Wednesday, December 23, 2009

It Gets Easier

In my goofy prenatal class, when we got to the breastfeeding section of the class, a chart was passed around. It looked something like the chart above.

The vertical axis is effort level and the horizontal axis is time. Blue for formula, red for breast. The idea is that formula is always the same level of effort with sterilizing, mixing, carrying junk around. It doesn't vary.

Breastfeeding often starts off bloody tricky, but over time it gets easier. I am here to tell you, this is true. Surely, an oversimplification, but true. (Note: I haven't actually formula fed a baby, but I've read up on it a bit, like the things you need to do to keep everything clean, and the gear you've got to carry around.. it sounds like a lot of work. Though I'm sure you get used to it too.)

With the baby almost five months old now, I feel like we're really getting the hang of it. She's turning into a little person more and more every day. She's easy for me to feed. She's easy for the DH to feed when I'm at work. She sometimes eats so much that she spits up a bit. That never used to happen, so I feel a bit more confident that she's eating plenty. Well, that plus her weight being in the 95th percentile!

Apparently I'm even discrete about nursing in public, which is not entirely intentional.

We're going to keep it up until she's done. I expect it to not always be as easy and sweet as it is right now, but I know it will always be rewarding and good for her.

How has feeding been challenging for you? Did it get easier?

Want to Breastfeed? Don't have Formula in the Home!

As my many posts which include the label breastfeeding attest, I've found breastfeeding to be important, interesting and challenging. I pause from my work three times a day to pump. I wear funny clothes to make breastfeeding and pumping easier. And I think in the end, one thing has been critical to our success:

Not allowing a single packet of formula in our apartment.

There were many dark nights - and days for that matter - when I was so frustrated with trying to pump and feed the baby at the same time, I would have taken any opportunity, any escape, to feed her without all the complication.

I remember she'd wake me, crying in hunger. I'd be so tired from not sleeping enough and the stress of adjusting to having a new baby, I'd feel compelled to try to maximize the accomplishments of my awake time. So in this sleepy haze, over and over again, I made her wait, crying, while I strapped on the pump, before I'd start feeding her. Sometimes I'd feed her a bit before starting to organize the pump stuff, but even then, she'd not be sated and would always be crying again before I finished getting the pump organized.

I was not at my decision making best. For some reason, I often wouldn't even accept the offers of help from DH.

Because I didn't have any viable alternative, we made it work. I pumped, we fed her, we cried. Repeat as needed. Had there been formula in the house, she would have been fed it. I imagine how it would sit in the kitchen, calling to my addled brain, like crack to an addict, offering to solve my problems.

If I had had formula in my house, I would have fed it to my baby, potentially starting a downward spiral of supply problems. I was offered it as I was leaving the hospital. I said no. I'm so glad I did. I'm glad formula exists for those who choose to or must use it. But I'm glad it's not here too.

How did you or do you plan to feed your baby? Got any just in case packets of formula around if you're breastfeeding?

(PS: of course, I don't think formula is like crack. They're both just something that's potentially tempting, one to a stressed out mama, another to an addict.)

Sunday, December 20, 2009

Did you bring any food for the baby?

DH, the BP and I went for dim sum a few weeks ago, with a really great coworker, his spouse and a friend of theirs. Much oogling of the cuteness of the BP was done and then the feasting commenced.

After some time and playing with chopsticks, the BP started making her fussy, let's have a snack sounds. I turned her from facing outward to facing inward, dropped the strap on the nursing tank top (which is pretty much all I wear these days) and she latched on.

I guess I said something like "ooh you're hungry!" as she was getting settled, as the coworker asked me if I'd brought any food for her. As his spouse started to giggle, I just looked down at the BP, and grinned and said "yep, two containers!" He didn't quite get it, until looking back as his laughing spouse and back at me... Then I had to start laughing too. We had a nice giggle over that one. He knew I was pumping at work and he said something referencing that he's thought maybe I was pumping all the time.

I guess I'm more discreet than I realized... or even intended! Discretion in nursing isn't really my goal. I try to balance the BP's need for food with the DH's extreme discomfort with me doing any nursing in public (NIP) at all.

What's your funniest NIP story?

What I Hate About Pumping

People keep saying pumping is hard work. I've heard some women decide to wean, partly or completely, their babies from breastfeeding when they go back to work, because they don't know they could pump, or because their bodies don't respond to a pump with a let down / milk ejection, or because their workplace isn't, for any number of reasons, a conducive environment for pumping.

I definitely acknowledge I am coming to this from a place of privilege. Other than my usual white, North American, educated, able bodied, heterosexual, cisgendered, anglo privilege, I should also acknowledge that:
  1. I had loads of support in getting started breastfeeding. Sometimes maybe even a touch of peer pressure, but I could have resisted had I needed to, I think.
  2. I have an awesome job with a great employer and the most understanding supervisor you could ask for.
  3. I have an office with a door. I had to cover over a little clerestory window for privacy (irony of this you'll see later).
  4. I live in Washington DC where, if I didn't have my own office, my employer would need to provide me a clean private space in which to pump.
There are probably a half dozen other privileges I forgot about, but that's a good start.

So, as I think I've already covered, getting started breastfeeding was a bit bumpy. I had to pump from day four because the Baby Piranha had a tongue tie, which wasn't correctly identified as the cause of her latch problem until she was seven weeks old, despite several visits to an (expensive) IBCLC.

That, Dear Reader, was seven weeks of almost full time pumping. Almost no nursing in public for me, other than some comfort nursing, which was pretty much non-nutritive.

Then, in the same week, I went back to work and got BP's tongue clipped. And started just pumping while at work.

Up until then, I was using a fancy hospital grade pump which was almost silent and very effective. I hated pumping because I had to do it. I wanted to be breastfeeding without all this plastic in the way. While pumping at home, I pretty much always did the deed on the sofa in our apartment. Usually only the DH and BP were around, other than visiting grandpas. Of course I managed to figure the not latching was my fault, and when we got past that, I was delighted.

For work, I got myself a middle of the road good pump. It talks. It's hilarious. And it speaks both English and Spanish. That is, it makes sounds that almost sound like words. Quite often it sounds like it's saying por ahi, which more or less means over here.

I also bought a little electric single pump, the cheapest, and loudest of the lot. In breastpump noise, you get less if you pay more, it appears. I bought it for home use after returning the really nice hospital grade one. As the BP and I get the supply and demand in better sync, I'm using it less and less.

So three times a day, five-ish days a week, I close my door to my office, pull my gear out of the little fridge I bought to store my stuff in, and strap on the gear, and pump. I can't talk on the phone because it's such a chatty pump. I've read some pumping mamas will stick the noisy end of the pump in a drawer to muffle the noise and talk on the phone while pumping. Unfortunately my office furniture arrangement doesn't allow for that. While pumping, I'm entirely available by instant message, which my coworkers and I use heavily anyway.

