#informed birth

[above-the-cuts]

So conflicted... G. thinks I'm crazy for this

I feel so guilty about being more informed for this birth. I had trouble bonding with N. right away because of all the things that happened (unwanted induction, nicu stay, third degree tear), so I’m determined to have a better birth experience this time. But I’d that really fair to N.? What if I bond faster with this baby? What if I let slip down the line that baby number two stayed on my chest for two hours after birth (as is the plan) but N. only got twenty minutes? Is this favoritism? I really want to talk to VBAC moms. I want to know if they have any of the same feelings I do. Because I can’t help but feel guilty for wanting better this time around. But I do want better. Birth is beautiful and wonderful but I really struggled with accepting what happened last time. I’m so terrified to have another nicu baby it’s unreal. I love N. more than I even imagined when I was pregnant, and definitely more than I thought I could those first few weeks and months. I put on a good face and did my mommy tasks but I didn’t feel anything like the head over heels in love feeling I’d expected. I was wary that she’d get sick again (I’d been warned that the early introduction of antibiotics could leave her more susceptible to illness) and they’d take her away from me. But half of me yearned for a break. I’ll probably never forgive myself for those first months. Not gonna lie, part of my early “blue” period after birth probably had to do with sex. Have you ever heard exactly what a third degree tear is? ” About 4 percent of women who deliver vaginally end up with a more serious tear in their perineum that extends to or through the rectum. This kind of tear can cause considerable pain for many months and increases your risk of anal incontinence… A third-degree laceration is a tear in the vaginal tissue, perineal skin, and perineal muscles that extends into the anal sphincter (the muscle that surrounds your anus)” (quoted from babycenter.com) And here’s the kicker: on average it takes up to four months to be completely healed and up to a year to feel normal again. No wonder my sex life suffered! But I pressured myself (I’d taught myself in high school/been taught by guys that I was only worth what I could offer. Breasts were out, what with nursing, so sex it was. G. never likes me to talk that way, because amazingly he loves me for me.)

I don’t want that to happen this time. While I’m no longer afraid of tearing, I’d much rather keep my perinium intact thanks. And I will not settle for seperation this time unless it’s an absolute emergency. But part of me feels that is unfair to N. Maybe I should have pushed to stay with her. Maybe she’ll resent me for it down the line. Or maybe, like G. says, I’m just being extra hormonal.

[katrinaberry]

Interesting thoughts on "sweeps"

Some thoughts on 'sweeps' from a meeting of one of the Positive Birth Movement London groups:

"At last night's positive birth group, a midwife explained to us the pointlessness of doing sweeps - the intervention whereby a woman's cervix is manually stimulated in order to trigger contractions. With great precision, she demonstrated the two common outcomes:

1) if the cervix isn't ready it will still be posterior, meaning the mw's fingers have to go in very deep, down and under to arrive at their destination, and that her wrist bone necessary leans heavily on labia. She then has to 'cup'/'scoop' her fingers, leaning more heavily with wrist on labia to facilitate action, until she can start to walk the cervix, (which is out of reach), forward for her to do anything with it. Note, the cervix' backwards-leaning position is self-protective. Sphincter-like in character, cervixes tend to avoid confrontation and again like all naturally tightly closed holes in the body, don't like being prodded. The cervix' position will have already told the mw that it likely to be tight and closed, because it is not ready, and as such nothing can be done.

2) the cervix is tipped forward, and possibly riper and softer. The mw now has greater access, and will insert fingers into available space and try to make space/separate the baby's head from cervix, in an attempt to stimulate activity. In many cases, contractions are brought on, but as the onset was nothing at all to do with the baby's readiness, the very common result is several days of latent labour, contractions that will lose a woman sleep, and leave her tired and ill-resourced for labour. Most importantly with this second outcome, the forward-positioned cervix is plainly readying for labour anyway, so the justification for continuing to interfere is highly arguable.

In 90% of cases where sweeps are urged upon a woman, it cannot be time and fear of things 'getting too late', as they are usually given at 41 weeks and even earlier - meaning there is plenty of 'time' to leave the body to continue what IT IS ALREADY DOING. Very often with this second scenario, the sweep is performed, and things do begin but that is because of above - because if the mw could reach, IT ALREADY WAS HAPPENING. More often of course, the onset is attributed to the sweep.

Finally, the mw said she has never heard of a woman being told that there is a significant chance of a sweep accidentally rupturing the membranes, and thus setting in train infection risk/ticking clock, OR exactly what a sweep involves, its aims, its effects, and the fact that is an intervention. I do completely feel for midwives who are under pressure themselves to 'offer' sweeps, who feel they have no choice but to follow guidelines.  I've no doubt there are midwives who truly believe it is worthwhile, who find it an invaluable 'tool' but even if that is the case, is every pregnant woman it is offered to, given all the information - the HOW and the WHY so that she can fully engage with what she is agreeing to. Because this is what maternity care that places mothers choice at it's centre should mean."

[katrinaberry]

"You can't control what will happen in your own birth story but you can control how you deal with it."

