“I do yoga and Pilates, but the body itself knows what to do,” she said. “When you’re breastfeeding, the body has its own way to shrink.”

Post from: Breastfeeding 1-2-3

How long were your labors?

Kid #1, 22 hours.
Kid #2, 5 hours.
Kid #3, 11 hours.

See a pattern there? Nope, me neither.

How did you know you were in labor?

Kid #1, contractions that woke me up at 3 a.m. I tried to go back to sleep but (a) I had to focus on breathing through the contractions, and (b) I was too excited!
Kid #2, water breaking.
Kid #3, water breaking.

Where did you deliver?

Kid #1, hospital.
Kid #2, hospital.
Kid #3, at home, in the birth tub.

Drugs?

Kid #1, spinal/epidural combination after 16 hours of labor. At the time I was very grateful for the relief, but with my second labor I realized that when the pain got bad enough that I wanted relief, I was getting close to delivering! For me, that’s when the really good progress is being made, and if I could just keep that in mind, I could go without pain medication. With kid #1, the epidural slowed down labor for two hours, and the nurse was about to suggest pitocin when she rolled me on my side and my water broke, speeding things along.
Kid #2, a failed epidural. I asked for the epidural, had trouble sitting still for the necessary IV (duh, because I was ready to push! No one checked me for dilation!) So five minutes after I got the epidural, the OB/GYN showed up and said, “You’re ready to have a baby!” I growled back, “I know!” Three pushes and an episiotomy later, my daughter was born, and I happened to look on the floor and see the tube for the epidural, disconnected and dripping on the floor. So I’m calling that an unmedicated birth, even though I caved and asked for the drugs
Kid #3, no drugs.

C-section?

Thankfully no. With #2 and #3, I was diagnosed with placenta previa. Fortunately, both times subsequent ultrasounds revealed that the placenta had moved away from the cervix as my uterus expanded.

Who delivered?

#1 Three teaching hospital residents I had never met. They threatened to give me an episiotomy and told me to push like I was having a bowel movement, resulting in a fourth degree tear. Luckily one of them felt so bad about that that she spent an hour stitchin’ me up!
#2 A doctor who was so embarrassed about being late to the delivery that he refused to see me for my 6-week follow-up appointment. He sent in another doctor even though I had made the appointment with him. Chicken.
#3 A midwife and her assistant, both of whom I knew and trusted.

Your turn

Play along and leave a comment!

Post from: Breastfeeding 1-2-3

Caused by postpartum hemorrhage so severe that the blood loss irreversibly damages the pituitary gland, Sheehan’s syndrome can cause breastfeeding failure. Other symptoms include loss of pubic and underarm hair, inability to tolerate cold, low blood pressure, and atrophy of vaginal tissue, as well as subsequent infertility.

p. 569. For more see:

~ Birthsource.com
~ “Infant Insufficient Milk Syndrome Associated with Maternal Postpartum Hemorrhage” (abstract) from the Journal of Human Lactation

Post from: Breastfeeding 1-2-3

I called the midwife at 5:45 p.m. to give her a heads up, and then went about doing some last minute birth preparations. The contractions remained quite irregular, sometimes coming 15 minutes apart, sometimes only one minute apart. By 8 p.m. we decided to take my 6- and 3-year-old girls for a walk in the Baby Jogger to get the 3-year-old to sleep and also to see if walking helped labor along. It was a beautiful, warm California evening under a full moon! We laughed and wondered whether that moon had anything to do with the timing.

I was feeling a lot of pressure on my pubic bone and aching in my back, but the contractions remained short and irregular. I felt surprised by the slow progress because my entire labor with my second child had been five hours total, and here I was going on 6 hours and not even ready to call the midwife to come!

Shortly after 10 p.m. I had four contractions in 11 minutes. I called the midwife at 10:23 p.m. Of course, right after that my contractions slowed down again: 7 minutes, 8 minutes, 8 minutes, 5 minutes, 12 minutes, 10 minutes…. I started to worry that the midwife would arrive, check me for dilation, and inform me I wasn’t ready for her stay. When she and her assistant arrived at 11:30 though, my contractions immediately kicked back into high gear: 3 minutes, 3 minutes, 2 minutes. My body had been waiting for help to arrive! The midwife didn’t even do an internal exam anyway. She simply assessed the baby and took my vital signs, and went about setting up her birth supplies. At our home visit earlier in the day she had asked about my preferences during labor — did I want a lot of hands-on support or did I prefer to be left alone? In accordance with my wishes, the midwife and assistant soon retreated downstairs, leaving my husband to support me and to finish filling the birth tub.