A couple of times, people have knocked on the door. I feel like saying "unless the building's burning down, please go away!" but what I've said is "please come back later!"

So, aside from the whole I have to pump because I can't be with my baby full time like I'd like to be, I hate pumping because... I have to close the door to do it! It's such a weird feeling. The only time I ever close my door with my inside my office is to pump, feed the baby if she's visiting, or change my clothes. Oh, of course, also for private meetings that I don't want overheard. But that's pretty infrequent, to be honest.

When I'm closing the door, I feel like I'm doing something naughty or shameful. I wish I didn't feel that way. I'm not sure I want to be pumping in public - it's a visually weird thing and guaranteed to make folks uncomfortable (especially since breastfeeding itself seems to make people so uncomfortable). But it'd be nice if I could maybe get over the naughty feeling myself. I think part of my mind is wondering what my coworkers are thinking about all this closing of my door (we tend to be a very open door office... people keep saying they thought I wasn't in the office when I had my door closed).

I have a cutesy doorknob sign that says something like "Do Not Disturb, Mom Working" and a cartoon picture of a pumping mama talking on the phone. Maybe I should start using it to lighten the goofy feeling I have about it?

I really don't hate pumping. I'm glad I can do it. I'm lucky I can do it. How about you?

Tuesday, December 1, 2009

What I Love About Pumping

So I've been chewing on a post for far too long (and yes, it is far too long - not as long as the birth story, but long...) about what I hate about pumping. And then it occurred to me that I don't want to come across as complaining about pumping or breastfeeding, because I'm delighted I can do it and that we overcame our hurdles to breastfeed. So, first, what I love about pumping.
  1. First and most importantly to me, I'm able to give the Baby Piranha the best food for her, even when I can't be with her, or when she's strapped into a car seat and I can't easily get nipple to mouth. This is such a great privilege of having the money and time and privacy to pump so that I didn't have to wean her from breastmilk when I went back to work after my paid leave from work ended.
  2. Because I've been pumping for awhile, a common side effect is that I have a bit of an oversupply. With that oversupply, I'm going to be donating some of my frozen milk to a friend who is trying to keep their multiple set of babies around the same age in milk. That is awesome.
  3. I love my cute PumpEase pumping support! I won mine in a contest on The Feminist Breeder's blog when I was pregnant. I had no idea at the time I'd need to be pumping as early as I was (four days post partum!), so had planned to buy mine after the baby was born. I'm so glad I got it early as it's critical to be hands free while pumping, as far as I'm concerned, to make it a little bit less tedious and more productive. *
Some folks I follow on Twitter say things about pumping being hard work, and I'm lucky in that it hasn't been hard for me. My MER just goes hey, pump, baby, whatever, here's some milk. It's not something enjoyable or particularly fun, but I believe it's important for the baby's health, and I'm mostly glad to do it.

What do you love or hate about pumping? Any surprises?

Come back next time when I talk about why I hate pumping!

Oh, and let's not count how many times I used the word awesome in this post. I know, too many. I will find a thesaurus, promise.

* Right so I got the PumpEase pumping supports for free in a contest. There were no strings attached to my winning the contest, I'm just saying they're awesome all on my own. Oh and they're made in Canada which makes them extra awesome as far as I'm concerned.

Saturday, November 7, 2009

On Sleeping

As I've mentioned, I take parenting advice with some grains, or bags, of salt. People I talk to seem to be obsessed with sleep.

The first few weeks after Em was born, sleep was precious and infrequent. If she was sleeping, I'd wake up all the time to check that she was ok. And then she woke up needing attention/love/food often. Babies are like that! I don't know how parents who put their babies in another room to sleep manage the anxieties of those first weeks.

But then she adapted to our patterns and started mostly sleeping at night and mostly being awake during the day. I started trusting that she'd live through the night. There was that rough day at seven weeks when my Dads were here, when I'd kept her in the Infantino baby carrier all day, so she'd been asleep all day, and then only slept, and thus I only slept, four hours that night.

We're now in a nice routine where she naps once or twice a day for a few hours at a time and then sleeps from nine or ten in the evening to three or four in the morning for a brief snack, and then back to sleep again for a few more hours, often until seven in the morning. I've actually realized that it's often me (and my milk supply!) waking her up at four - she's no longer that hungry, so I usually pump a little extra for while I'm at work. And then we go back to sleep.

Before baby, I expected my sleep would be interrupted regularly with baby. First with feedings and diaper changes, then nightmares and nighttime illnesses, fevers, vomiting, then as she gets older, just worrying while she's out for an overnight with friends, and then parties and more! Parenting, as far as I'm concerned, is not about getting a good night's sleep.

I thought this was commonly known. I'm surprised by everyone's interest in how the baby is sleeping, if I'm sleeping, and the suggestions and tricks for getting her to sleep more. She's a baby with a teeny tiny tummy! I just don't expect her to sleep through the night for awhile, and even when she starts, I hear it's common to stop and start again.

I suspect that some people's inquiry as to whether or not I'm getting any sleep (and oh! I am, thank you) is more about making conversation, like commenting on the weather or making jokes about working hard vs hardly working. I know before I had a baby, I didn't know what to ask about them.

However, the parents who seem to be sleep obsessed make me wonder if I've just got a weirdly easy baby, which is entirely possible, or if my expectations are just a lot lower. I know the nights to come where she's awake once an hour again will be challenging. But knowing that they are coming makes them easier to deal with.

Do you talk a lot about sleep? What are/were your expectations about parenting and sleep?

On Parenting Advice

Parenting advice, I've found, is a real mixed bag. I think most of it comes from a good and helpful place: people want to tell you things that worked for them, or that they think is accurate. You get to thank them and do what you think is right, or argue with them if that's your style.

I'm so new to being a mom, that handing out parenting advice seems a bit foolishly optimistic to me. I've only been doing this for just over three months - who am I to say if I'm doing it right? Yet I am confident enough to reject some parenting advice out of hand, like the well meaning acquaintance who outlined his detailed plan for crying it out, which he inflicted on his children. To which, you might be interested to know, I said it was interesting that it worked for him but I absolutely couldn't see how I could do it.

I had lunch with a pregnant friend yesterday who may end up being a single parent by choice, after trying to conceive for a long time. She's not told our group of friends that she's pregnant yet, so I'll keep her identity under wraps for the moment.

She said something about now that she's finally pregnant, the idea of parenting is overwhelming and scary. I mumbled something about having felt the same way when I saw that pregnant indicator on the pee test stick late that night last November. And many times since then - there were even thoughts of OMFG, what have I done? I can't do this!

