Sunday, August 29, 2010

Interventions: Guest Post from Emily Murphy

My pregnancy was more than something that just happened to me. It was a journey--a journey that has led me here today, passionate about birth, at peace with my body, and regrettably, disgusted with our system of maternity care here in America. I began this journey just as any other young, fist-time mother—with the idea that I would deliver my baby in a hospital, under the care of an ob.  Although I was hoping for a natural childbirth, I never thought that I would have to fight for it.  But the more I read about maternity care in America the more horrified I became.  In America, where 28 countries have lower maternal mortality rates and 41 countries have lower infant mortality rates, pregnancy is treated as a life threatening, emergency situation, and because two lives are involved it is doubly dangerous. In America women are wheeled into emergency rooms, whisked off to an LDR, hooked up to every machine imaginable and left waiting in peril until the doctor is able to deliver the baby. The doctor saves the day! Good thing because the mother needed an emergency C-section; her baby was in distress.  But how did baby come to be in distress?

What is so frightening about the use interventions is that one often leads to another, which leads to another, then another, and soon you are traveling that slippery slope to a c-section.  You go into the hospital too early, your labor stalls and they administer pitocin; pitocin causes those super-contractions, making labor more painful for you so you need an epidural; the epidural slows your labor because your uterus relaxes, and more pitocin is administered.  This mega-dose of pitocin causes the baby to go into distress, which is picked up on the fetal monitor and you are wheeled off to the operating room.  So really, in the words of Marsden Wagner, they had to use in intervention to rescue the baby from the intervention. Where in the world does this system make sense?

 Well the answer is obvious—and since in America pregnancy is seen as an illness and the mother as a patient, the doctor is left with the burden of a perfect outcome every time. And how else can a doctor ensure this unless he/she has control of all aspects of birth? Thus, the intervention. Now, although I believe that the c-section and other modern interventions can be incredibly useful as life-saving technologies, I believe that they are grossly overused. In fact, the use of some interventions has become so common that they are actually considered routine procedures (the use of ivs and continuous fetal monitoring, for example).  Some other interventions are not considered routine, but are used so often that many nurses and obs do not know what to do without them.  These include the use of labor inducing drugs such as Cytotec (which, by the way, is not FDA approved for pregnant women), labor enhancing drugs such as pitocin, and the epidural.  And some interventions are actually on their way out because they have been shown to be counterproductive/useless.  Examples of these are the pubic shave and the episiotomy (although many obs still use episiotomies routinely).   All of these procedures are simply that—procedures.  Why does something that is a natural process need a procedure? 

The more I read about interventions and what most interventions lead to (the C-section), the more I realized that I needed to be proactive in how I would achieve my natural childbirth.  I wrote out my birth plan and proudly took it into my next prenatal appointment.  The answers I received from my ob were not what I was hoping for, but at least she was honest. But, I was not yet completely discouraged—that happened when I went on the hospital tour. 

The tour was basically a run down of all hospital procedures: when I was suppose to come in, how I would receive an IV and a monitor, when I could get an epidural, how long my labor was allowed to ‘stall’ before they would administer pitocin and break my bag of waters, what position I was allowed to be in while I pushed, how long I was allowed to push before they would call for a C-section, and did I mention that I was allowed an epidural? It was all too much. 

At almost 30 weeks, I left my ob and sought out the care of a midwife.  With my midwife I did achieve the beautiful natural childbirth I was hoping for.  Would I have had the same natural childbirth had I remained with my ob?  Could I have slipped past all the intervention hurdles the hospital had ready to throw at me? There is no way to tell.  What I do know is that I did not want to give control of my body up to a doctor who, if I was lucky, would have spent a total of 3 hours with me, and that there is no one in this world who is better able to deliver my baby than me.   

Friday, August 20, 2010

Birth Records

A few months ago, I wrote that I wanted to review my birth records with the midwives to better understand what led to my cesarean. Well, today I did it. I went over my chart. Talk about emotional!! I am pretty much a wreck right now. In fact, when I was walking to the car afterward, I managed to lose the parking ticket you need to get out of the lot at Magee. I had to go back inside and get the valet to print me a new stub. (Luckily I had not lost my receipt)

Anyway, I also wrote about this chart reading on my personal blog, but wanted to share some of my thoughts and talk a bit about what was in that record. For one thing, it never said "emergency" or "elective" in reference to my c-section. It was just a bunch of paragraphs with headers like "indications for cesarean."

