Saturday, October 1, 2011

A Birth Story as told by the midwife

I had just dozed off when I got the call from Tracy. "It's time, the contractions are pretty regular, six or so minutes apart" It wasn't a surprise - I had received the warning call an hour or two earlier and I already had packed my little survival bag - extra socks and a long sleeved shirt ( laboring moms can get hot, so they often like to have the room temp pretty cool) snacks to stabilize my blood sugar, and gum, since we'll be in close contact. My midwife bag was always in the car, ready to go.

Tracy told me she wanted things low key and she wondered if I could come alone. I told her that since the closest medical help was an hour away, I would feel better if my both Deborah and Belle were there. I told her that we would only come into the room when she wanted us, or when necessary. I told her that she'd appreciate their help when it came time to birth the placenta and move from the pool to the bed with her new baby. And she was good with that.She just wasn't ready for the troupes right now. As we ended the call, I told her I was glad that her baby would come tonight.

I got dressed and went into the kitchen. The kitchen always seems extra cozy when just about all of the world is asleep. Even the horses next door were quiet. I called Deborah and Belle- they would be on their way.I made a cup of tea, and my husband came in and packed a few extras for me, as is his usual routine. He gave me a sleepy kiss and I was on my way.

I drove down the lane and under the cottonwoods, and onto the little 2 lane highway. Tracy lived in a nearby ranching community, and as I drove ,it felt like just me and the Arizona landscape that I love so well, all lit up by a big moon. I never really mind working at night.I reflected on the fact that Tracy had reported contractions six minutes apart, but during our 5 minute conversation she'd had 2. That would be just like Tracy to under play. No drama for her.

It was easy to find Tracy and Kenny's house in the dark. I passed only a couple of houses on my way, and their's was the first house with a light on.

I was greeted by the family's hound dogs- Kenny came out to hold Miss Sunshine back. He showed me into the kitchen where 3 cups had been set out on the counter. He didn't have to show me the coffee percolating in a blue enamel pot on the stove- the aroma led the way. But as I entered the kitchen, that scent mingled with the heavenly fragrance of warm ripe peaches. The kitchen island was covered with them , and with produce from the family garden - chiles, tomatoes, squash, mmm. It smelled wonderful.

I turned to take my bag into the bedroom, and only when I heard her voice softly say, "Hi, Paula" did I realize that Tracy was there, laboring quietly in the low light cast from the kitchen into the living room. I was happy that Kenny had quickly dropped the host courtesies to kneel beside Tracy as a contraction came on. She made no sound, but indicated the contraction by looking at Kenny, then looking down.He was rubbing her lower back with a ball, and it was easy to see that they didn't need to exchange words. They were completely tuned in to each other as they worked quietly together.

After a couple of contractions we went into the bedroom, and checked on Tracy's progress. She was 6 to 7 centimeters open - well on her way. And the baby's heart tones were strong and regular. "Can I get into the pool now?" Tracy asked. Kenny told me it was all set up, I only needed to turn on the water at the water heater. So I did that. She got into the pool, and I settled at the kitchen table with my paper work and a cup of coffee. I looked around at the country style surroundings and the animal skins over the curtain rod, the deer antler hat rack. It felt very comfortable and warm there-- unless you're a fox!

Tracy and Kenny had intended to send the older 3 children, Lena-May, Tucker, and Samuel, to her sister's home but had decided that they could stay in the tent that they had set up in the yard outside. Kenny was keeping a small walkie-talkie handy and periodically one of the children would report in, "Samuel is still awake." "Sister is awake." They were trying to be calm and doing a very good job, but that's hard to do when your baby brother is about to arrive!

All was quiet in the little house. After a while a car drove up. Kenny came to the door to hold onto Miss Sunshine, and then he went quickly back to Tracy's side. Deborah and Belle came in. I showed them how I had set the intruments and equipment up on the kithcen table, not wanting to disturb Tracy and Kenny. They peeked through the door to say "hi" to Tracy, and then we three settled around the kitchen table, quietly talking about our day. Every 15 minutes or so, one of us would go in and listen to heart tones. Although Tracy made no sound, even from the kitchen it was clear that what they were doing was working and that she was progressing well. At one point I heard a slight sound of a mom ready to be sick. I started into the large bathroom where the pool was set up, to help. As I opened the door, I saw that Kenney was on it. Tracy looked up and I read her eyes to tell me she needed her privacy more than she needed my help- Kenny had it covered for her.

After a few minutes I went in to check heart tones. Tracy said to me, "Paula I realize that I'm scared" I asked her what it was that she was most afraid of. She said, " I really don't like to push. I don't want to push" And I responded, "Well ,then, don't push." I told her that she didn't have to. That at home we don't need to do a lot of forceful pushing. The baby would come out by just the natural forces of labor, if that was what she preferred. Tracy looked at me like she wasn't sure if she bought it, but, okay.