At least, that's what went through my head up til Emily was born. Then, other than the breastfeeding issues we had, I've just been questioning if I'm doing it right.

While I was pregnant, I worried that I'd be completely incompetent, that my husband would abandon us (I have no idea why I thought that - he was the one who lobbied for a baby after all!), that Emily wouldn't be healthy, that I'd chicken out during labour, that I'd be a terrible parent.

I didn't seriously worry about being a single parent - my husband is very loyal and family oriented. I knew we'd have parenting style conflicts and oh boy has that been accurate! But he's here, parenting along side me. I almost wrote helping me, but considering he's at home with Emily every day I'm at work, which most weeks is five out of seven days, and doing a lot of things like cooking, shopping, cleaning and grocery shopping, it might be more accurate to say I'm helping him!

Today, I'm working on learning how best to apply the Attachment Parenting principles, and balancing parenting with working, looking for a new job and doing a little bit of career development too. She's going to be a work at home mom - awesome - but probably a single mom too - and I think that presents a special set of challenges. I murmur reassuring noises but I've got very little in the way of practical suggestions for her, on how to manage money, day care, breastfeeding, meetings...

So I don't know what to say to my friend who is not only having normal pregnancy anxiety, but also may be additionally anxious about doing all of this essentially on her own (her family is almost as far away as mine).

Advice on parenting I have always found most useful when it falls in the category of "this is what works best for us, do what you feel is right" - so any thoughts or resources you'd like to share on what you wish you knew about parenting in general or specifically, taking care of things as a single parent, please share them below! And of course, she isn't actually asking for advice, but it's what I can offer, plus hand me downs... :)

Tuesday, October 27, 2009

Hypnobabies Review

While helping me to create a birth plan, my doula suggested I consider hypnosis as part of my pain management plan. She said the Hypnobabies course was ... I don't recall the word: I think she said the course was the only birth hypnosis class that DONA accepts for continuing education credit, or something along those lines, but that I should look at a bunch of different classes and pick what works for me.

I did a bunch of reading and decided the HB was right for me. I can't remember why, but I think it was at least partly because the course helps to teach you to do hypnosis while being up and moving around. The others focused on hypnosis and delivery in the on your back position as far as I could tell.

So, I went to the HB website, put out about USD$200 for the self study course and overnight shipping, and started studying away. This review is just based on my experience with my purchase: I didn't get any free stuff from the good folks at HB.

As the stalwart readers who made it through our birth story know, I did rely on the HB CDs during labor, especially some of the middle part that was long and sometimes painful. By the time I had the epidural, I had kind of given up and had figured I was going off for a surgical birth anyway, so I wasn't really trying anymore.

During labor, it was great to have had that training in managing how my brain processed the feelings of labor, and for that I'm very thankful.

However, what was especially great for me, and the main reason I'd recommend the HB course to any pregnant lady I meet is the Pregnancy Affirmations recording. I am normally a person who worries. Sometimes I literally lose sleep while worrying about stuff: ironically, I will lie awake worrying at night about oversleeping and missing a flight. Somehow missing a flight is an earth-shattering catastrophe in my mind. I worry about money, my family, my health, my family's health.. etc.

That affirmation CD helped me be the most relaxed, happy pregnant lady you'd ever want to see. I figured pretty much everything was normal and healthy. During my slightly hilarious prenatal class at the birth center, everyone else always seemed so nervous. I'm guessing it's because I had repeating over and over in my iPod that everything's fine and wonderful.

I loved how useful the CDs were for me. What I didn't love:
  • the name Hypnobabies. Who came up with that? I was embarrassed to talk about it. I kept picturing zombie babies. Weird.
  • the book that came along with the CDs which purported to be the only prenatal class one would need. Most of it focused on preparing for birth, which was great, but I felt like when the author veered out into other topics, their far out man started showing. The author has some pretty wacky ideas about prenatal health: grain of salt here readers! And it was desperately badly edited: spelling and grammatical errors as far as the eye could see.
It just occurred to me that I've not posted about my prenatal class, the one I had to endure every other Wednesday afternoon in order to give birth there. And then get kicked out anyway. I must share that with you all at some point.

Has anyone else tried self hypnosis for birth or anything else? Any thoughts on the difference between hypnosis and mediation? I've never been clear on what distinguishes them.

Didn't you have a baby? In which I make a lot of links

You'd be forgiven for thinking that I was pregnant, had a wild and wacky birth experience and then the baby went *poof* and disappeared, considering how little I suddenly have to say.

To be sure, here's a picture of her Royal Cuteness, Piranha Princess here. She's somehow caused time to advance extremely quickly and will be three months old very shortly.

Well, the issue is really just that I'm so busy being blissed out with her, working my job that I love, and looking for a new job in the Vancouver/Lower Mainland area for next year, that little time is left for the niceties of keeping folks up to date, beyond the tweeting and postings to Flickr that I try to maintain.

I should note that I'm meeting some awesome new people on Twitter - many in the Vancouver area, and some rather far away. But all have interesting things to say.

And now back to our regularly scheduled programming

Sunday, October 11, 2009

The Working Mama

The working mama, or why this blog hasn't been updated in a long time.

The last update was Sept 11. I think that was right before the Grandpas arrived. We had a great time and I got my September plugged duct (there has also been an October plugged duct but let's not get ahead of ourselves...)

We did loads of touristy things, ate loads and then they went home. The above photo was of me and Em sitting on a double decker tour bus with the Grandpas on their first full day in DC. Then I went back to work. My first day back was tough but I didn't cry. Alex was awesome - he texted me loads of photos of Emily. I've been posting my favourites to my flickr collection of Emily photos.

Day two was actually better because we finally took my friend's advice and took Emily to an ENT to have her tongue tie evaluated. He clipped it on the spot and she immediately started nursing better. I have a whole post or two burbling around inside me about the incompetent boob I had for a lactation consultant who didn't think her tongue tie was the problem. Anyway, she's nursing so much better now! Then I went to work and it was ok.

Working during the day and nursing during the evening and overnight has been going well, but it's been exhausting. When I do have some free time, or the energy to balance my netbook on my knees while feeding Em, I'm applying for IT consulting and support jobs in the Vancouver BC area.

I seem to be getting a plugged duct about monthly, not sure why. It's always on the left, where I have less supply and Em prefers to nurse off the right: which came first, the supply or the preference, I'm not sure.

But at any rate, if you know anyone in the Vancouver area looking for a brilliant and charismatic communicator geek, tell them to drop me a line! I'm normally a lot more modest, but I'm in job search mode and I figure it's time to (temporarily) throw modesty out the window!