This is a great example of how HypnoBirthing really does help in all birthing situations and being calm, confident and informed makes for the most positive of experiences.

Catherine and Damian had this to say in mid October about how they felt having just done the HypnoBirthing course with me:

"Damian and I are really so glad that we decide to take your hypno birth course.  It's fair to say we both had some reservations before starting -not wanting to put pressure on ourselves to be the perfect natural parents.  I think one of the things that resonates the most with both of us is the reassurance that birth, as life can't always be predicted, but hypnobirthing is a tool we can use regardless.  It is an attitude and perspective we both believe in that can help us to calmly work with the birth we are meant to have.   Feeling informed, and confident about the reasons for our preferences, we have been able to have sensible conversations with the medical team at Homerton.  Our midwives and consultant have treated me as 'high risk' due to previous medical history and abdominal surgery.  The consultant was very respectful of our decision to hypnobirth and as a result has agreed to sign me off for a natural birth at the birth centre.  The variation of daily practice Damian and I can do together and individually as we go about our day, makes the lead up to the birth of our baby relaxing and actually quite exciting rather than filled with unspoken dread.   Thank you so much for all of the information and for how you approach it."

And in the middle of November...

Lila Elizabeth Howkins arrived on 19/11 weighing a healthy 8lb 4. Damian and I wanted to share with you our birth story as I found reading them on your blog so helpful in the lead up to Lila's arrival. I had been having on off surges since a few days prior to guess date, increasing in strength and regularity. For my sanity I had been having regular reflexology, acupressure massage, aromatherapy oils and acupuncture, all promoted more surges. At 12 days past guess date, we made the difficult decision to be induced. We discussed the risks at the hospital and decided that based on my medical history of major abdominal surgery, it was safer to begin the process incase there was a reason why she wasn't coming. I had the gel induction and it had an immediate effect. Surges became more regular but were manageable without drugs with Damian and I enjoying using our hypnobirth techniques and excitedly loving the onset of labour. I was quickly 3cm. The staff left us on peace with our lavender spray, music and massage to progress. 20 hours later despite regular strong surges my cervix was unchanged so we were moved to delivery suit and my waters were broken. It was made clear to me that the decision was ours, but I was strongly urged to take the advice to advance the labour. The midwife that took is through to the delivery suit was lovely. She explained everything really well and was at the same time really interested in hypnobirthing. Her background was in acupuncture so she was very welcoming to our methods, dimming lights, understanding preferred wording and waiting for me to request pain relief.  The consultant in charge that day had said to our midwife that if we could progress my labour by breaking my waters, then I could have a water birth in the delivery suit. The whole team was very aware that I had wanted to give birth naturally on the birth centre and we're being as understanding as possible. I knew that braking the waters would have a strong effect. Almost immediately, my contractions were measuring 10 on the monitor and were 5 in 10 minutes. Two hours later, I was checked and still no further opening of the cervix. Very quickly, the surges had become unbearable, they were coming too quickly for me to focus and hypnobirth my way through them. I was also violently vomiting so was offered anti sickness drugs and a saline drip. The medical team explained that a hormone induction drip was strongly recommended, I knew by this point it would not be manageable without pain relief so I requested an epidural. I had a feeling that things weren't quite right and that Lila would not be arriving quickly. My labour was now set firmly on a path of medical intervention. I accepted that in my case it was needed.  I was aware that this was likely to be a long haul situation and my strength would be needed for later. I had decided in advance that I would request an epidural if the birth was induced by drip and too painful for me to be able to realistically cope in a long drawn out synthetic labour. This took away an element of turmoil I may have felt otherwise. To me the most important thing was to be healthy and well enough to enjoy receiving my baby in the first few days of her life. The head consultant of the dept came to see me as I have a more complex medical history. She talked to us about cesarean and if that was required, she would perform it. She had spoken with my previous surgeon who was also on call should it be required. We felt calm and informed and well looked after. The epidural and drip were immediate relief and I was able to have a few hours if much needed sleep.  After hours of drip induction and consistently strong surges on the monitor, there was still no further dialation. After 40 hours of labour only still at 3cm, the decision was made that a c-section was the only safe way to proceed. Everything was calm and at no moment did we feel panicked or out of control. All of the hospital were respectful of our hypno birth wishes but also took all precautions to keep me and my baby safe, she was monitored and stayed stress free throughout. Very quickly Lila arrived! Nothing else mattered. The team checked and passed her to Damian. I was given skin to skin in theatre and helped to latch her on to breast feed by an amazing midwife and nurse in recovery. The consultant let me know at the end of the operation that it would have been impossible for me to give birth naturally, they had found that scar tissue from my previous op and my bladder (which had slipped to the wrong place) were both obstructing my uterus. Although the contractions had been working hard, there wasn't space for the uterus to open any more than it already had. I'm really glad with every informed choice we made along the way and incredibly grateful to the team at Homerton who delivered Lila to us safely. Lila is adorable, she's well, feeds well and is strong. Our birth story was not a picture perfect hypnobirth, but also, it was not a traumatic experience. Studying hypnobirthing gave us the reassurance to stay calm, the rounded education to be confident in knowing our decisions were right for us. 36 hours later we were discharged from hospital, Lila and I both in good health. I think this was because we didn't get distressed through the process so could begin to recover quickly. We are now really just enjoying Lila and being at home as a family. I'm normally the type to shy away from sharing personal stories so openly, but I really found reading the birth stories on your blog helpful in the lead up to birth. I hope reading this reinforces that you can't control what will happen in your own birth story but you can control how you deal with it. Positive, calm, informed choices will help you to feel relaxed and prepared for the challenges ahead. Catherine, Damian and Lila X

