8/13/09

"Bonjour Nicolas!"

These are birth notes from the last birth I attended from my perspective. The official birth story belongs to this couple. I'm sure I left something out, as birth brings so many magical moments.

It was 4:47pm and mom called, to tell me she had been having contractions all day, and they were 5-6 minutes apart and seemed manageable. We spoke for a few minutes and I told her that when I woke up this morning I thought to myself "I better get the birth ball and my doula bag in the jeep, I think today is the day." Mom was 40 weeks and 6 days, and this was to be a VBAC attempt after a traumatizing c-section experience with her 1st son.

Mom decided to call the midwives and see when they wanted her to come in. At 5:00pm mom called me back to tell me that the contractions were building and only 4-5 minutes apart and that the midwives wanted her to go into the hospital. I assure mom I will meet her there shortly.

Around 6:30 I meet mom and dad in the hall of OB triage, where we greet each other and get mom checked in to triage. The nurses get mom hooked up to the monitor, and check mom to find that she is 1-2cm, 50% effaced. Mom is discouraged by this and quickly I remind her that her body is working hard to get her baby out. I encourage her to trust that her cervix is doing what it is supposed to while I softly help mom to imagine her cervix like a rose, blossoming into each contraction.
"Remember, your cervix is like a rose, you can't stop a rose from blossoming. Let it go, give yourself permission to open"
After an hour in triage, at about 7:30 the nurse suggests that mom walks around for 1-2 hours to "get things going". Mom and dad hadn't eaten dinner because they had planned to order pizza at home before labor intensified. We go to the cafeteria and get some food.

We walk, and each contraction builds like a soft wave. She is leaning on the chair or dad while breathing deeply during contractions. We walk, at a snails pace...through the noisy hospital corridors as the janitors wax the floor. As we walk mom handles her contractions so well, I wasn't sure at this point that she was progressing.

9:03 pm, mom wants to stop the walk to go back to triage, contractions are more intense, she is feeling a little nauseous and starts to tremble a little. We get back to the room and as mom is checked the nurse reveals mom is a 4-5, 80% effaced!!! Mom says "So, does that mean I can stay?" Nurse: "Oh, yes! You're having a baby!"

Soon after, mom started stripping clothes (good labor sign!) and she was feeling flashes of hot and cold (another good labor sign!) Mom had not slept much the night before so she laid on her side to rest. She loved the warm rice sock on her back and dad stayed close by moms head, keeping her space full of love. Dad stayed very involved and never took his eyes off mom.

10:30 we get settled in the birthing suite, mom labors leaning on the back of the bed on her knees. I plug the Ipod Player in, dad puts his Ipod on and a Joni Mitchell song is playing. I dim the lights and put out my flame less candle to help create a peaceful space for mom.

"Oh, here one comes..."
"Take a deep breath in, breathe for your baby...that's it, just like that."
"I don't know if I can do this..."

"You are doing this! Remember each contraction is bringing you closer to meeting your baby."

Mom's bag of water broke at 11:20 pm. After being checked at 11:30 mom is 7-8cm almost 100% effaced, shaking in the knees, cold washcloth on forehead, fan blowing, mom is doing awesome. I remind mom that this part is transition, usually the shortest part, but the most intense.

"I'm feeling a lot of pressure!"

Mom knew in advance she might want the epidural, and dad & I supported mom with massage and reassuring words while she labored waiting on the anesthesiologist to arrive. The midwife said that by the time the epidural was placed, mom was complete and ready to push. It was 12:30am.

Mom dug to the deepest, most sacred parts of herself to push strong and hard to birth her baby. Baby Nicholas was born with his eyes open at 2:10 am. As mom looked at her son she whispered "We did it, we did it!" What a glorious moment! This moment of empowerment brought tears to my eyes!

What a beautiful baby that latched on instantly.

Dad's primary language is french, so as he held Nicholas for the first time he said "Bonjour Nicholas!"

This beautiful embrace brought tears to my eyes...again.

8/4/09

"Over here, Mr. President"


Pushed author Jennifer Block recently wrote a new blog about health care reform and why maternity care should be included in the reform work. In this recent piece she says "Over here, Mr. President" if you want to cut health care costs just look at maternity care. Block says:

"Childbirth, in fact, costs the United States more in hospital charges than any other health condition -- $86 billion in 2006, almost half paid for by taxpayers,"
And here's the worst part:

"Yet we have among the worst outcomes: high rates of preterm birth, infant mortality, and maternal mortality, with huge disparities by race."
On the BOLD blog, here is a great piece about Jennifers article:

It's a no-brainer that maternity care needs reform, but ironically as Block points out the women's health community has never fully embraced this cause. Why? One word: abortion. Reproductive rights advocates need ACOG (American College of Obstetricians and Gyns) on their side. You lose them and you could jeopardize women's access to abortions. This, Block asserts, is the reason reproductive rights advocates haven't been knocking doors down to complain that one in three women are c-sectioned in the United States, that mothers who had C-sections are being denied vaginal birth as an option in at least half of the hospitals in the US.Hearing all of this is painful and tragic.

And, women's health advocates aside, there's more worrying feedback mothers are getting about their maternity care. Block attended Childbirth Connection's symposium on maternity care and..."An executive from Geisinger Health System made a startling admission:

"There are many healthcare organizations across the country [that] have become, unfortunately, dependent upon NICU [Neonatal Intensive Care Unit] volumes to fund many of their other services."
In other words, our for-profit system not only rewards the overuse of intervention even if it leads to more sick babies; in some cases, it depends on it.

These are hard words to swallow, especially if you're pregnant today. But do not despair. BOLDness is out there! As Block points out, midwives are offering outstanding care for low risk mothers. And if 10 percent (instead of the current 1%) of the population in the US used midwives we'd save $9.1 billion in healthcare. It just makes CENTS!!!

To read Jennifer Block's full piece click here.

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