Friday, September 11, 2009

Brief Breastfeeding Update

First things first. Thank you all for the awesome comments on my blog, on facebook, twitter and in email. Your support and kind words have been sustaining me through some dark and challenging moments. I'm drafting a post in my head with the title "Thank PTB We Have No Formula in the House." And now:

I think we're getting the hang of this. And now it's time to go back to work (well, next week) and figure out how that's going to work all over again.

But, no, seriously, starting a few days ago, Em started to really nurse using the nipple shield. She'd get a few ounces at a time and I was really pleased.

Somewhere along the line, I noticed that it seemed like she would latch on better to the shield if I laid her down and hovered my breast over her. One day I tried doing that without the shield, after we'd already been nursing a bit with the shield. She latched on! It was wild.

She's still doing that - latching on without the shield after a bit of time with the shield. It's not all the time, and she goes back and forth on whether it's ok with her or if it's going to make her cranky, but it seems to be mostly ok. Funny too that she prefers the right side - I'm going to take her back to my awesome chiropractor in a week and ask her to see if everything is ok in her neck. Apparently it's not just mommies that can have birth injuries!

She also doesn't nurse well at night - we still haven't gotten side lying nursing figured out, and she just doesn't latch as well, nor stay awake very well, so I'm still pumping before bed and when I get up so that we have milk to feed her overnight. I think she's getting better overnight too though.

My dads are here this week and we're having a great time. But it's very busy with sightseeing in addition to the baby care that I'm still just getting used to.

Sunday, September 6, 2009


So, speaking of being grateful, before Emily was born, I was nervous about how I'd feel about her when she was born. I was worried I wouldn't bond with her. I wasn't sure what everyone meant, precisely, when they go on about bonding, but I was worried that I wouldn't do it, or wouldn't do it right.

There are loads of reasons why I was worried about this, a lot of them when boiled down, point to my anxiety about reproducing my mother's mothering, which involved a lot of neglect, manipulation and eventual abandonment. I'm pretty sure she was mentally ill in some way or another, and that she suffered from post partum depression at least after my sister was born, if not after my birth as well.

I thought I felt connected to Emily while she was still in my womb, but I wasn't sure that was real. I spoke to her, and rubbed my belly, and did everything I could to care for and protect her. But I wasn't sure it was real or if I was going through the motions.

I was worried that when she was born, I'd be repulsed or cold or somehow feel wrong or disconnected from her.

I am giving thanks to the PTB every day for being wrong about that. The moment that she came out and I had her on my chest, I was totally in love. She was immediately so beautiful and precious to me, I feel silly, in retrospect, for having been concerned about bonding.

Despite our ongoing problems breastfeeding (more on that in another post), and some dark moments, where like Whozat, I worry she is rejecting me or doesn't love me when she won't latch, I feel she has bonded with me as well.

When she's not nearby, as she isn't right now, I feel like I'm missing an arm. Or a vital organ - you can live without an arm. I am dreading returning to work: I thought six weeks' leave would be great - nice to have longer - but I'd probably be bored and stir crazy and eager to get back. Couldn't be further from the truth!

Don't get me wrong, especially coworkers and supervisors reading this - I love my job. I was out with some new mommies the other night, and we were trying to not talk about our babies, so we started talking about our paid jobs. I was trying to explain why my job is difficult to telecommute, despite it being an IT job, and I was illustrating the troubleshooting we do. I had a huge wave of appreciation for how much I really like my employer and my job. That hasn't changed. I just wish I was going to have more time to be a full time mom to Emily.

I'm just glad I'm no longer in school so I can dedicate evenings and weekends to being with her and available to her. Because I feel so connected to her, very little else matters. If that's not bonded, I don't know what is!


I'm glad I finally posted my birth story here for you to ogle and be impressed with. I found a lot of pleasure in re-reading it numerous times while editing and adding comments to it.

I've noticed that every time I get together with my doula, we end up rehashing the birth. I don't know how she feels, but I'm constantly coming back to the phone call to the midwives to let them know my water had broken Tuesday night.

I wish I hadn't made that call.

I wish I had said something to MidwifeL to let her know how little water had come out, or had remarked on how exaggerated women's water breaking on TV is (because it isn't - when they finally artificially broke the second bag of water, it was an absurd amount of water, and more and more kept coming out. I kept trying to clean it up, it was hilarious). Maybe that would have been a clue to her to ask me some questions.

I wish I'd stayed with my original instinct that everything was fine, that I wasn't yet really in labour, that there was no need to alert or alarm anyone just yet.

Because there wasn't. Emily was fine. She was still protected from any risk of GBS infection by the second bag of waters. Had we realized that, I wouldn't have needed/agreed to start the antibiotics, and then the subsequent cascade of interventions. I still think that Emily wasn't supposed to be born until August, and we pulled her out too soon. Ok, only a few days, but I think it would have been easier and more likely less medicated had we waited and let things progress naturally.

Someone on Twitter tweeted a link to You Should Be Grateful, an article written by a woman who had a cesearean delivery of her twin baby boys. She recounts how when she expresses remorse over her birth experience, people tell her things like all's well that ends well and that she should be grateful for the healthy babies, and to put the surgical delivery of her babies out of her mind.

She explains that she is delighted and in love with her babies, but that the way they came into the world was one of the worst days of her life. She doesn't regret her babies, just the surgical intervention that brought them out to her.

I feel the same way. Not quite the worst day of my life - the second day ended pretty nicely with Emily of course - but I feel like I was out of control. I know I said I felt like I owned the decisions but in retrospect, I realize that I didn't feel like I had any other viable choices.

I didn't have quite such a dramatic disappointment - I at least got to push Emily out and I'm not recovering from major abdominal surgery in addition to trying to get breastfeeding working. But the hospitalization, the artificial membrane rupture, the constant fetal monitoring, the Pitocin, the epidural: all of these things were things I wanted to avoid, and while I agreed to them in the moment, I only did so because I thought it necessary for the health and safety of my daughter. Ok, except the epidural, but anyway...

However, she was never in any danger, except from these interventions: in particular the combination of Pitocin and epidural. She was fine.

And I should have stayed home and off the phone. If there's a next time, this won't be forgotten.

I'm going to stop perpetuating the bullshit about putting this behind me and being grateful for Emily. I am grateful to have her with me; she has changed my life immeasurably in the almost six short weeks she's been with us so far. But I'm not likely to stop being angry about the huge diversion from the normal birth I had planned. There just wasn't any reason for it.

Thursday, August 27, 2009

Lansinoh Product Review and Giveaway!

I helped write a review of some Lansinoh products at Lansinoh gave us the products to review and is sponsoring a giveaway of diaper rash ointment. Go check it out! Also, Lansinoh run an interesting blog worth having a look at, By Moms, For Moms.

There will be a second review and giveaway coming soon!