The first paragraph matched with my memory. It detailed my progression and effacement and stuff. I was happy to see the words "progressing normally" even though I wasn't opening at the prescribed 1cm per hour timeline OBs like to see. Of course, I should expect midwives to know that opening is allowed to take longer than that!

Then, the report began to talk about my son's heart rate and I was both shocked and relieved to see how low it was for how long and what measures they had taken to bring it back up. I learned about all sorts of things such as intrauterine resuscitation, the fact that it was a full 10 minutes from noting a heart rate of 40 BPM until they began operating, and also that they had given me a drug called terbutaline.

I need to read more about this drug, but apparently it slows down contractions. In the end, I asked the midwife about my deep, dark fear. At the center of all my "what-if" fears had been the memory of someone asking me a question: do you want this procedure? It seems as though I must have said yes in the operating room, but of course I didn't want it AT ALL. For months, I agonized over what would have happened if I'd said no.

The midwife today told me that there had not been time to seek written consent for the surgery and what I was remembering was likely the doctor obtaining verbal consent for the procedure. Very different from me having a choice about it!

I feel a lot of closure after having that discussion. I feel, finally, that I really did all I could to avoid surgery and that my midwife did all she could to avoid me having surgery, and even after that, the attending OB did all he could to avoid it, too.

I could spend the next year trying to figure out why my baby's heart rate dipped and he didn't drop, but I no longer feel like I need to do that. Today was a big day.

Thursday, July 8, 2010

Good Birth Vibes

Just when I start to get discouraged about birth, I get to hear a wave of wonderful birth stories. In the past month, I've heard three great ones. Two friends had beautiful, natural births, one had a VBAC, and another friend had a vaginal delivery that she was very excited about. This last friend had the great courtesy to deliver her baby while I was in my home town visiting family, so I got to meet the wee bairn!

Has anyone else heard anything exciting about birth lately?

Thursday, June 24, 2010

Baby Mammals

Our chapter leader Amy has long wished to write a blog post about the Pittsburgh Zoo, and I don't want to steal her thunder. But I just read something interesting in my Zoo Insider that made me think about the way our society regards birth and the postpartum period.

There's a little article in the Insider about how one of the sea lions is pregnant. The article says sea lions have about 15% infant mortality and that a huge factor in survival is the mother/baby bond. It emphasizes how crucial it is for moms to accept their pups and begin nursing right away.

When I think back to the way my birth experience affected the early days of my mothering experience, I shudder. I had such a difficult time bonding with my baby, mostly because I was wigged out of my mind on drugs for several weeks, but also because I was in a bad way emotionally. The fact that I didn't even get to lay eyes upon my baby right away meant we instantly got off to a delayed start for our bonding process. But, because of various medical complications from my birth, it was literally weeks until I even looked at my son without painkillers and steroids affecting my vision.

I just feel like it's a little backwards when we totally emphasize the mother/baby bond for zoo mammals and write newsletters about its importance, but yet deliver 33% of our human babies in such a way that breastfeeding and bonding is compromised. What sort of difference might it make if OBs and regular old American families got newsletters about mother/infant bonding, urging everyone to root for new human moms and their babies in this way?

Of course I am rooting for Maggie and her new baby to have a great experience. I also want society at large to know that birth matters and that mothers' experiences are really, really important for getting our human families off to a strong start.

Tuesday, June 15, 2010

Ina May's Guide to Childbirth

An ICAN friend leant me a copy of Ina May's Guide to Childbirth by Ina May Gaskin. I am about halfway through reading it and find it a very emotional process.

The first half of the book consists of beautiful birth stories. There are 130 pages of women describing their natural births. I finish each story in tears, either because the story was so beautiful or because I learned something about my own body or birth that makes me feel...well, just really eager to try again.

Of particular interest to me were the VBAC stories in the collection. I felt like the mothers in this book did a fantastic job of verbalizing my own thoughts and feelings about birth and I really felt like I rejoiced with them when they placed their own newborn babies on their stomachs or started nursing right away.

I am just a few pages into the second section of the book, where Ina May discusses the birth process and what I assume will be her guidance through a beautiful labor. She has a lot to say about fear and its affect on the cervix. I find myself wondering (well, who am I kidding! Fixating!) whether my anxieties about motherhood and my fear of medical interventions lead to the chain of events resulting in my c-section.