I went back into the kitchen and a few minutes later I heard the first very slight hint of a labor moan. I felt that Tracy might be nearing full dilation. I waited until the next and when I heard another gentle moan I went in to listen again. Another moan and I walked around the tub. I thought I might see one of the external signs of complete dilation, such as a red line to the base of her spine, or a bit of blood in the water. I looked and uttered a very surprised, "Oh!" as I saw a large bubble of amniotic bag, which on closer look had a sweet little baby's head inside. I asked Kenny, "Did you want to catch the baby?" He said, "No I think I should stay here where she needs me." I believe he was surprised, too when I bent down and told Tracy she needed to birth the baby's body now. I said "One push, Tracy" And as she said, "I don't want to", her baby slid gently into my hands. At that very moment, Deborah and Belle quietly entered the room. The baby was still in the veil, covered to his navel. I lifted it off him and over his back- it was a strong bag! Belle and Deborah helped Tracy to turn her body over the umbilical cord and to sit, as she recieved her baby into her own hands. She smiled, and Kenney gave a little chuckle as Deborah and Belle and I backed a few steps away to give them some space. There were a couple of photos taken. This looked to be nice sized little guy with such a perfect round head and face! Beautiful Boy! Quiet, and taking it all in.

After Tracy stood to deliver her placenta, we tucked them in to bed with a snack. With mama all cleaned up, the rest of the kidlets were invited to meet their new little brother. Samuel, the next youngest, hid his head on Daddy's shoulder, looking pretty unimpressed. He was overwhelmed at the sight of 3 women in mom and dad's bedroom at 1:00 am. But he warmed up a little as we did the baby exam. The siblings enjoyed that part, and new Baby Kenney happily sucked his thumb.

Deborah and Belle and I gave our congratulation hugs to the new family and gave Baby Kenney our welcome to the world. It was a good night. We left feeling job satisfaction that I am sure is rare in this world. Coming home in the quiet of the wee morning hours, slipping into our warm beds, we each gave thanks for the gift of meeting new life.

Thursday, September 15, 2011

For Grandparents

Becoming a grandparent is such an exciting event. And whether this is your first grandchild, or a new one of many, it's a big change in the life of a family. We are expecting our 10th grandchild in January, and I really couldn't be happier. Ginger Lily .. I can't wait to see her, to hold her. My husband and I have already bought her a couple of tiny outfits. Something "Gingery"

I have heard that the swahili word for grandchild means "mine of mine". I don't know if that's true, but I love it. My grandchildren all feel like "mine of mine".

But, as grandparents,it's not about us! We acknowledge that our experience is certainly secondary to the experience of the expectant mom and dad. This is definitely another one of those times as a parent that we must adjust and get used to a new role!

I often wonder whether expectant grandparents are aware of just how they impact the experiences of their adult children. It might surprise them to know that as a midwife, much of the discussion about how the pregnancy is going and how the couple is feeling about the pregnancy and upcoming birth, is actually spent talking about influence of the grandparents .I'm absolutely certain that what the expectant grandparents intend,is to contribute to the experience in a positive way. And quite often, that's exactly what they are doing. But too often, and without negative intentions, the grandparents can inadvertently contribute to stress in the lives of their expectant daughters and sons.

So, from the perspective of your daughter's midwife, here are some thoughts about how to use this time to create a stronger and more pleasant bond.

First, let's just think about it. What, really, do our adult children want? I think they want the same things that we wanted from our parents. Respect for our own wisdom and independence. Acceptance. And maybe a little space to create our own lives the way we want to live them :-) right? And if, as parents, we have done our jobs well, we can step aside with confidence that our adult children will make good choices. And they have the right to learn, just as we did when we first became parents.

My first words of advice are to be positive. For generations a large part of our identity as women has been based on our birth stories. So , if your birth stories are positive and empowering - share. That's good. That's powerful! If your birth stories are negative and might introduce fear, why not find a way to turn that around? There are so many ways to instill positive images- tell her that her body is strong and beautiful. That she was made to give birth. That today's women are so fortunate to have choices. And how about this one -- that you support her decisions. That this is her baby and you believe in her ability to birth the baby in the way that's best for her and her family. That you believe in her ability to make appropriate decisions as she raises her children.

If she's planning a homebirth or a waterbirth, and you have doubts about that- do some research before you share opinions or judgement. would be a good starting point. And know that you may remain a bit uncomfortable with the idea until the baby is safe in it's mother's arms. That's normal and it's okay. In our generation we were raised to put our faith in the medical community, and those feelings don't change over night. But in the end, you will feel better about your relationship when you have supported your daughter.

Now, on the other end of the spectrum, for many expectant grandmothers, seeing our daughters claim their power can be extremely healing. I have had grandmothers and great grandmothers come in to appointments with their daughters and talk to me about their births. I have had many older women say that this is the first time they have ever talked about their own birth experiences. Often times the pregnant mama enjoys this intimate sharing of the feminine experience. And she finds that a lot can be learned from her elders. But it's Very important to remember that this is about Her. She is the one we are focused on. What a wonderful thing, to be able to remember our stories and have a time to process the similarities and the differences in our lives compared to our daughters lives! If you find yourself triggered to relive your experiences during these incredible rites of passage, you might wish to do journaling, art work maybe even get a womens group together and talk. Let your daughter lead the way in regards to how much she really wants to focus on what your pregnancies and births were like. As I said earlier, this can form a more powerful bond if she is interested in and excited to hear about your birth experiences. But if she feels that the energy is shifting and it's becoming more about you, that can be annoying to her.