Wednesday, August 26, 2009

Our Birth Story

My friend and doula, Jessica Lenz, was by my side throughout my pregnancy, labour and delivery, and she was invaluable as a support person and source of information. She wrote the following and I have added my commentary and thoughts in italics.

I would have loved to have a home birth, and I think the process would have been a lot more mellow. But our apartment is just too small.I don't know what the square footage is, but it's wee and feels cramped when we have two visitors! So the birth center was a good compromise.

Even after CaroLyn’s estimated due date came and went, it wasn’t a huge surprise that little Emily was taking her time considering everyone anticipated her appearance later rather than earlier given that most babies in CaroLyn’s family are overdue by weeks…even CaroLyn herself as a baby was overdue by 4 weeks!

Ready to take a few days off of work to catch up on sleep, prep for baby, and just relax as a couple before two made three, CaroLyn decided Tuesday July 28th would be her last full day at work until the baby arrived. The plan was to return to the office for a half day on Wednesday to wrap up a few things and attend a final change management meeting... Little did she know that Emily had her own ideas about what would start that day rather than the next!

At around 7:40pm on Tuesday night after a single intense contraction that was definitely the first non-Braxton-Hicks contraction, her water broke.

I was standing in the kitchen when the contraction came and it was so intense that I knew something was different. I somehow had the presence of mind to look at the clock to note the time and then noticed water running down my leg!

Being completely prepared, CaroLyn knew that the first stage of labor could take hours and sometimes days, so at this point after making a quick call to Alex, the midwives and her doula, and sending an email to her supervisor and maternity leave replacement, she settled in for the evening with a glass of wine and attempted to sleep. (At this point in your pregnancy, a glass of wine to help you relax and sleep is perfectly fine for both mom and baby.)

Little did I appreciate that this would be the last largely uninterrupted rest I'd get for a long time!

Throughout the evening and into the morning her contractions began to pick up, but were irregular, only coming every 7 to 10 minutes, lasting 15 to 20 seconds. Occasionally there was a 4 minute, 1 minute in length pattern, but it never made it passed 4 or 5 contractions in a row and therefore the common 411 contraction call (4 minutes apart, 1 minute length, going on for 1 hour)—the call you make to the midwives to say, “I am coming in!”—never quite got there.

So, around 1pm the next day, it was time to go to the birthing center regardless because CaroLyn had tested positive for Group B Strep (GBS) and this requires a dosage of antibiotics every 4 to 6 hours after about 18 to 24 hours once your water breaks to prevent infection from spreading to the baby. The infection rate is extremely low, but the antibiotics further reduce the chance of infection. Unfortunately, testing positive for GBS, however, does require regular visits to a healthcare provider until the baby is born and thus throws off your ability to comfortably labor at home without distractions…this would definitely prove to be the most frustrating part about the entire labor process! (Note for future reference: eat tons of garlic and take tons of vitamin C before going in for GBS test for all future babies!)

On entering the birthing center there were quite a few smiles from the midwives and staff eager to see CaroLyn starting labor.

First things first, time to establish whether CaroLyn was actually in labor and whether her water really did break. A simple test with a strip that changes colors can indicate if the fluid really is from the amniotic sac; and sure enough, it was! Therefore, the administration of the antibiotics did need to get started. After carefully checking to see how CaroLyn was progressing, MidwifeC indicated that CaroLyn was 4cm dilated, 50% effaced and at 0 station. Contractions at this point were still between 5 to 7 minutes apart but lasting only about 30 seconds. So, although moving along, CaroLyn was not quite at active stage labor, but still progressing steadily.

After receiving her first dose of antibiotics at 2:10pm, CaroLyn, Alex and her doula decided to try to jump start labor by walking around Eastern Market—no need to sit around and wait at the birthing center when active labor had not kicked in. After a quick stop at Starbucks for a bite to eat, all three hit the streets walking and stopping briefly during contractions.

Starbucks? I know, shocking.

Although the trio looked like a normal group of people walking around, the fact that CaroLyn had a heplock IV on her wrist (for the intravenous antibiotics) that was leaking blood, not to mention the fact that she looked very pregnant, got a few stares from folks on the street. That did not faze the team, though, as they continued to walk around the area with CaroLyn briefly stopping and leaning into Alex during a contraction.

That heplock was a mess! I never should have let MidwifeC put it in my left hand - that's the one I use, um, in the bathroom. It was a constant annoyance. And after I got sent to the post partum recovery room, I was told had to keep it in awhile longer, just in case. Two days later, I asked if they could take it out now, as it was really gross, and the nurse was horrified at how nasty it looked, and took it out right away.

This stage of labor, although long, can sometimes be the most special part of labor for a couple because they begin to bond ever so much closer as they realize their baby is finally coming. CaroLyn and Alex spent a few special moments holding each other while Alex sweetly spoke to both CaroLyn and the baby. At one point during a brief contraction, the team looked up and noticed a pair of pigeons on the roof of one of the local bars…as if mimicking Alex and CaroLyn, the pigeons groomed each other giving the care and love the other needed at that very moment. It was a sweet symbol of the love that was all around.

After a few blocks, CaroLyn’s doula suggested that they climb stairs as a way to increase the contractions and get them a little bit more intense and closer together. Stair climbing is one of the best things for moving labor along. So, where to find stairs….the Capitol of course! As the team headed over to the Capitol (about 6 blocks away), they realized that access to the steps was blocked off, so instead, they headed over to the Library of Congress that also had a good number of stairs.

With a quick trip inside the building for those ever frequent bathroom trips that are needed (especially during labor), scaring the security guard as he thought CaroLyn would have the baby on the steps, and grabbing a bit of cool air conditioning, CaroLyn and her doula proceeded to go up and down the stairs of the Library of Congress. They found a section of the stairs right next to the water fountain in front that was shaded and when the wind blew slightly, a mist of the water sprayed up making the breeze and water a refreshing place to do stair climbing.

While Alex went to park the car and rest a bit, CaroLyn and her doula climbed up and down the steps for an hour and a half from 4:15pm to 5:45pm. Contractions were steadily increasing, becoming a bit more intense and typically peaked at the top and/or bottom of each set of stairs. CaroLyn would lean over the side towards the fountain, feel the breeze and breathe through the contraction while her doula rubbed her back.

The Library of Congress of course is a tourist attraction, and so there were plenty of people taking photos….We are sure a few captured the lovely pregnant woman in labor in their pictures without realizing it! Comically, at one point, CaroLyn leaned over the wall near the fountain during a contraction, and I suppose tourists in the area thought there was something interesting to see, so they proceeded to lean over too, to look down at the view, not realizing at all that CaroLyn was actually having a contraction. Pictures were taken and they were off.