By midnight I was in the tub, and again we were laughing to ourselves. “Can you imagine if we were driving to the hospital right now instead?” Our kids were sound asleep in the next room, and there I was luxuriating in the warm water. Things were going just as I had hoped.

I had long stopped timing contractions, and I simply focused on breathing and rocking through them. I imagined myself “blowing” the cervix open with each exhale. I silently cheered myself on. “This pain is the good work of pushing the baby out! Relax and let your body do what it knows how to do. You are doing it!” By 1:30 a.m., staying silent wasn’t enough. I started to make low growling sounds and I told my husband it was time to summon the midwife back upstairs. By 2 a.m. I had a flashback to my hospital experience with my second daughter, when I absolutely could not sit still for the nurse to insert an IV. As it turned out then, I was complete and ready to push, but we didn’t know that until the doctor finally arrived 15 minutes later. This time, I knew I was about ready to push, and I had my husband awaken the children.

The 3-year-old was quiet and alert. The 6-year-old just wanted to keep sleeping on our master bed, but the midwife assured me she would perk up when the energy in the room changed, as she knew it would when I was ready to give birth. The assistant checked the baby’s heart rate, and then the midwife did the one and only internal exam of the entire labor. She confirmed I was complete and ready to push at 2:30 a.m.

I was relieved it was time to push and I found pushing to be preferable to the previous stages of labor. Still, I found it difficult to focus my energy. A hand at the right place helped show me where to concentrate my efforts, and soon I could feel the baby making progress. I alternately grunted or held my breath through the pushes as the midwife guided me through how hard to push. She knew I didn’t want a fourth-degree tear like the first time, or a second-degree episiotomy like the second time. Just as she was saying that the skin was very tight and she might need to perform an episiotomy, out popped the baby’s head! That surprised all of us, and I felt a rush of relief and joy. It makes me cry as I think of it now! It was 2:51 a.m. as the rest of my beautiful girl slipped into the water. The midwife caught her and handed her to me on my chest.

The baby hardly cried, but she was already pinking up and clearly healthy. She scored 10/10 on her Apgar scores. I snuggled her warm in the water as I delivered the placenta. My older girls took the opportunity to express their amazement. They felt the umbilical cord pulsing. They touched the baby’s toes and that made her open her eyes, much to their delight.

As the midwife carried the baby to the bed, my 6-year-old said, “I love that pink baby!” I got out of the tub and joined the baby to nurse. She nursed off and on for an hour, switching sides three times! She was alert and content and just the most wonderful thing to see!

After an hour of that bonding time, the midwife and assistant examined the (as yet unnamed!) baby at the end of the bed. She was healthy in every way. I was amazed that she didn’t fuss as they moved her around, weighed her and measured her. She was 7 pounds 2 ounces, 19.5 inches, with lovely features and a beautiful, round head. She hardly looked like a newborn — she looked more like the day- or two-old babies seen on television births.

As it turns out, I had torn exactly where the doctor had done the second-degree episiotomy. The skin simply couldn’t stretch where the scar tissue was. So I received 5 internal stitches and 6-7 external stitches.

Someone later asked me whether the whole experience had been painful or hard or scary. I answered that for me, the labor had been all three. But at the same time, the experience was peaceful and glorious. It had gone exactly how I wanted, and both the baby and I were safe. That is what I hope for every woman — the power to choose the setting for her birth and the good fortune to have the experience and outcome desired.

Post from: Breastfeeding 1-2-3

Born Thursday, July 17, 2008
at 2:51 a.m.

At home, in the water.

Our first nursing session lasted a blissful hour. I am happy and feeling well! More details later!

Post from: Breastfeeding 1-2-3

First up in my investigation of hospitals: seeing if there are any Baby-Friendly Hospitals near me. Unfortunately, while 17 of the 64 U.S. hospitals and birth centers designated as Baby-Friendly are in California, none are close enough to me to be practical.

Next I check the breastfeeding rates of local hospitals. Luckily the California WIC Association issued a California Hospital Breastfeeding Report for 2007. The report notes:

More than 86 percent of California mothers breast-feed or provide breast milk for their infants during the hospital stay. Unfortunately, only half of these babies—43 percent of all California infants—are breastfed exclusively; that is, breast milk is their only food.

Clearly it is important to choose a hospital that has both a high breastfeeding initiation (”any” breast milk) rate and a high exclusive breastfeeding rate. Oh my goodness, I just compared the two hospitals closest to me. Which would you choose, the one that has an 88.3 percent initiation rate and a pitiful 8.9 percent exclusive rate, or the 86 percent initiation rate and 49.5 percent exclusive breastfeeding rate? Or maybe it’s worth driving another 10-15 minutes for the hospital with a 90.3 initiation rate and 62 percent exclusive rate? I’m thinking that last choice is the best. It also happens to have a high level NICU and a tunnel to an excellent children’s hospital, should that be necessary.