In this day and age of career women, and easy travel, often times families are far removed from one another in regards to distance. A young pregnant woman might find that her suport group is shifting, as much of her social network has probably been around work or school, and maybe she doesn't have a lot of close friends with babies. Becoming a mother can be isolating. It's a time when a new mom might need extra support from her mother.

If you are planning to travel some distance to be available for the new family, it will be great, but can pose challenges. You may need to arrange to take time off work; you may want to purchase plane tickets in advance. These things are hard to plan! Keep in mind that the typical first time mother gives birth a few days after the designated "due date". And remember when you were pregnant? If an expectant mom is given more than one due date, they typically like to focus the earlier one. That can prove to increase stress and put a twist in your travel plans. There is a 6 week window during which time the baby could arrive! If your time is limited, keep an open mind. If you want to be there for the birth a good attitude and good luck will help! Know that you might be there to visit your daughter in the full bloom of pregnancy, or see the baby after the birth. Letting go of expectations will decrease stress for all involved, and that will increase the probability that her body will function normally in the the time that's best for the baby.

If you are visiting toward the end of the pregnancy, here are some tips to facilitate an easy care free visit and a timely birth:
Plan some fun activities together- Don't just sit and wait for labor! Some good ideas include short day trips, take in a movie- but get her an isle seat. You might want to do something like give her a gift certificate for a nice massage then go to lunch together. The idea is to do things together that will keep her comfortable and relaxed. Enjoy time together. She should not feel like a ticking time bomb. If your visit will be more than a few days, you might also consider a night ot two in a motel. That will support her normal rhythyms and her body's receptivity to the hormones that get labor started.

And during your visit, remember the power of your words. Make sure that you avoid statements that put pressure on her - even if you think you are joking around or teasing. With the whole family anxiously anticipating the arrival of the baby,you'll definitely be talking about the blessed event. But make that just a part of your discussions.

After the baby comes you can sit down and release a big sigh of satisfaction. For a minute! :-) Try to get some rest during the course of her labor so that you can be better able to help when she's exhausted after giving birth. You'll want your priority to be taking care of your own "baby" so that she can take care of hers. If that means a little baby rocking while she rests or takes a shower or bath, I'll bet that can be arranged. Otherwise just supporting her bonding is the best thing you can do for her. Most grandparents are more than happy to do a little cooking ( or picking up take out!) and taking care of some basic household duties so that she can recover. I know I don't even need to mention that. Also, tired new parents might need some reminders to take care of mom's recovery needs. It won't hurt if you familiarize yourself with postpartum care instructions.

Most importantly, enjoy your bond with your new little family member. Babies are very aware and the memory of that love early on will set the stage for a fun relationship in the years to come!!

Thursday, August 25, 2011

Musings on Childbirth Education

Sometimes when I think about it, just the idea of chilbirth education classes is kind of interesting. It says a great deal about the culture we live in. We so value knowledge. But yet, what happens to the wisdom?

When I was a young woman expecting my first baby in 1973-74 childbirth classes weren't even available in my community. Everythinmg I really needed to know had come from my mother, my grandmother and my aunts. They all had their birth stories, and whenever they shared, there was kind of a glow in their voices and in their eyes. Even the more difficult births were discussed with smiles of great satisfaction. Each discussion ended with a statement that giving birth was the most amazing, or beautiful, or satisfying thing a woman would ever experience.

I have always enjoyed reading, and during my pregnancies I read everything pertaining to natural childbirth that I could get my hands on. While the goal was to learn, in retrospect I think that the reading was more about the energy. The energy of connecting with my baby. The energy of doing this for and with my baby. The energy of love for being pregnant.

The over-all message was that birth is normal. If you just relax and have a positive attitude it's very do-able.

And until the 1940s - 1950s the way women learned about birth was from their community of women, especially women relatives. It was seen as a normal part of life. Advice was shared, little mysteries were shared. But really, the concept was that babies come out. How much did you really need to know about the nuts and bolts, the science, the engineering side of it?

As childbirth moved into hospitals and became a medicalized ptocedure, it became surrounded with more fear. The prevailing attitude was that women needed drugs so that they could be rescued from the pain and shame of childbirth. And that women were too frail to withstand the rigors of birth. With birth now taking place in medical institutions, infection rates increased and the message of fear took a very strong hold on American women.

So, soon we had a few pioneers in the field who recognized that fear was our enemy when it comes to birthing our babies. It's ofen said that knowledge is power. And it's clearly true that women have the right to understand how our bodies work. And so, mostly due to the work of Fernand Lamaze, Marjorie Karmel and Henci Goer,( who formalized The Lamaze Method)we now have Childbirth Education Classes.