After a good 4 hours out walking around and climbing stairs it was time to head back in for the next dose of antibiotics…so it was back to the birthing center.

Although CaroLyn was definitely progressing and the contractions were getting stronger, she was still able to speak through every contraction and most were still not lasting longer than about 30 seconds. So, the midwives suggested that Alex and CaroLyn have some alone time to try to move things along. (Intimacy can trigger all kinds of things…including labor!) From 6pm to 7:30 CaroLyn and Alex enjoyed the shower, and then settled in to a great pattern of nipple stimulation using a breast pump and rocking on the birthing ball. (Nipple stimulation is often suggested by midwives to induce contractions as it sends a signal to the uterus that it’s time.)

Using the nipple stimulation and birthing ball definitely kicked up the contractions and CaroLyn herself had a wonderful glow around her face as each contraction intensified. At times during a contraction she would cry out, “awesome” or “excellent” as a way to remind herself and encourage her baby that this meant more progress. Through each contraction CaroLyn would lean forward onto the chair in front of her with Alex rubbing her head and her doula behind her stroking her back helping her visualize bringing the baby down.

I don't know where awesome and excellent came from, but I was definitely channeling my inner Ninja Turtle during labor!

As time went by, the team changed positions slightly to allow CaroLyn to stand on one foot with her other leg bent and resting on a chair. She continued to do the same rocking motion as on the birthing ball to help move the baby further down. Alex stood in front of her giving her support and through each contraction CaroLyn would lean forward onto Alex and breathe through the waves going through her.

Unfortunately, around 8:30pm this wonderful progress slowed down dramatically when the midwives indicated they did not feel CaroLyn was in active labor and advised her to go to the hospital for a dose of Pitocin that would speed things up. This was quite surprising to hear from the midwives who tend to be very pro birth center and usually do not push for interventions like Pitocin, but they were concerned that CaroLyn’s GBS status, her bag of waters being broken and her slow progress to get into active labor could jeopardize the baby’s health.

I don't even remember Pitocin being discussed at this point - it must have alarmed me so much that I've blocked it from my memory. Going to hospital and getting Pit was such a deviation from my birth plan that I could hardly bear to hear it.

MidwifeS, did another vaginal exam to see if there was progression and at this point she indicated that CaroLyn was still between 3 and 4cm and was only at -1 station and about 70% effaced. She also indicated that she could push the baby’s head up (meaning the baby was not engaged in the pelvis) and that the baby was still surrounded by water and another membrane. This should have been a clue to all the midwives that CaroLyn had not fully ruptured her bag of water and that she was progressing perfectly given where her body was at this stage in labor. In addition to this, it is also interesting to note that the midwives reading of the baby’s station was also different, indicating that the baby had moved backward in the process, or that one of the midwives had read CaroLyn’s cervix incorrectly.

Wait - membranes are still intact? Huh? Kinda wish I'd questioned that at the time.

Instead of allowing CaroLyn to just stay at the birth center and sleep (as it was now approaching 10pm), the midwives asked that she go into the hospital. This was after repeated discussions with CaroLyn and the midwives, and CaroLyn calling MidwifeL, the medical director of the birth center and questioning the center’s policy. AHHH frustration!

I felt at this point that I was being extremely abrasive with the midwives - I remember saying to MidwifeS and later to MidwifeL "so to be clear, you're kicking us out now?" I wanted to make sure I didn't have any other option. The decision was driven by policy, and I assume - I was not told this, I am assuming - that the policy is driven by lawyers' paranoia or insurance restrictions. Their policy stated that a women who tests GBS positive can only be at the birth center for 18 hours after waters breaking if she's not in active labor - it had already been 24 hours. I still tried to fight them but lost. Thankfully, they're professionals and understood where I was coming from - because I needed them on my side when we got to the hospital!

CaroLyn was definitely strong at this point and knew her body would progress at its own pace and there was no need for any medical intervention to speed things up. Unfortunately, because of all the stress, the pressure from the midwives, and being exhausted, labor was slowing down. This can often happen to women in labor when they feel threatened or stressed—they can literally close up their cervix and progress only when they feel they are in a safe and comfortable environment again. (We see this often with animals giving birth in the wild.)

After speaking with her doula who continued to remind CaroLyn that she was progressing and that at this point there was nothing wrong with either mom or baby and that CaroLyn did not have a temperature (an indication that there could be an infection), CaroLyn, Alex and their doula decided to get the last dosage of antibiotics at the center and instead of going to the hospital, go home and try to sleep for a few hours, regroup and proceed to the hospital by 2am for the next dosage of antibiotics.

As frustrated as they were, the team packed up and went home to sleep.

Alex took this opportunity to really catch up on his sleep…he was out like a light after crawling into bed. For CaroLyn, although she tried resting, the anxiety was still with her and instead of sleeping; these few hours back at home were more about de-stressing and getting her body back to a comfortable place where she could feel at ease to continue with her labor. She also had a few phone calls around midnight from family to see if baby Emily had arrived yet. Being back at home, resting without constant pressure and a brief chat with family helped give CaroLyn a second wind and by 1:15am everyone was back in the car heading this time to hospital for the required dosage of antibiotics at 2am and to “check-in” permanently to the hospital to give birth to Emily.

I also repacked my bags. I had packed for the birth center, lots of snack food and some clothes, but not much toiletries, nor a laptop (no wifi at the birth center but I rightly guessed there would be at the hospital), plus - pessimistically, I guess - a copy of my living will and medical power of attorney. And a nightgown that I don't think I put on once... Or maybe I did and then took it off shortly thereafter?

After arriving at the hospital and checking in (which also included a room change because of an irritating noise coming from the ceiling), CaroLyn continued to speak with the nurse who gave her a lengthy survey questionnaire on her pregnancy and labor. This process took over 30 minutes and included all kinds of questions from “what kind of birth education did you take during your pregnancy,” to “do you have a history of abuse,” to “do you plan to use cloth or disposable diapers”. At 2am in the morning and trying to get back into labor, this was not the kind of survey you wanted to be doing. CaroLyn was a good sport about it, and finally once finished she was able to get her next round of antibiotics and then was left alone until 5am.

The survey was hilarous. I can't believe they do that to women in labor. MidwifeS was there and said, after the nurse left, she'd never seen anything like it.

For the next 2 ½ hours CaroLyn and her doula walked the hospital floors trying to restart the labor that had slowed down because of all the chaos and moving about. What seemed to do the best at bringing on stronger more intense contractions were squats. We couldn’t find stairs, so doing squats holding onto a bed in the hallway by the elevators seemed to be the best alternative, and it definitely helped tighten up those inner thigh muscles!

Because CaroLyn was now in the hospital, we had to sneak food to her instead of openly eating and drinking whenever she wanted. During the squats and walking she snuck in a few granola bars, honey and juice…all great sources of energy.