I feel like if Ina May had been in that LDR room, she would have told me first to blow raspberries and make out with Corey during contracts, then to verbally tell my body to open, and then she would have made me feel like 18 hours is still a "normal" time for a cervix to open up. Yes. Even 18 hours.

One thing I feel certain of is that this book is a fantastic read for any birth junkie and probably should be essential reading for pregnant women. I'm so glad Emily let me borrow it!

Saturday, June 12, 2010


I haven't written in awhile. Yes, I have been busy with work, but mostly I've been afraid. Somewhere on facebook, I saw a discussion about (of course!) birth and one mother mentioned something frightening about her c-section. This mother had been convinced by her OB that she was in an emergent, dangerous situation and needed what she believed was an emergency cesarean. Later, this mother reviewed her medical records and saw the word "elective" instead of emergency.

I haven't been able to sleep since. I am so terrified to even request my records. What if mine reflect the same thing? When I've tried to talk to some friends about this, they typically say, "What's the difference?" How do I begin to explain the wide, wide world of difference there?

The fear that my surgery was an unneccessarian has been clouding my ability to think. I am trying to summon up the courage to call Magee and snag a copy of my medical record. I don't think I can read it alone. I think it's important to know, though, what it says about me, right? Why should I let someone else tell my story without my input or knowledge? But what can I do if I disagree with the story it tells?

Thursday, May 27, 2010

Rock on, Tilda!

I was reading the latest issue of Bust magazine and came across what I felt was an awesome bit of insight from actress Tilda Swinton. When asked about new motherhood, Tilda told Bust, "It's like a new person comes into being--you as a mother. But the old person, the not-mother, goes on. And you ignore her at your own peril! If you think she's not going to come bite you in the ass 20 years later,'ll have a big surprise on your hands."

I think that's so great to read because I felt like she captured something I'm feeling. Instead of changing into just one new person, I felt like motherhood sort of smashed my old self into this new self and sometimes, well sometimes I can feel them both sort of needing attention. I love that a well-read magazine publishes sentiments like these to let women know it's definitely ok to need to pamper your "not-mother" self every now and then.

Tuesday, May 25, 2010

Body Image

At the first ICAN meeting I attended, Amy (our leader) mentioned that many women feel betrayed by their bodies after a traumatic birth experience. This resonated with me so strongly!

I think I had pretty good body image before I got pregnant. Sure, I felt awkward about bathing suit season, but I felt really confident in my fitness and my muscles and I knew my body could do anything I asked it to. And I asked it to do a lot of things! I had all these exciting goals I was working toward, like pull-ups and rope climbs. As I mentioned in an earlier post, I played rugby for ten years.

And then my birth experience turned everything upside-down. I really felt, for a long time, that it was my body's deficiency that somehow caused my c-section. WHY hadn't my baby descended into my pelvis despite such strong contractions? WHY was my cervix stalling at 5 cm? The questions came from everywhere, relentlessly, and they were all focused on what I viewed as my body's betrayal of my mind.

My midwives were great at answering the technical questions about my birth. The therapist I started seeing was great about helping me to realize that sometimes, there is no answer, there is no specific person or thing to blame, and things just happen.

But the sense of betrayal and even anger at my body lingered for a really long time. It seeped into every other thing I did, including my breastfeeding experience. Through my research as a writer, I've spoken to a number of new mothers who felt this body anger. Women kept saying, "If only!"

If only I had pushed harder. If only I had bigger hips. If only I hadn't succombed to the pain and begged for the epidural...we women, it seems, turn to our bodies when we seek something to "blame" for our birth experiences.

I think it can take a really long time, and most certainly a strong support network, to overcome these feelings. One thing that I found really helpful in the beginning was affirmations. My therapist suggested I find something, each day, that my body had done and to verbally affirm this amazing achievement.

My body grew a healthy baby! My body is amazing.

My body carried laundry up and down stairs on 3 hours of sleep. My body is amazing.

What has your body done today?

Monday, May 24, 2010

Physical Activity After the C-Section

I haven't posted in a few days because I was preparing for, playing, then recovering from my first rugby game in almost 2 years. You see, before I became a mother, I was a competitive athlete (in addition to all my other roles and identities). For ten years, I trained like a fiend for the only full-contact sport in the world where the rules are the same for men and women alike.

Rugby is an intense sport for many reasons, the biggest of which is probably the cardiovascular fitness and strength the game requires. I was in amazing shape when I got pregnant and, with the approval of my midwives, was able to continue working out up until the day I delivered. I actually had gone to the weight room and done 75 overhead olympic lifts the morning before I had my son. I tell other athletic moms-to-be that power cleans were my secret labor inducer.