For most of my career as a midwife, I have had objections to the mainstream childbirth education methods. First of all, the idea that there is one actual "method" that could work for all birthing women kind of offends me. Each woman will find her unique strengths and her way to birth her baby.You can't put that in a box. I also found it interesting that none of the early methods were devoloped by women who had given birth. Lamaze, Dick-Read, Bradley, Laboyer are all very caring individuals that have done much for furthering positive beliefs about childbirth. But as far as convincing me to buy into any of these methods as the way in which all women should give birth- these guys share a particular disadvantage - they're all men, none of which has ever given birth to a baby.

Thankfully, there are now many choices for women wanting childbirth classes. There are several educational programs available today developed by women who are mothers and some by midwives. Interestingly, it seems that many of these programs designed by women offer a variety of tools to ease your birthing experience and are less dependent on a set "method" of birthing. They tend to offer more in the way of guidance to your own empowerment.

Lately I've been teaching HypnoBirthing, and I love it. While it's promoted as a method, it's a method of connecting with your own birthing instincts, your own individual power, and connecting with your baby. It's based upon eliminating fear and through postive messaging to your body and mind,enhancing a peaceful normal birth experience. I believe that I've seen amazing things with Hypnobirthing- shorter labors, easier labors. I think I love it as much as I love waterbirth.

At the midwifery office, Belle also teaches a class on basic comfort measures, and tools for facilitating an easier birth. Part of this class is recognizing your own strengths and personal challenges and how you can use these parts of yourself to have a better birth. Thank you, Belle!

Recent research shows that the number of women who attend childbirth preparation classes is diminishing. The study showed that CBE has in recent past,been prevalent among white women with higher education. But the numbers of women who express an interest in CBE is declining among all socio-economic groups. I wonder why? I doubt that it's because women no longer have fear of giving birth. It's probably about the combination of wide-spread availabilty of information on the internet, and the fact that the majority of American women just want an epidural and don't want to be bothered with it. Sorry that sounds harsh. It's just the way it's been going.

So now, back to the original thoughts... hmm.. the knowledge is available. How available is the wisdom? I think it's very available, but how does the mainstream American woman, who has been inundated with negative messaging find her wisdom and gain peace in her birthing process?

Thursday, August 4, 2011

My Calling

Sometimes I find myself in a position to write a profile on myself and my midwifery. This is Soooo challenging . How can I say what midwifery really means to me in a profile?
Midwifery is the rhythm of my life , the beating of my heart; it runs through my deepest veins. Sometimes it runs through my veins as naturally as smoothly as our unconscious sleeping breaths. Other times, as naturally, it pounds with passion, coloring my feelings in a way I cannot contain.

The mystery of the feminine, of birth, is more engaging than any author you will ever read, any movie that keeps you on the edge of your seat. Who will this child be? How will he change his world. How will this mama be affected - will it be as a gentle breeze over grass, or as a storm can forge a new river through the face of the earth?
What can I bring to these families?
And will I actually know, be aware of, the ways in which each woman has changed my life?
All I really know is that each woman, mother, and midwife that I get to work with will leave her lovely marks on me. I am So very grateful that midwifery is my calling.

Friday, July 22, 2011

The Emotional Signposts of Labor

Nicole here for your post today!

Did you know that for most women it's completely possible to have a baby and never have a gloved hand in your vagina the whole pregnancy?

In this world of routine cervical examinations starting at as early as 35 weeks in some practices and hourly progress assessments in the hospital it's easy to forget that! But an experienced and knowledgeable birth attendant or supporter can make a pretty accurate guess of how close the birth is by how the mother is feeling and behaving. These indicative behaviors and feelings are widely called the "emotional signposts of labor" and all it takes for someone who has spent a fair amount of time with the mother is to watch her for a few moments and her labor progress becomes pretty clear.

Today you get an inside scoop to what birth workers know. Handy, right? Especially for you dads out there!

Unlike the stages of labor, there are five, instead of three, major emotional signposts.

1. Excitement. When labor starts many women think "FINALLY!" They want to walk or move to encourage contractions, they glow with anticipation and enthusiasm. Smiles come easily, some women want to tell everyone, others worry that this isn't really "it", and keep the news to themselves for the time being. This usually lasts from wherever labor started off at dilation wise until about 4-6 centimeters, which is when active labor kicks on. Best thing a supporter can do? Help distract mom with conversation, jokes are especially effective, since laughter helps sphincters open up (which is essentially what the cervix is). Make sure to keep it away from anything that offends her, and stop when she gives signals she wants you to stop!

2. Acceptance. Mom becomes more introverted, quieter. She still smiles and interacts between contractions, but during contractions she likes to concentrate. Many are still excited about the upcoming birth, others, especially if labor has been long, start to feel a little anxious. Wow, it's really happening, the baby really will be here soon! As this stage progresses, most women want to call in their supporters, though others will want to retreat into dim lighting, silence and solitude. This is active labor, from about 4 centimeters dilation until about 7-8. The best thing you can do for mom now is to follow her cues. If she wants quiet and dark, give it to her. If she wants lots of physical contact, give it to her. She's really working hard here, and stress or too much outside stimulation can make labor more difficult, longer or even reverse.