I don't think anyone told me not to eat but figured Jessica knew of what she spoke (and of course hospitals are famous for not letting women eat or drink in labor) so I accepted her help in concealing my consumption!

By 5:10 in the morning on July 30th (now 34 hours since her water broke) MidwifeS (who followed us to the hospital and who would be in charge of her birth instead of a doctor), offered to check CaroLyn’s cervix again to see if there was progression. At this point, CaroLyn was now 5cm, 90% effaced but still at -1 station. CaroLyn had made tremendous progress considering everything she had just been through. She managed to de-stress, put herself back into a calm state despite the many changes in her environment and get herself ready for a more active labor.

Although the midwife was suggesting the introduction of Pitocin at this point, her doula suggested that perhaps at this point why not try to break the other membrane/bag of water to see if that would encourage her labor. MidwifeS agreed to do this, and sure enough this would definitely do the trick in helping CaroLyn progress more steadily. It turned out that at 7:40pm on Tuesday July 28th CaroLyn had actually only broken the first layer of her bags of water. There are actually two bags of water and the one that CaroLyn had ruptured before was the very thin one that sits between the other bag of water. So, in actuality, she hadn’t fully broken her water!

With a huge gush of water flowing out now, her contractions sped up and became more intense.

Whoops! I thought my water had broken earlier, but I was by myself and figured maybe a cup or two of amniotic fluid was all she wrote. I'd also read about babies' heads blocking the exit of much of the fluid, so I thought maybe that's why there wasn't huge quantities. In all the excitement, I forgot to mention that to anyone... It wasn't just one gush either. There were multiple gushes. Wow, that was a lot of fluid! It was like what you've seen of a huge gush of fluid when women go into labor on TV. Except it went on and on and on!

Over the next several hours CaroLyn and her doula continued to work through each contraction. The room was dark and in the background was the sound of the Hypnobabies CD that played positive affirmations to help CaroLyn get through each contraction and focus. CaroLyn continued to do squats for a little while, but what she found most comfortable was sitting on the birthing ball and then leaning over a chair with each contraction. To get through these more intense contractions, now coming on every 3 to 4 minutes and lasting 50 seconds, CaroLyn had to stand through each one. She would sit on the ball rocking back and forth and then stand, taking deep breaths through each contraction. Her doula was there continuously reminding her how to breath, how to focus, and to encourage her that with the intensity that things were getting closer…and for the first time, CaroLyn had trouble speaking through her contractions. She was definitely in active labor!

By 7:45am MidwifeS came back in to check to see how CaroLyn was progressing. She was now 6cm, 90% effaced but still at -1 station. Contractions were holding steady at 3 minutes apart and lasting 50 seconds. The midwife suggested again that perhaps CaroLyn introduce Pitocin to help move things along. After speaking with her doula, CaroLyn decided that by introducing a small amount of Pitocin (the lowest possible dosage) and then taking her off of it once things really progressed and contractions were only 1 to 2 minutes apart, would be a suitable compromise at this point.

I was incredibly discouraged to hear that I'd only dilated one centimeter in all that time, after rupturing the membranes artificially, which I'd hoped to avoid doing.

By 8:23am 6 units of Pitocin were administered. Unfortunately, this put CaroLyn on a continuous fetal monitor and lessoned her movement a bit. However, she still managed to stay on the birthing ball and stood with each contraction leaning against the chair.

The continuous fetal monitor means I got hooked up to a machine with a fairly long cord. Plus the Pitocin is administered through a constant IV drip. So my belly is hooked to a machine on one side, and my left hand is hooked to the IV pole all the time on the other side. Up til then, I had been getting intermittent monitoring and just hooked up to an IV periodically. This was my first leash that really limited my movements.

Contractions definitely started to pick up and the intensity was very strong. CaroLyn moved to the edge of the front of the bed and we put the birth bar up so she could lean into the bar during contractions. She had a few more rounds of honey, but by this time she was so exhausted and tired that she just wanted to sleep….unfortunately, right when contractions were getting the worst!

CaroLyn was amazing! Somehow she trained her body to sleep between each contraction. She literally would fall asleep, snoring even, and wake for each contraction and then fall right back asleep….she continued this pattern even when her contractions reached 1 minute a part and were lasting over 90 seconds.

I don't know - I think my body did this on its own. I was just trying to chill between contractions. I normally find it hard to fall asleep.

Alex helped to hold her as she slept for one minute and soothed her as she went through a contraction. Her doula was there by her side the entire time reminding her to take deep, slow breaths to help her get through the peak.

At 12:55pm (now 8 hours of active labor, 41 hours of labor total); the midwife and doula were certain that she was entering transition (the hardest part of labor) and it was suggested that CaroLyn get checked one more time to see how far along she was and how close she was to pushing.

Looking back at this, we probably never should have had another vaginal exam and just continued through the contractions using the coping techniques and deep breathing that CaroLyn was doing so well at. Unfortunately, the exam only brought on frustration. CaroLyn had not progressed at all over the last 8 hours. She was still 6 cm and at -1 station. Her cervix was just not opening up yet despite the fact that her contractions were becoming more intense and closer together. This can sometimes happen with women who have a history of cervical damage or who are carrying large babies. The cervix will open up; it just takes time and patience to get through the next phase.

I've had some cervical damage. Emily is a large baby. Nuff said.

Discouraged doesn't quite cover it. At this point, being told I was still 6 cm, I saw myself being wheel off for a c-section right then. I think I would have been too, if not for the care of the midwives rather than an OB.

The news, however, sent discouragement CaroLyn’s way. She was so exhausted that the only thing she had on her mind was sleeping….and she definitely deserved some sleep at this point after being mostly awake for over 41 hours. While MidwifeS tried to tell her some options, CaroLyn fell right asleep in the middle of the conversation. After one minute and another contraction, CaroLyn indicated that she just couldn’t go on with this much pain if she was progressing so slowly. Against her own plan, she asked for the epidural, and by 1:20 in the afternoon she was able to finally sleep without pain…a courageous and wise decision knowing that the hardest part of her labor still lay ahead.

So now I've got the epidural - that's a needle giving me painkilling drugs right into my spine - plus all the above stuff. Because I'm numb from the waist down, I also got a urinary catheter which I had to be careful to not yank out. I'm a fricking pin cushion at this point!

At some point, can't remember when, I got an internal fetal monitor - which means another cord, going off to my right (the catheter tube went to my left) was a cable connected to a machine at one end, and Emily's head, via my vagina, on the other. Fun and games for the whole family!