[katrinaberry]

“Our birthing day was fabulous but not how we had planned”

Hello all, I want to share the wonderful news of the arrival of our daughter, Ava-Lucia, last weekend at Homerton Birthing centre. We are now at home getting to know each other. It is wonderful! I attach a couple of piccies taken a few hours after birth... Our birthing day was fabulous but not how we had planned (lesson no. 1 from our new teacher- baby may have a different schedule!). So a shortish version of how Ava-Lucia came into the world... We were 'overdue' and into our 41st week when our membranes released at 4 in the morning...mild contractions started but wore off towards the morning. Although you are meant to go straight to hospital to get your waters checked when they break, gabriel and I decided to continue with our day as planned and hoped that we would spontaneously go into active labour and deliver at home. So this meant that I attended an acupuncture appointment in the morning and the acupuncture lady aimed to give me a big boost to kick start my labour and get things moving. I knew the clock was ticking as the hospital like labour to get going within 24 hours of the membranes releasing...on the way back from the appointment, the contractions started up again (on the no. 48 bus!) and so all seemed to be moving in the right direction. We had an appointment with a homebirth midwife in the afternoon. She wasn't sure if there was meconium in my waters so she advised us to go to hospital to get checked out. This was a bit of a shock as meconium in waters = no home birth ;-( Of course, we followed her advice.   At the hospital they weren't sure if there was meconium in the waters or not but wanted to stay on the safe side so wanted to monitor us closely...i.e. no prospect of a homebirth for us. We had to stay in hospital. As my waters had broken over 12 hours before, they also started talking about 'augmentation', 'induction' and all these  medical procedures that I truly wanted to avoid. After a few tears and some negotiation, the consultant gave us some time to 'mobilize, mobilize, mobilze' (what is this a military operation?!) to get our labour going naturally. All throughout this time, I was having regular contractions but Gabriel thinks that the doctors didn't believe I was in active labour because I was just breathing through the surges and taking them calmly. As there was no space in the birthing centre, we were first located a room in the labour ward. This was a very medicalised environment, with bright lights and lots of machines. Very far from our imagined home environment. The midwife also wasn't very sympathetic to our birth wishes. After a few hours of labouring, walking and bouncing on the ball, I was examined and it was revealed that I was still only 1cm dilated and hadn't made any progress. My heart sank! The midwife started to talk of induction and drips etc and it seemed my worst fears for the labour were coming true....but we waited to discuss the situation with the doctors who came round to us a little while later. In the meantime, I continued to breathe through the surges, listening to nice music and focus on an opening flower! When the doctors arrived, they were absolutely wonderful and completely understanding of my birth wishes. As everything was fine with me and baby, they would give us another 6 hours in the birthing centre to get our labour going. I could have kissed them! It was such a relief. We were allocated a room and for the next 5 hours, I used the different aids in the birthing centre, my TENS machine (this was amazing), music, balloon breathing, and the affirmations (these were such an amazing source of strength and re-assurance during my labour) to get things going. To cut a long story short, I amazed the midwife by dilating in super fast time from 1cm to 8cm. No wonder the contractions were so painful! Gabriel had to further negotiate to get us a birthing pool (the concerns about meconium still loomed over us) but again, the consultants were wonderful and happy for us to go into the water. And so that's what we did. The water was just so soothing and relaxing, and after a night of labouring, I could have fallen asleep in that pool. This meant that my surges began to slow down so we had to get out of the water occassionally to keep the momentum up. After a couple of hours, I was fully dilated (yey! what a moment that was) and could follow my body's desire to push/ breathe down the baby. It was at this stage that the tiredness, the slowing down of my contractions, my inpatience and the lack of encouragement from my midwife meant that I just wanted to get the baby out! I lost trust in my body to be able to breathe the baby down, couldn't feel the contractions like before, and so followed the advice to push push push! This was really hard work and took a couple of hours before the baby arrived. Unfortunatly, she had done a big poo just before coming into the world so had to be cut from me straight away and cleaned up in a different room (followed by a bare chested daddy). This was quite dramatic and scary as a team of staff swarmed into our room and whisked her away. A few minutes later, she returned with her dad and we were given some time alone to bond and breast feed. This was a magical time (before I had to go to theatre for some stitches!) So despite not having the home birth and ending a bit dramatically, our birthing day was wonderful. We felt that we were able to follow most of our birth wishes and are in awe of the little person that has arrived as a result. We hope you are all well and enjoying parenthood, karen, gabriel and ava-lucia xxx