3. Doubt. For many women labor gets even harder. She may be thinking "Can I really do this? This is too much, I can't take it any more." This is transition, from about 7-8 cm clear to 10. She communicates in one-word sentences, grunts, groans, even screams and curses much of the time, as talking takes too much of her focus away from what her body is doing. There are powerful forces at work and mom starts to wonder if she's up to the challenge. Many women cry out that they can't do it, for someone to take the baby out of them. They can't get comfortable, and many want to run away. You may see a lot of squirming, position changes and hear a lot of vocalizations, or mom may become completely silent. For many women this is the most intense part of labor. The best thing supporters can do during this signpost is respond to mom verbally when she tries to communicate, praise her efforts (those are good sounds, that's a good position), touch or don't touch as she wants (many women can't stand to be touched during this phase), and remind her that she IS capable of this, she IS doing it and labor WILL end!

4. Second wind. Out of the ashes of transition rises the birth phoenix. Slowly or all at once, mom gets a surge of adrenaline and like magic she comes down from the cloud that labor took her to, and she can move and speak again. She is more cognizant of what is going on around her. Some women are astounded by the change in their mental state, others accept it calmly and make the switch from passive participant to active force in their labor more slowly, but the change comes. She goes from riding the contractions to using them and puts all her energy and focus into getting the baby OUT. Many women report that the pain of labor greatly diminishes during this phase, which is the second phase of labor, or the "pushing phase". The whole energy of the room changes and you can see it in the mother's and your birth team's faces. Eyes are bright, the face is focused and calm, the birth is near! The best thing for you to do now is to help support her in whatever position she feels most comfortable in and encourage her verbally as she pushes. Talk prenatally about whether she wants you to coach her pushes (counting to ten, for example) or if she wants to listen to her body. If you plan on catching, now is the time to prepare for that.

5. Lastly, after labor has ended, the baby is born, mom's hardest work is done, relief and joy expand and fill up the whole room. Everyone is smiling, some are crying. This is the 5th signpost. Afterglow :)

Enjoy your birthing experiences, everyone!

Friday, July 15, 2011

Including siblings at the birth

In the years that I've been serving women at birth, some of my favorite birthing experiences are the ones that include siblings. Early in my career, it was much more common- if the baby had older siblings, it went without saying- they would be at the birth.
Well, that was in the 70s and times have changed. People have different ideas regarding what is best for the laboring mamma, what is best for baby and what is best for the family. But if you have older children, I would encourage you to think about including them at the birth.
When children are included in the experience of pregnancy, and birth, I believe that it validates and empowers their position in the family. It sends the message that they are important enough to you that you want them with you during life's biggest events. When you share the experience together, it reinforces the roles you play as parents and solidifies the family bond in a powerful way. And the children seem to immediately feel that connection with the baby. I believe that decreases problems with jealousy and sibling conflicts.
On the other hand, some parents worry that the older child may be traumatized , and no one wants that.
While many children express a desire to be involved and to witness the birth, others are simply not interested. They're just not into it, and that special time away with a friend or relative instead is the treat they prefer. Like the rest of us, children bring their individual personalities into the equation. Some get excited and blissed at the mention of the baby's coming. Some kids seem to act as if they're getting a brain scar just talking about it, and to others, believe it or not, it's boring. So we need to look at each child individually.
Many moms feel that experiencing a natural childbirth is enough of a challenge on it's own and they don't want to be distracted by the needs of their older child ,or to feel that they should control their expressions of the labor experience. These are valid concerns and need to be examined and weighed as you make your choice. Sometimes including children is just not the best option for you.
If you do want to consider this option, but you are unsure of whether it would be a positive experience for your child, you can get a feel by watching their reactions when you talk about the upcoming birth, or talk to them about their own birth.What do they express- what do they have to say about it?
What about the age of the child? Many parents express concern that their child is too young to prepare. I actually believe these very young children know more than we think. They often do very well and act as if they knew it all along.Older kids and teenagers may feel awkward. Too much information, Mom and Dad! Others feel that their maturity lends to a wonderful bonding and learning experience.
Check out some births on youtube. For starters I would recommend hypnobirths and waterbirths. You can google the hypnobirth channel and you can pretty much be guaranteed that you will find gentle peaceful births there. If she wants to watch more, that's a good indication that she might do well at your birth. If she gets up and walk away or expresses fear or disgust - that's your sign.
If you do decide to include your child, there are few ways to prepare to make it go better. Let them know what the process is like. Mom will have sensations or pain in her belly and that's normal. Older kids will want a more detailed explanation. For young kids, keep it simple. The sensations come and go away. Mom will need you to stay kind of quiet and still. Then it feels like going to the bathroom. Mom might say funny things. If your child(ren) are small, you can tell them mom might make sounds like animals. Sometimes it sounds like a cow, or a bear or a tiger. They can practice those sounds with you. Older kids may want a job to do, such as cold cloths for mom's face or giving mom a drink. Small kids can hold a flashlight or guaze square. Sometimes they like to help us with the newborn exam, or help Dad to cut the umbilical cord.
One busy little boy held the flashlight at a water birth. After mom and baby were tucked into bed, he would kiss the baby, then go back, shine the light into the pool, and demand, "More Baby!!"
Be sure you explain that there will be blood, and that the placenta will come out and that babies cry. Let them know blood doesn't mean that mom got hurt. I like to explain to little children that since baby can't eat food in there, the blood coming through the umbilical cord is what keeps baby healthy. That, and the placenta , will come out when baby doesn't need it anymore.So when they see baby with some blood on him it's almost the same thing as when they're eating pizza or spaghetti and get sauce on their hands and face.Except that it comes from what will be baby's belly button and not missing his mouth!
If you do decide to have your child with you at the birth, I would recommend that you consider having someone at the house specifically to see to your older child's needs. Someone the child enjoys and feels safe with. She or he can be sure your child is fed and entertained and sleeps if the labor is long. She can offer reassurance and support, and if you should end up needing to go to the hospital, this is the person who can stay home with your child, or bring him or her to you, as needed.
At the birth, know that your child will look to the adults present- he will be aware of the looks on our faces. If mom is making noises and everyone's face is showing joy and anticipation, this is all that's needed to remind him or her that all is well.
If just as the baby is born, your older child starts to cry, don't assume he's traumatized. Look around the room; is anyone else teary-eyed? As one little girl said, "No, I'm not sad! I'm crying because I love you Mommy!! I love you Daddy!"
No matter whether you decide to share this experience with the older siblings, or to arrange another alternative, be sure to communicate that their position in the family is as strong as it always has been. Your love will be stronger than ever as your family starts on this new beginning.