At any rate (ha ha), please keep your fingers crossed for me for a safe and smooth home birth, with a 100% breastfeeding initiation rate and a 100% exclusive breastfeeding rate!

Post from: Breastfeeding 1-2-3

Please take a moment to vote in the new poll!

Post from: Breastfeeding 1-2-3

A woman’s birth experience can have a tremendous impact on breastfeeding success. For information on breastfeeding after a cesarean, see AskDrSears.com and Kellymom.com.

Post from: Breastfeeding 1-2-3

To see the results of the last poll, click here.

Post from: Breastfeeding 1-2-3

“I’m a doula, and it’s GREAT that you’re addressing this! One of the best ways to have a mom who gets off on the right foot breastfeeding is to have that mom hire a doula. Women who have a doula in attendance at the birth of their child are statistically significantly more likely to have a successful (and longer) breastfeeding relationship. And, thank you, too, for listing more than just the DONA site for help in finding a doula in one’s area. Although DONA is perhaps the most well known certification group, they are certainly not the “best” or the “only” one. Not that they have drawbacks, per se (my partner and back-up is a DONA trained doula and I’d feel great knowing she was supporting one of my clients if I weren’t available because of some emergency), just that they’re not the only ones around.

For the most part, I’ve found that the certification process, and who is running it, doesn’t really matter to mothers looking for a doula. However, oftentimes, it DOES make a difference to the woman looking to BECOME a doula. The organizations all have a little bit of a different perspective on birth and how birth should be attended, so most women looking to become a doula will spend many HOURS carefully considering how each certifying body and its course will benefit her as a doula. It’s actually a pretty important milestone in the “life of a doula” to have chosen one’s certification course, and sometimes it’s Childbirth International, CAPPA, or ALACE.

Bellywomen dot net [http://www.bellywomen.net/] is a great resource, too, for women who have a need to be attended by a doula, and can’t afford (really, honestly can’t afford, not don’t want to fork out the money…what I do is REALLY hard work, both emotionally and physically, and if a woman CAN afford to pay me my fee, it is wonderful to be recognized for my abilities) to going rate in the area, they can look on bellywomen for a doula who is willing to work on a sliding scale or willing to fully donate their time (for really destitute clients). Many of us are willing to take a sliding scale or free birth per every so many full fee births to help women in the community who otherwise wouldn’t have the benefit of labor support. I have had many women contact me off of bellywomen, actually, simply because they want to breastfeed and having a doula gives them the best chance they have in their situation to breastfeed.

When you look for a doula, if there are several choices in your area, I highly suggest that you meet face to face with your potential doulas and talk for a while before you make a choice. This is to gauge chemistry. Having this woman in your birth space could be a significant decision for you, and if you have time to make the choice carefully, you should do so! I love my job, but I’d much rather my friend get a birth over me if the chemistry is better between a woman and her than to get the job myself and have the mother have a less than optimal experience because the chemistry just wasn’t right. And you’ll know right away with most doulas if you’re a good fit or not, so don’t worry that, after you’ve met your prospective choices, you’ll make the wrong choice. Kinda like finding the right mate…you’ll know!

The goal of a doula should really be to have birth be something that YOU DO…not something that happens to you or for you. That means that one of her major goals is education before your birth. Informed consent is a big responsibility. And to be TRULY informed when you sign any paperwork and/or make any decision, no matter how big or small, is a large part of birth being something that the mother does, rather than something that is done to her. Next, after having done her first job well, it is a doula’s responsibility to support the mother in the informed choices that she makes. I know of one doula who, if the client doesn’t take her advice, will leave the mother. This isn’t only malpractice right then, but also in that she doesn’t trust her SELF to educate her clients fully, to ENCOURAGE them to make decisions that will make their births their own. So, no matter the decision, if it was made with foreknowledge, then if it’s the right one for the mom, it’s the doula’s job to support it. This is why some women I know make very compassionate friends but would make awful doulas!…because they wouldn’t be able to support a mom no matter her choice.

Good for you, for talking about Doulas. Unfortunately, not enough women know about us and the work we do. I can’t tell you how many women I have met since I started working as a doula who say, ‘Wow! I really wish I had known about doulas when I had my baby!’”

Thanks MammamayI (cute username by the way)!

If you want to read more by MammamayI, she also had a passionate response to the Mom to Mom question on Toddler Nursing.

Post from: Breastfeeding 1-2-3