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.