Monday, July 11, 2011

Preparing a sibling for the new arrival

I think that for the vast majority of the families we work with,joy and bliss are the the driving emotions when you find out you are pregnant again. But when it's your second baby, you might also experience a bitter-sweet emotion, because this pregnancy signals a kind of beginning-of-the-end of the honeymoon relationship you've had with your first born. Your first child has been the center of your world and has enjoyed all of your undivided attention. You may wonder how s/he will adapt to being an older sibling, and how will you split your time. Can you ever really love any one- even your own child, as much as you love your first ? Yes- you can. You will find that your love multiplies.
But there are a few helpful tips to make things a little easier.
First of all, remember that young children are generally more aware than we give them credit for. Sometimes you'll see changes in behavior, or they say things , that lead you to believe they knew a new baby will be making the scene even before you knew it.
Some parents want to know when to tell an older child. Some parent feel that their child would be traumatized if there were to be an early miscarriage. Others don't want the whole world to know about the pregnancy and they know that if the older child knows, soon everyone will know :) I would say that if you are asking that question and you aren't of the mind to tell your child as soon as you know, wait until you have heard a heart beat. I would even suggest that you bring your child in for a prenatal exam so that he/she can hear the heart beat, too.
Talk to your child about it and share your love for the new baby with them.
When you are far enough along, let them feel the baby's movement in the womb.
As you are sharing with joy, don't be alarmed if your child expresses negative emotions. This is normal, and maybe even good. It gives you an opportunity to listen and support, rather than reprimand and make him feel guilty. It's okay to say something like, "yes, sometimes mommy feels the same way. I really like the times we have just you and me" or "just you and me and Daddy". This will give your child the sense of security that you truly do accept her for who she is, unconditionally. And then later you can turn the conversation again to how lovely it will be to share the experience together and how lucky baby will be to have him/her as big brother or big sister.
If your older child is very young, say 2 or less, it will be very helpful if you can find a way to spend time around younger babies. At first you'll just want her/ him to see the baby and learn from just that. Later, as time goes on, be sure to spend some time holding other babies; hopefully you can allow your child to touch the baby so that when your baby arrives it won't be the first time she/he gets a lesson in being gentle around the baby.
There are also lots of books to read to your child about becoming a big sister or brother. Point out the kids you know who have little brothers and sisters.
Beyond the psychological and emotional preparation, there will be a need to look a logistics.
If you are planning to wean your child, or train him to sleep in his own bed, or potty train, timing is important. It's helpful if you don't time these challenging shifts in such a way that your older child associates them with the pregnancy or new baby. I like to suggest midpregnancy to your 6th or 7th month. That generally leaves enough time that big brother or sister will be well adapted and not angry with the new baby for cutting him off.
As you get nearer to the end of the pregnancy, involve your best friends and closest family members(or have them read this blog ;) I think it's nice when someone bringing a present to the new baby brings something to the older sibling, too. It doesn't have to be much. Remind your friends that people come over and their first request is to see the baby. It's lovely if some of your friends and family can initially focus attention on the older child before the oowing and aaahing over the new baby begins.
It's also nice for mom and dad to have a new toy or two, even a baby doll, maybe or a stuffed toy, stashed in a closet to open when big sibling is introduced to the baby. Some parents will give the gift as a present from the new baby. It's also nice if close friends or family take your older child on special play dates, maybe for a movie , ice cream or a trip to the park. That will make him feel special while it allows you some time for undisturbed bonding with your new one. Maybe you can switch it up with Dad once in awhile so he gets the same bonding and you get undisturbed time with number 1.
When it's time to get your home ready for the new baby, you might want to set things up differently than you did for your first. Many moms set up a rocking chair as a "nursing station" with the things you'll need on a table within reach. I recommend snacks like fruit, protein bars. Lots of moms keep the phone, a burp cloth, the tv clicker handy. With a second child consider setting up a cozy corner of a couch or a big overstuffed chair instead of the rocker or glider. You might have books to read to your bigger kid as he shares your lap, and quiet toys, like puzzles crayons and paper to have on the floor right beside you.
If your child is a little older, it helps to start well before baby arrives with developing more indepenence. Start fairly early lifting and carrying your child a little less as time goes on.If he's old enough, he could start dressing himself. You could move snacks to a shelf in the kitchen he or she can reach. Encourage her with entertaining herself a little more all the time.
Always remember how tuned in to you your child is. If you are ready to move forward with the changes and shifts in your family, big brothers and big sisters will take it all in stride.
Most importantly - know you'll have good days and bad days. We always want perfection when it comes to our children. But it's okay to be human. Be gentle and kind with yourself.