All kidding aside, one of the most difficult things for me to mentally adjust to was the physical limitations after surgery. I was going to have a natural birth and start working out again after, like, one week off. And then, instead, I was flat on my back unable to sneeze. Training had always been my way of dealing with stress, too. There was nothing a sweaty workout couldn't clear up.

So, having to face the most intense experience of my life (motherhood PLUS my first experience with any sort of physical complication, injury, or surgery) and then spend five weeks "taking it easy," well that was tough.

It's been ten months since Miles was born, and I am only very recently beginning to feel rested enough and recovered enough to truly test myself physically. It feels so, so, so amazing to exercise again! But boy, my body is really different now. For one thing, I still can't sit up from lying flat on my back. Other things seem much easier (like any sort of lift mimicking hoisting up a 21 lb baby...).

Returning to fitness is a slow and winding road. It sure feels good to be driving it.

Thursday, May 20, 2010

Staples vs Stitches?

I noticed an article on Stroller Derby the other day where the authors started a debate around staples vs stitches for a c-section incision. The article references a study done at the University of Insubria in Italy that found, cosmetically, the two methods produce equal results. It then refers to an earlier study that found staples increase the chances of complications post-surgery.

When I had my c-section, I had internal stitches and external staples for a few days. These were then replaced with those butterfly sticky things, which stayed put for more than a month before coming off in the shower. My scar is in pretty good shape these days in the sense that it's pale pink and only gently raised.

What sort of closure method did other moms encounter? I don't recall being given a choice or discussion about it, but then my surgery was an emergency one and not a planned or scheduled operation. Did other moms have a similar experience? How are your scars holding up these days?

Wednesday, May 19, 2010

Birth Control

Immediately after my surgery, I'm talking immediately, like when I was still being wheeled into the recovery room and asking my husband what had happened, a resident popped her head over my bed rail and asked me, "So. What method of birth control will you be practicing?"

I was pretty out of it, on drugs, etc. Not to mention I had just become a mother! I was certain I misheard her. "What?" I said, all polite methods of asking her to repeat herself forgotten.

"What method of birth control will you be using?"

"We haven't discussed it yet," I told her, incredulously. Every few hours for the next two days, someone came to my hospital room and asked the same question. My mom told me to say abstinence. My husband got really cranky and suggested a number of dirty things I should say instead.

My midwife eventually explained to me that there was a medical risk in getting pregnant too soon. What the residents meant to be explaining was that I should avoid pregnancy (and the uterus-stretching it would cause) for 18 months. In order to avoid this, they wanted to make sure I knew everything there was to know about birth control.

I eventually just told them something to make the questions stop: diaphragm.

What a bad choice that was! I left it on my chart so long that, at my 5 week checkup, I actually had to get fitted for a diaphragm. Good lord, that's a horrendous invention. Terrifically awful in every way.

But what else was I supposed to use? Eighteen months of condoms sounded like a terrible idea to both my husband and me. The idea of an IUD in my uterus filled me with fear. I didn't want a hormonal birth control anymore...I felt like I had limited options.

Needless to say, the diaphragm did not last long and I switched to the mini-pill, which is safe to use with nursing. But I don't really like that much because I don't want to be on a hormonal birth control, like I said before. And I'm terrible at remembering to take the pill! What mother of a new baby can remember to take a pill at the same time every day? I often don't remember to brush my teeth (I'm ok admitting that).

What birth control method did other new moms find successful in between babies? I'm dying to know what other choices are out there AND how those choices play out in real life. Anybody have some good advice?

Tuesday, May 18, 2010

Family Planning

I was advised after my delivery that I should not get pregnant for 18 months. Now, my husband and I were initially planning to have our kids be 3 years apart anyway. I had no desire to get pregnant before 24 months...until someone told me I couldn't.

I have never taken kindly to being told what to do. I'm a Taurus! I'm stubborn. I'm also spiteful and dramatic and have these terrific martyr fantasies where I blame my birth experience for the structure of my family.

Only, if you think about it, it's not so dramatic. I know lots and lots of people who want their children to be one or two years apart. There are practical explanations for this: the kids will be good friends, close together in school, the time away from working will be compressed. There are moral or just preferential reasons for this, too: folks like big, close families. There are millions of reasons behind people's family structure choices.

