God's mercy and grace and we can minister to others. Why is it that we have such a hard time waiting? I am beginning to believe due dates are evil and create much unnecessary stress. We all know babies do not have a calendar, they have no idea that someone came to the conclusion that gestation is 40 weeks, they don't care that the world has stopped to wait for their arrival or should they. What moms and babies do know is that there is a perfect balance and a intricate dance of hormones between them and they communicate with each other constantly. The two of them decide when is the best time to be born. The baby releases hormones that signal the mom to prepare for birth, the mom releases hormone that signal the baby's lungs to develop.

As a mom, what can you do benefit the most from this process?

1. Meditate on the Word - take a quiet time each day and read the scriptures, apply them to your life, pray for understanding
   
2. Stay active- take walks, visit with friends, go out with our husband, have fun
   
3. Trust your body
4. Surround yourself with supportive people- you are going to encounter those who are negative and create doubt in our mind, love them and accept that they don't know all the answers.
   
   As friends and family to an expectant mom, what can you do to help?
   
   
   1. Support their decisions- trust them
      
   2. Don't call and ask "have you had that baby yet?" or "aren't they going to induce you" or "you know that baby is getting too big for you to have" (I thought I would absolutely scream if I heard those phrases one more time and I wasn't even the one having the baby!!!) Calling and talking is fine, ask them about their day, how they are feeling, if there is anything you can do for them or any place they would like to go.
      
   3. Remember they are still a woman, even if they are carrying a baby within- pregnant women are very sensitive to comments. "you sure are big for x months", "your baby looks so small, are you sure he/she is growing ok?", "how much weight have you gained?"

Through this process I have learned to be more sensitive to women who are at the end of their pregnancy. I have an understanding of what it is like to field comments from well meaning friends, to wonder what the future holds, to wait and not be weary. I can encourage those moms who are struggling while at the same time informing them of their options and monitoring for anything abnormal. I feel blessed to have had this experience and know I am a better midwife because of it.

I will trust you Lord...and wait.

Evidence Based Maternity Care

http://childbirthconnection.com/pdfs/evidence-based-maternity-care.pdf

This is an awesome article...very LONG, but great about evidence based maternity care and how we in the USA stack up. It give loads of references and is well written. It can be a wonderful resouce for anyone wanting to gather stats, make an informed decision or look at the cost of intervention, both financially, physically and emotionally.

Postpartum-Dads

I am hearing more and more moms saying they are going to pump breast milk so that dads can be involved in the care of the baby. I have such a difficult time understanding this logic. Let's look at some ways dads can be helpful in the postpartum period and be very involved in the newborn babies life.

Mom and baby have co-existed for nine months, this relationship is not going to change overnight. Moms and babies need to continue to co-exist after birth only now the position of the baby has change. If you look at the physical needs and psychological needs of the newborn, it would appear that if it were not for size, the baby would stay inside for a longer period of time. This same rate of develop that baby had inside mom, continues outside...baby continues to get nourishment, comfort and care from the mom once outside. What does that mean, the time of separation is not at the time of birth, but is a gradual process over the next few months. The reason the baby is expelled from the body is because if it stayed inside, it would no longer fit through the pelvis. Some look at this period after birth as the fourth trimester. Moms and babies should not be separated at this point for both of their sakes.

Dads continue to do for your wife what you did during pregnancy for the fourth trimester

• help with household chores (keeping the house clean or at least not messing it up any more is huge.
• making sure moms have food to eat (this doesn't mean you have to cook, you may pick up a meal, coordinate friends and family to bring in meals, heat up a frozen dinner)
• be her legs ( she is likely tired and sore, get her things so she doesn't have to get up)
• take care of other children (again you don't have to do all this yourself, coordinate with friends and family)
• encourage her verbally ( she is likely to feel inadequate, hormones are doing crazy things, don't try to fix it, just let her cry if needed, tell her things will get better and hold her)
• be patient ( you will get your wife back :)

Some wonderful women wrote on labors of love face book...check it out. You can just hear the love in their hearts as the tell of all the many wonderful, little things their husbands did for them.

Risks of C-section

This organization have some wonderful handout on many different issues facing pregnant women. Since I had just written about avoiding a c-section, I thought I would post the risks of having one. I find the hazards of repeat cesareans particularly interesting. We hear so much about the hazards of VBAC and the lack of accessibility, I think if most women sat down and looked at the long term risks and benefits, they may work harder to avoid them in the first place and then would fight harder for their right to VBAC. http://www.vbac.com/pdfs/CesareanFactSheet.pdf

Avoid C-Sections

As I read this article this morning I was saddened by the fact women have, in many areas, lost their ability to birth naturally after a c-section. This makes birth choices even more important.

The thought that kept coming to my mind was how can we avoid the first cesarean. I have a heart for those women who have had cesareans and want the option of a VBAC, but my hands are tied. Most women do not go into childbirth desiring to have major abdominal surgery.