Tomorrow -- Including Siblings at the Birth

Monday, June 27, 2011

VBAC in Arizona

Do you know that Arizona is one of only 4 states that prohibit Licensed Midwives from attending women who have a history of a cesarean birth? In Yavapai County there also are no hospitals that "allow" Vaginal Birth After Cesarean ( VBAC) This leaves women who have that history with 2 choices- neither of which are acceptable to many, many women, or to me. They can choose to submit to an unnecessary surgery, or they can birth their babies at home without the help of a trained attendant.
Think about it ! Is there any other situation in which a large group of people would be subjected to forced surgery , against their will, due to politics? We wouldn't stand for that. So why, during the time that should be such a positive life changing experience, do we accept this?
Many studies show that VBAC is safe. Many studies show that what is unsafe with VBAC is chemical induction - which happens in hospitals.
There are many who choose to have unattended homebirths. That is their right. But many of us just aren't there. I'm a midwife. I like to think that I have something to contribute to a birth, such as overseeing the normalcy of the process and the safety of Baby and Mom. Also, because of my experience I can just make the process a little easier sometimes .
..I like to imagine what would happen if the women who want VBACs in the hospital, would just show up in labor and refuse to sign the form consenting to cesarean delivery.
And if the families who choose to birth at home unattended because they feel that's the best choice they can make under these circumstances were to come forward and confront the state - along with the moms who submit to a repeat c-section because they feel that's their only choice.
We can do that, people. Now is the time.
Mail your letters to :
Will Humble
Director, Arizona Department of Health Services
150 N. 18th Ave
Phoenix AZ 85007
You can cc Thomas Salow, his Legal Advisor.
Everyone please write! Whether you have had a cesarean delivery or not, let your voice count. Even as a tax payer- unnecessary cesareans cost you! Thanks!

Monday, June 20, 2011

Another Introduction

Hello, all!

My name is Nicole, and I'm grateful to be part of this experience and have the opportunity to write for parents and birth workers in central Arizona. I'd like to take a few minutes to introduce myself to you all!

I moved here to Prescott Valley two years ago, but my journey into birth work started 3 years before that. I was 19 and woke up one morning after a vivid dream of giving birth on my living room floor. I was raised in a family where everyone gave birth in hospitals. I didn't even know that home birth was an option or that midwives existed any more, but I got out of bed and started researching that day.

I came into contact with a local midwife and started an apprenticeship with her. The depth of her wisdom and knowledge and the way she treated her clients was magical to me. But I was very young and had yet to start a family, so she kept me at arm's length, and I didn't gain any birth experience. Turns out, she was wise in doing that as well, since less than a year after I started my apprenticeship I became pregnant myself and put midwifery on the back burner. I recognize that being a midwife is a very intense calling, and I didn't feel I could be the kind of mother I wanted to be and also the kind of midwife I wanted to be while my children were small.

Even though I wanted a home birth more than anything, for a variety of reasons my daughter was born in a hospital. Her birth was difficult for me, and I had a lot of healing to do, emotionally and physically from it, but our story spurred me on and taught me a lot about supporting women in the child bearing year, in hospital and out.

I soon found that I couldn't stay away from birth work for long. I kept catching myself researching, I was always looking for another book on pregnancy, birth, breastfeeding or parenting. I still was unwilling to be on call all the time, but I wanted to be involved in the process, so I became a certified childbirth educator through Childbirth International.

A year later I lost a baby to ectopic pregnancy. And as tragic as it was for our family, I learned a lot from that too, about supporting loss and about compassion and the balance of life and death. In the end I am grateful for that experience as well.