Getting the epidural in my back was a huge deal. They kicked everyone but MidwifeS out of the room. I had to sit on the edge of the bed and lean over her shoulder with my legs apart to make room for my belly - I needed to curl my spine forward so the doctor could insert the needle. The doctor was really nice about it - I was expecting him to make some kind of remark about me having had enough of the natural labor process - I was feeling guilty about my choice and projecting it on him, I guess. I had a few contractions while he was inserting the needle and that was insane - I was in this weird position, in intense pain and couldn't move or I'd be paralysed (or at least I thought I might be - I don't know how actually risky that was).

Almost a week after Emily was born, my back still ached where the epidural went in. My chiropractor did something to make it better in one wonderful adjustment!

By 1:45pm on July 30th her epidural had kicked in and she was dilated to 7 cm but still remained at -1 station. CaroLyn was completely taken off of the 6 units of Pitocin she was on early as the baby could not handle both the epidural and the Pitocin at the same time. (This is very common when women first get the epidural. A drop in the baby’s heart rate can happen very briefly because of the change in the woman’s body due to the epidural. Giving the woman extra oxygen can help get needed oxygen to the baby and all is fine. This can be a bit scary for the mother because all the nurses will run in and the room is a bit chaotic without really telling the mother what is going on.) Once CaroLyn took a few deep breaths of oxygen, her baby was doing great.

Even though I wasn't on the Pit any longer, they kept my left hand hooked to the IV, giving me fluids and the every four hours antibiotics. So the pin cushion continues. Those fluids were wild - I got so much that my hands and feet swelled up insanely after birth, and when I got home from the hospital, I'd only lost 3 pounds from my maximum pregnancy weight! It took me awhile to figure out the fluids were to blame for both. Four weeks later, I'm in the middle of my normal pre-pregnancy weight range.

I think it was shortly after this excitement that my Dad called and I think I was kind of incoherant and tried to explain I was sucking on oxygen and probably shouldn't be using a mobile phone, due to some risk of fire that I invented on the spot. Something about mobile phones and gas stations, you know.

CaroLyn’s doula took this opportunity to explain various options to her once she got to the pushing stage of labor. Because the scenario was now very different than CaroLyn had imagined it, her ability to push the baby out in the water or on her knees/squatting would be more difficult because of the epidural. Also, due to the fact that they were now in a hospital and not the birthing center, there would usually be a time limit in terms of allowing her to push before they might use other medical interventions as forceps, the vacuum, an episiotomy and/or a cesarean section.

CaroLyn’s doula spoke to her about taking herself off of the epidural once she was 10 cm dilated and ready to push as a way to better feel the baby coming down the birth canal. Most women who have an epidural lose feeling in their legs and pelvic area and therefore have a very difficult time pushing the baby out because they don’t know where to push. Many women end up pushing in their face instead.

After this discussion, at 3:25pm CaroLyn was finally 10cm dilated and was at +2 station! Although she had an epidural without Pitocin, she went from 6cm to 10cm in 2 hours and 25 minutes completely on her own with that extra bit of sleep and comfort that she needed…she was ready to push and she was ready to reduce her epidural strength to allow for the feeling of labor to come back to help her experience the birth she wanted and get her back to her original birth plan.

At 3:30pm, pushing began. It can take a bit of time for the epidural to wear off and so the first hour was slow, but with progress. Given the fact that CaroLyn’s labor was long we were all hoping for a short pushing stage, but Emily just was not ready to come out yet.

Alex stayed up by CaroLyn’s head the entire time, wiping her brow with a cold washcloth and giving her ice chips. One of the nurses (we had now gone through 4 nurses because of shift rotations!), and her doula held up her legs and helped her focus on where to push and for how long. MidwifeL, was now the midwife on call as MidwifeS had been on call for 24 hours with CaroLyn prior. MidwifeL helped CaroLyn focus and continued to give her continuous perinea massage and mineral oil on the perineum to prevent tears or an episiotomy.

Once the epidural wore off enough, CaroLyn was able to change positions and move around to help the baby come out more easily, as anyone can tell you that gravity is far better for pushing a baby out then lying on your back horizontally. CaroLyn was up on her knees and used the birthing bar on the bed to help push the baby out.

Once again, CaroLyn had that glow. Just as she did when she was making her first real progress in labor at the birth center using the birthing ball and nipple stimulation, CaroLyn had an excitement come over her and her face radiated a beautiful shine of empowerment. She was determined to push her baby out the way she imagined her labor and birth to be like. She regained her strength and energy and continued to push in several different positions. CaroLyn used the birth bar while kneeling, she tried kneeling towards the back of the bed on all fours, and she lay sideways to help position the baby in the best position to come out. She also decided to use the mirror to help herself focus and see the baby coming out.

After 3 ½ hours of pushing, although her strength was still there, CaroLyn was starting to feel discouraged. Her doula gave her a few pep talks about visualizing the baby coming out and that all she needed to do was push a bit harder to get the baby to crown. Emily was right there for hours just going back and forth between each contraction and we just needed her to stick.

What we didn’t know at the time, was that while CaroLyn was trying to push with the doula and another new nurse, the nurse who had been with us for 3 ½ hours of pushing was out in the hallway arguing with the midwife that CaroLyn had gone passed the allowed time before a c-section is performed. The hospital protocol does not allow women to push past 3 hours (let alone be in labor for 40+ hours!).

MidwifeL made a comment to CaroLyn about reaching the end of the line and said that she would not use a vacuum or forceps to get the baby out and that the only way would be through a c-section. MidwifeL stepped out of the room for a minute to regroup, and at that moment CaroLyn had another contraction. On her second big breath in, she pushed as hard as she could and finally her baby crowned! Both the doula and the new nurse told CaroLyn to stop and hold the baby in place and to breathe short breaths. MidwifeL came back in quickly, along with MidwifeS who was just coming back on shift, and slowly CaroLyn started to push the baby out further.

Unlike doctors who would have encouraged her to push fast and probably would have given CaroLyn an episiotomy a long time ago, MidwifeL guided CaroLyn in her pushing and helped her stretch so that baby Emily could come out smoothly and safely.

After 47 hours and 52 minutes (with 4 hours and 2 minutes of pushing…defying all hospital rules and protocols) at 7:32pm on July 30th, 2009 Emily Alexandra entered the world without a single medical intervention (only a bit of an epidural to help her mom recoup) by CaroLyn reaching down as Emily’s shoulders appeared and pulling out her own 9lbs and 4oz baby. Alex and CaroLyn enjoyed her first cry as she looked at them both in the eyes and let them know she was finally here.

Welcome little Emily, you made quite an entrance to the world!

Thanks Emily, Alex and CaroLyn for letting me be your doula and also letting me have the wonderful pleasure and privilege to cut the cord once Emily was born.—Jessica A. Lenz

Whew! So that's our birth story. It was rather intense and the outcome rather wonderful!