Cesarean sections impose regulations on when or how often we can reproduce. Isn't that terrible? My son is 10 months old now. When he was first born, I couldn't imagine ever becoming pregnant again or replicating the experience of parenting a newborn baby. Now that he's super cute and cuddly and (dare I tempt fate to say) easier, I can have serious conversations about expanding our family.

Except my damaged body puts those plans on a necessary hold for 8 more months.

I've looked around on the internet and read a bunch of magazines and literature. I think this is an issue that is often overlooked.

Was anyone else out there advised to postpone pregnancy due to surgery complications? What did you think about the "spacing"of your kiddos?

Monday, May 17, 2010

Poughkeepsie VBACs on the Rise

Women delivering near Vassar got some optimistic news this month. According to an article in the Poughkeepsie Journal, the area's primary c-section rate has dropped as its VBAC rate has increased. The area showed a 22% increase in VBACs for 2009!

The trick seems to be for the directors of obstetrics to lay on the pressure. The article indicates that the hospitals showing this data used midwives in the hospital to assist deliveries, promoted VBAC, and were "very careful about inductions."

Seems like good Standard Operating Procedure to be emulated!

Friday, May 14, 2010

Maternal Mortality On the Rise

Moms are dying in childbirth. I'm not just talking about the "third world," but here in the United States. Women are dying. California Watch reports that the death rate for mothers in California has tripled in the past decade and the "dangers of obesity" plus the rapid increase in the cesarean section rate are suggested culprits.

This is a big deal, folks. Women are dying in increasing numbers...not the other way around. One of the most chilling sections of the article, for me, was this: "it’s hard to ignore the fact that C-sections have increased 50 percent in the same decade that maternal mortality increased. The task force has found that changing clinical practice could prevent a significant number of these deaths."

In other words, if our society stopped pressuring mothers into cesarean sections that were not medically necessary, fewer women might die.

And if the death toll doesn't alarm you, other risk factors should. Increasing numbers of women are slipping through cesarean delivery within an inch of their lives. The article quotes California's Center for Family Health deputy director Catherine Camacho as saying, “For every maternal death, there are 10 near misses; for every near miss, there are 10 severe morbidity cases (such as hysterectomy, hemorrhage, or infection), and for every severe morbidity case, there is another 10 morbidity cases related to childbirth.”

The bottom line is that a cesarean section is a big deal. People make the operation out to be "no big thing," or a "quick and easy" procedure. Nothing could be further from the truth. It's major abdominal surgery. Without question, cesarean sections save lives of moms and babies, but this operation should not be taken lightly.

Thursday, May 13, 2010

OB Peeves

You know what bothers me? When I talk to women about their birth stories and learn they had c-sections because their doctors said something along the lines of, "let's just make you guys parents right now! Huh?"

Essentially, these doctors make it sound like a big party that needs to get started a lot sooner, like the c-section will jumpstart parenthood, kick the family into high gear. Meanwhile, mom can't get up to change a diaper or sneeze without fear for days or weeks or months.

I don't know when we as a society lost the concept that labor takes a long time. Maybe when we started seeing babies born within the confines of 30-minute sitcoms? I guess this pervasive media imagery of quick birth can make moms feel they are abnormal when their labor takes more than a few hours. Combine this societal pressure with the authority of the white-coated doctor suggesting your body is taking too long and you have all the ingredients you need to get bullied into a c-section.

In the past few weeks, I've talked to moms who actually had their OB say to them, "We could be here all night...or we could make you guys a family in a half hour!" Now, I am not a doctor and I was not in the room monitoring the babies' or mothers' condition. But it strikes me as odd that a doctor would offer the option to continue laboring if there were indeed eminent danger.

Pressure like this from doctors really gets me angry. I understand that it's easier for OBs to operate for a few minutes than to linger at the hospital for an unknown period of time waiting for a vaginal birth. But those OBs aren't the ones who then spend weeks gingerly hosing an incision with a peri-bottle or having to buy granny panties because regular underwear irritate your scar. Worse, those OBs aren't dealing with scar tissue or bowel obstructions or difficulty bonding with their new infants. Not that recovery from a vaginal birth is a trip to the just seems insensitive to me for doctors to suggest major abdominal surgery as a means to a quick family photo.