When my husband's job brought us to Arizona I immediately began making connections in the birthing community, and lucky thing, too, because not long after moving here we conceived our son. I knew that having my baby at home was absolutely imperative for me, and so that's what we did. Paula supported our family as we brought our son into the world, and our birth workin' paths have continued to cross ever since, and I was flattered and thrilled when she invited me to blog with her!

And that's my journey into birth work, and how I got here today. Five years of studying, two very different birthing experiences, a loss, a move and an undying passion for helping mothers have the best experiences they can.

I look forward to writing for you guys!


~Nicole Hanson

Friday, June 10, 2011

My story

When I was having my first baby, at the age of 19, I read voraciously. I was consumed with my desire to do everything right for my baby. I had read about homebirth and midwifery, and I thought that was what I wanted. But after researching every avenue available to me (I even asked my doctor, LOL) I resigned myself to the fact that it was not an option for me in Prescott AZ in 1974. As was typical for me at the time, I just went with the flow and did what I could to have the best birth possible and focused on the positives. I had a naturall birth, which was pretty rare around here at that time. The doctor was new and she was supportive. She even allowed my husband to stay in the delivery room, although she was reprimanded for that. I had a nice labor-- 5 hours from start to finish, and the most beautifull baby ever born. I was very receptive to those love hormones, and I was sure that my child was the Christ child in female form. Nevermind the barbaric set up and procedures in the hospital at that time. I was proud of the way in which I had birthed my baby, and thrilled with my baby. My life was good.

During my second pregnancy, I became acquainted with neighbors who had all unassisted homebirths. I was asked to come babysit when their teenaged daughter gave birth, but instead I was the only one in the room with her, supporting her as she birthed her own baby.

That was such an amazing and powerful experience. She had such a long difficult labor, but she never questioned her own ability. When the baby was born, she called down to her mom to bring the placenta pail and a tub of warm water for the baby's first bath. She got up and sat on the pail and delivered her own placenta, then bathed and dressed her newborn little girl. She was evey bit as in love with her baby as I had been with mine. But no one was hovering over her as if she might harm her baby, make horrible parenting decisions, or interfere with her bond or breastfeeding.

I knew that I not only wanted births like that for my own children, I knew that I wanted that type of experience to be available to all moms in our community. The only difference was that I wanted assurance that everything was healthy and normal. I, too, have faith in God, but I believe that God has given us wisdom, that when used appropriately, provides for safety and
an empowering experience.

Up until the time that I went into labor with my son, my husband and were still undecided on what we would do. There was no midwife available, and we had talked about doing it ouselves. But we were at my parents' home in a snow storm and couldn't get home. We were unprepared. We went to the hospital and I gave birth 45 minutes after my first contraction. I have to say that at that time, this was new to us and we just weren't quite ready for a homebirth.

This time I had a different doctor. I don't like birth horror stories, so I'll pass on this opportunity to tell mine. Suffice it to say that on january first of 1977 I gave birth to another perfect child. A rolly-poly baby boy with thick black hair. I was in bliss.

A had not released any plans to mke better birthing an option. Within weeks, doors began to open for me that reaffirmed that midwifery would be my calling. I met a midwife and began assisting her. I met other students from near-by towns and we began studying together. A midwifery school opened in Tucson and with the help of my parents and husband, I enrolled. I got licensed. I've been attending homebirths since 1977, in one capacity or another :)

I have had 2 wonderful homebirths since then, and now, 10 grandchildren, most of them born at home.

My family has always been my life's blood. I'm passionate about family. But midwifery is my life's blood as well. I love feeling a part of the female experience. We are a sisterhood; at any time a woman is laboring, there are other women in other parts of our planet bringing in new life. That's a powerful and amazing connection. And we are also connected to the generations of women who have birthed before us.

I love being able to see a couple becoming a family. I love working with women and their partners during that process. Seeing a small family becoming a bigger family.

More than anything, I love seeing a woman connecting to her power, using her own intuition and wisdom, and her vulnerability, to birth her own baby. One woman said to me that when she got up the day after she gave birth, she stood in front of the mirror and looked into her own eyes. She was amazed to see a different woman than the one who had looked back at her the day before. I believe that every woman is changed for the better by becoming a mother.

Many women are so moved and changed by their own birth stories that they feel drawn to serve others by doing birth work. I love my work and am so blessed to do it. But if you take on this life, know - it's a life, not a career. And it seems at times that it can be a path with a bit of blood, sweat, and tears mingled with the joy and awe.

I am humbled by the women I serve, and full of gratitude for the families that invite me to share in their lives.

Sunday, June 5, 2011


Well, welcome to my blog!  This is a new experience for me and a little bit intimidating, but I intend to have fun with this.  What will we talk about? Hmmm,.....Everything, especially but not always, pregnancy, birth and midwifery related.  Sometimes a little political, sometimes educational. Probably a lot of rambling, too. You'll just have to find out what goes on in the mind of this midwife.. And of course, I will welcome all of the input I can get. See you soon!

More information on me and my work.