Here are some things to consider:

1. Educate yourself. Even if you don't desire to have a natural birth, take a non-hospital based class. You will learn about many other aspects of pregnancy, labor, birth, postpartum, baby care and self care. These classes are usually several weeks long. There is a reason for this. You can only retain so much information at one sitting. You will have questions come up after you get home, write them down. If you don't take a class, read and research on your own, ask questions, prepare for you birth. I love The Thinking Woman's Guide to Better Birth by Henci Goer. The other reason to educate yourself is you don't know how things will go with your birth. Your epidural may not work, you may have a very fast labor and there not be time for medication, you may be stranded on a desert island...ok that one is a bit of a stretch. Would it not be better to be prepared than terrified of what is happening to you.


2. Choose your care provider carefully. Find out what their c-section rate. Find out how many of those c-sections are primary vs. secondary. What is their attitude towards c-sections? This can be altered due to the number of high risk patients they work with, but even that may be a clue to you. Interview the hospital or birth center where you plan to deliver. Ask the same questions. Some facility protocols are normal birth friendly than others. Remember in the rest of the world midwives care for normal, low risk women, doctors care for high risk women.


3. Choose carefully who is with you during birth. Your support person is vital to the success of your birth. Only invite people expect a positive outcome. If you are birthing in a hospital setting or a birth center that does not offer labor support, hire a doula or invite a friend who can help you reach your goals.


4. Avoid induction. The rate of induction has skyrocketed! There is a convenience factor for both families and care providers but the risk are huge. When you are induced, you opportunity for having a vaginal birth plummet. There is a delicate dance between mom and baby as to the right time to be born. Babies go through the final stages of developement, moms bodies prepare for labor. Everything works in perfect harmony, leading to shorter, more productive, more satisfying labors and births. The old addage the apple will fall when it is ripe is so true.


5. Avoid unnecessary intervention. Intervention, when necessary, can be life saving. When used unnecessarily, intervention can lead to higher risk. An example, the simple introduction of IV fluid in the bloodstream distrupts the natural balance of hormones needed for labor to continue. To get labor back up to a productive level, pitocin must be added. Pitocin leads to more painful contractions because of the way it acts of the uterus and brain. Pitocin requires closer monitoring which inhibits movement. It can also lead to fetal distress. Less movement, more restraint and more pain often leaves moms with little option other than asking for pain relief. This is usually in the form of epidurals. Epiruals limit mobility which can cause malpresentation making labor longer and more difficult if not impossible. Most women don't realize when the allow an IV to be placed, they are actually signing up for a "package" deal which could very likely completely sabbotage their orginal plans of a normal birth.

Childbirth is a normal process. Let's not give up our ability to have babies normally. Count the cost ahead of time.

http://www.time.com/time/magazine/article/0,9171,1880665-2,00.html?iid=perma_share

Snow is SC

We drove home today from the coast. It rained most of the day so travel was a bit slower than usual. Once we got home the snow started and now we have a winter wonderland. I always like the snow. It cleans the air and the mind. Everything looks so pure and white. The crispness of the air is refreshing. I love to walk in the snow.

Winter is a natural time of pruning. The snow is heavy and burdensome. Old branches fall from the weight of the snow. If the tree has been well cared for by professional pruning, well fertilized, good root system they fair much better.

Labor is that way also.

Women who have a good support team, supportive husband, loving family, and care providers who are respectful of their wishes fair better. Those who have grounded themselves with a good childbirth class are not easily swayed in the tough times. They don't break under the pressure. They are confident in their ability and they stand strong.

Women who go into labor well nourished and healthy have more stamina to sustain them through labor and birth. Exercise such as walking, swimming, yoga, and strength training prepare the body for the hard work that is ahead. It also give confidence in knowing what you are capable of doing.

Pruning back you life and focusing on the priorities is also helpful. This might be getting rid of excess baggage around the home, trimming back schedules, eliminating activities or streamlining material possessions. It may also be a great time to get rid of emotional baggage. If there has been sexual abuse or trauma in your past, this is a good time to talk with a couselor or your care provider. You probably don't need to rehash the details but acknowledge it and recognize there are going to time you are going to feel very vulable during labor and establish for yourself safe boundries.

Birth is a process of releasing. Releasing your fears, surrendering to the contractions and finally releasing the baby from you body.

Just like the tree that is well pruned, well nourished and has strong roots, your body too will produce the most glorious fruit.

Balance

I go through times in my life where I am very balanced...spiritually, physically and emotionally. This is always my goal, however, there are times it is necessary to be out of balance in order to accomplish a major task. The key is getting that balance back and staying balanced the majority of the time.
Why do we have such a hard time doing this? Do we not recognize the value? Do we not have the energy? Do we not know how to achieve it? Is it harder for women? Do we feel more spiritual when we are giving sacrificially?
If we don't recognize the value, we will never strive for balance...what is the value? You are in a much better place to serve if you are in a healthy place yourself. You can only give what you have.
How can we achieve balance?
Meditate on the Word-the Lord gave us an incredible set of instructions, it is up to us to read and apply them
Exercise-our bodies waste away if we don't use our muscles. We release wonderful endorphins when we work our muscles. We have a sense of accomplishment when we move.
Eat Well- this means different things to different people. You get direct result based on the "fuel" you put in your body. Step your diet up one step...if you are eating out, make better choices, if you are eating canned and processed foods, eat frozen. If you are eating fresh, step up to organic. You probably will not stick with a plan that changes everything at one time...take baby steps and stick with it.
Get enough sleep- your body heals as it sleeps. Your body needs 6-8 hours of quality sleep every night. If you are not getting that at night, take naps. You handle issues better if you are well rested. Life goes smoother.
Be Thankful-Life will throw you curve balls...be thankful, look for the growth, the benefits and the good that will come out of it.

God's Perfect Timing

We always tell moms their babies will come in God's perfect timing. We know there is a delicate dance that goes on between moms and biabies just before birth. Babies produce a hormone that prepares mom's body and moms produce a hormone that helps babies make the final adjustments before birth. Although that is a much simplified version of what goes on, it is true. Science is now able to document it.
This waiting game is often very difficult for moms in our culture. We want everything on an orderly time schedule, one that doesn't interfere with our other plans like work, birthday parties, special occasions, etc. It is hard to be still and wait upon the Lord.
I had an interesting experience today that brought this all to mind, I had my plans and my schedule. I had everything lined up to be in perfect synch with my plans. Meetings were scheduled, appointments were made, there was much driving involves so that was taken in to consideration.
As it turned out, we left later than expected, I had actually planned an extra bit of time so we were still ok. About an hour into our schedule of activities, two police cars past us at full speed and running their lights, a few minutes later two more police cars past in the same manner. I felt there must be s big problem ahead. Not too much time past and we came to a halt , inching forward at snail's pace. More police cars, ambulances, fire trucks, DOT trucks sped past. This thing must be huge. About two hours later, we approach the scene of the accident. Jay counte 17 vehicles, some mangled beyond belief. We made a quick adjustment in plans, cancelled one appointment which really needed to be done and thanked God for His protection. Two hours late and cancelled appointment are nothing like what these folks were going through.
We stopped to get coffee and just as we got back in the car my appointment called, turns out she was 15 minutes away from where we were and could go ahead and meet right now instead of later. THis was such a blessing because with that change, we could go on and do Jay's appointment and still make the last event of the day.
Everything worked out perfectly and I am grateful. I have to wonder what would have happened if we had left on time. We will never know, but for tonight I am going to be grateful for all things...Thankful Jay got to spend some time with his mom and dad, thankful we were running behind schdule, thankful for the flexibility of others, thankful for a wonderful and loving husband who was willing to let me do my appointment when we thought we could just do one and not both. I am thankful for traveling mercies as Jay and I are both on the road a lot!
Now back to the patiently waiting that comes in pregnancy, give thanks for the extra days you are able to carry you little one inside. It is a special blessing that is self limiting. This time will not last forever. We don't know what the future holds.

Lovely Day

Amy and I visited a wonderful young couple today who are interested in having an out of hospital birth. They are furniture makers by trade. I almost had a "Mimi momment" and bought a custom made baby crib. I restained myself. Their work is absolutely beautiful with much attention to detail.
We then went to Laurens High school and talked with a group of about 25 students who are interested in nursing, EMT and other health related fields. I love talking to young people. They are so full of questions and so full of life. They loved the birth film but were a little grossed out by the placenta...we love placentas :) I also feel when we talk to these young people it helps them stretch and grow just a bit in their understanding of what is normal. Birth is normal! Stay away from interventions unless necessary. I try to instill confidence in their ability to give birth. Many have never even considered having a baby without medication. Now they have something to think about.

Breastfeeding-the first few days cont.

Be responsive to your baby, but recognize that there are other ways to soothe besides being put to the breast. Other people can soothe your baby also. This idea will disturb some people, but babies have the capacity to securely attach to one than one person. Some of the best adjusted families are those who have help come in for the first week. This allows moms to get much needed rest and babies to be nurtured by others.

Some babies have very little interst in the breast for the first few days. These babies hold out for the milk. They are vigerous nursers who empty the breast of colostrum within a few minutes and then have no desire to nurse. Once the milk comes in they are very content.

Proper latch is vital in a good nursing relationship. If it is painful to nurse, there is a problem. Seek help in establishing a good latch. Call your midwife, a LaLeche League leader or member, your childbirth educator, a postpartum doula, or a lactation consultant. Don't wait unitl you have a crisis on your hands and you are ready to throw up your hands and quit. Get help early. If your nipples are sore, a tsp of salt and 1 cup of warm water will do wonders. Follow that up with lanolin cream. Don't use soap as it is very drying.

If you are concerned about milk supply, 6-8 wet diapers a day indicates enough milk. If you still have questions, get your baby weight. The average baby will gain about 6-8 oz a week.

Feed yourself. You will feel much better and produce milk better if you are well rested, have enough fluids and are eating enough...about the same as you were eating in pregnancy.

Breastfeeding-first few days

As you know I am re-reading BabyWise. I am not advocating this method but rather looking critically as some of the suggestions for parenting. Rather than rehash the book, I decided to share some of the ideas that have worked with moms and babies over the past ten years. Some of those ideas are in line with what I have read, others not. You decide for yourself if these would be helpful to you.
Moms sometimes ask me right after baby is born...how will I know my baby is hungry? Great question and shows interest in the child's needs.
Babies come from the womb in various states of hunger. Some attach to the breast immediately while others look around, get settled, root and lick a bit and then latch on. Some suck vigerously right from the beginning, others "play" at the breast. This is all within the realm of normal. After their first nurse, babies will most often take a very long nap, a period of non-reactive sleep. These little guys are saked out. They have no interest in anything. They have had a tough journey and the are ready for sleep. There is no need to wake your baby during this time. It may last 4-6 hours, we have had a few babies sleep, only waking briefly to look around a bit, for 8 hours. As long as baby is pink, well flexed, breathing without any distress and maintaining their body temp, they are fine.
After this inital sleep, babies will nurse every 2 to 3 hours. These nursings will take from 20 to 30 minutes, usually. The important issue here is good active nursing during this time. Once baby is attached, they need to be encouraged to stay awake and complete that time without falling asleep at the breast. What I find when babies are allowed to fall asleep at the breast is frequent, short nursings, very sore, tired moms, and discontent babies . This is frustrating to everyone concerned.
Oh my, time for church...more later :)

Sleeping Babies

I have been contemplating a post I read recently about babies not sleeping at night. I decided to reread a book "Being BabyWise" because of some very bad reviews I had heard. Comments like "this method is dangerous" and "detrimental to breastfeeding relationships"
My first exposure to this method was with a family who had two children, they now have six. When I arrived at their home for an initial visit, the children were in their room, with a baby gate in the doorway so they could see their parents. They played contently for about an hour while we talked. At the end of our meeting, the mom pulled out banana bread and drinks for all of us including the children. They sat at the table with us and "engaged" in conversation while we enjoyed our delicious snack. They were polite, the mother was calm, the home was orderly and pleasant. I asked her what parenting technique she used and she shared with me the book. As with anything you read or are exposed to, she had made modifications to the method to fit her family needs.
I have watched this family grow through the years. They are respectful to one another, loving and compassionate. Their lives are orderly. They are happy and well adjusted.
My point in all this pondering...read for yourself, take the good, ditch the bad and accept that there are many different methods out there and they all work for some people. Take a look around you and observe the families you admire, use them as a model. You may not do everything they are doing, but you can pick up a nugget from each one.
Be responsive to you children, but not reactionary. This can go two ways. You may be react because of the way you were raised...I won't ever do _____ to my children. (very dangerouse words) Or you may react to your child. Take the time to figure out what your child is needing (yes needed are different than wants) and respond appropriately.
Use common sense. Children have no boundaries except what you set. They are constantly testing those limits to see what is acceptable. It is ok for you, as the mom, to have needs. You are not selfish if you need sleep, to go to the bathroom, take a shower, or eat. I know you may be thinking, surely moms don't feel guilty about doing basic care for themselves...surprise, I actually talk to moms who have not showered all day because or eaten because if they put their baby down, they will cry...and they feel they are being bad mothers for allowing their baby to cry for the 10 minutes it would take to hop in the shower. Now lest someone take what I just said and completely twist it around...I am not advocating ignoring or abandoning your children. What I am saying is recognize your need, recognize your child's need and make a compromise.
It may look like this...
Mommy needs to _________ (you fill in the blank: get a shower, fix lunch, get sleep) You have been fed, changed, held and loved. I understand you like to be held and mommy loves to hold you, but right now I need a ________ so I am going to put you down in this safe place and I will be back to you in just a few minutes. You will not warp your child or make them insecure with this approach. They are very smart. They will learn you have not abandon them, you do come back, and they learn to comfort themselves.
I will reserve my opinion of BabyWise until I have finished rereading it. I let you know what I think. For now, remember that you family is a unit made up of memebers and each member has needs. The family unit will function much better and with less resentment in the long run if each member has their need met and no one member's needs are elevated for extended periods of time.