I know that, in the throes of labor, many women are anything but ready to question suggestions by their doctor. That's why I hope labor support partners would ask a few questions upon hearing such a suggestion. Namely:
  • What are the side effects and complications of a c-section compared to laboring and delivering vaginally?
  • Is my baby in distress or danger?
  • Am I (or is my laboring partner) in distress or danger?
If the OB is honest, she or he will indicate that there are "33 areas where cesarean section was found to involve more risk than vaginal birth," and only "4 areas where vaginal birth was found to involve more risk than cesarean section," according to research conducted by the Childbirth Connection. In other words, it might be worthwhile to "keep going all night" if it means avoiding psychological trauma, limited early contact with the baby, infection, your baby's chances for developing asthma, or any of the other high risks associated with a cesarean.

It is my wish that doctors would stop suggesting major abdominal surgery so flippantly, but if they don't, I hope mothers and labor supporters will read some evidence-based materials and not take such a decision lightly.

Tuesday, May 11, 2010

Conscious Woman

Through the course of my research about birth trauma, I stumbled across another great resource. Conscious Woman is the online home of a series of webinars. Basically, anyone with an internet connection can register from anywhere in the world and join conversations with professionals about...well, zillions of topics.

The section I found most helpful was the series on Healing from Birth Trauma. One of the messages of the site that really stuck with me was the view that sometimes*, medication for Post-Partum Depression is really just a bandaid.

In my case, for instance, I don't believe I suffered from PPD. But I sure did exhibit symptoms of Post-Traumatic Stress Disorder and exhaustion. I followed my gut and did not take the antidepressants my medical doctor(s) were quick to offer...again and again and again. Many women don't seek other opinions, take the drugs for PPD, and, when they stop taking them, still haven't healed from their traumatic experiences and are not sure what the heck went wrong.

Enter Conscious Woman. The webinars on the site focus on other means of healing, like Emotional Freedom Techniques and another on physical healing. In my case, I was so wrapped up in my emotional trauma it took me about 6 months to realize I had neglected some of my physical damage.

I didn't visit a practitioner of CranioSacral Therapy, Visceral Manipulation, or Urogenital Manipulation, but I was inspired to go see a chiropractor and make an appointment with my GP after months of nagging hip pain, aches in my incision site, and a general feeling of coming apart at the seams. In short, Conscious Woman gave me a very gentle kick in the pants to take care of myself.

I like that the webinars don't require me to leave my house and that I can watch them at odd hours (what mother of a new baby wouldn't appreciate this feature?). I also appreciate that the site gets me thinking about my health physically, mentally, and socially. I have yet to check out any of the other webinars (though would certainly love to investigate the one about marketing and online communities!) but certainly plan to in the future and hope to see more great content in the birth trauma section.

*I don't want to diminish the devastating effects that PPD can have on families or the ways in which medications can help women to win this battle. In some cases, though, women are misdiagnosed by hurried medical doctors or just offered medications that don't treat their actual symptoms.

Monday, May 10, 2010

Nursing After a C-section

One of the hardest parts of my birth experience was not being able to nurse my son right away after my surgery. I remember the staff handing him to me in the operating room right after they unlashed my arms and they told me to hold him. "I can't feel my arms," I said.

"Of course you can! Just hold your baby!" they told me, shoving my burrito-wrapped baby into my body as they wheeled me down the hall. As soon as we passed my mom, I begged her to take Miles before he slipped from my hands, because I assure you, I could not feel or control my arms.

Though groggy, I knew I had a small window of his quiet alert period as my best bet to begin nursing. It was hard watching that ticking clock and knowing I was just too incapacitated to take advantage of the opportunity. Nevertheless, I was bound and determined that I would breastfeed this baby!

I'm not sure how much time passed, but I eventually felt like I could, or at least would like to try to, nurse. I still didn't have great control of my arms, but asked the midwife if she would help me out. Best decision ever! Shannon helped me to open my hospital gown and she positioned my baby on my chest for me and, now that I think of it, she held my breast for me, too. I remember feeling my son's little mouth searching around, trying to figure out what was going on, and then giving a little suck-suck. What a magical moment! It overpowered the drugs and made me feel really proud of myself.

I tried again every few hours and as I got more sensation and awareness back, my son and I got better and better at breastfeeding.

By mid-morning, my milk had come in, I had full control of my arms, and I was on my way to getting good at nursing a baby. Some of the things that helped me nurse right after my surgery were:
  • I was a total task-master about getting the lactation consultant in my room. I asked every time the nurses came to give me meds!
  • I asked each shift of nurses to check whether I was breastfeeding well, whether my son was latched on, and whether I had the c-curve hand position down pat.
  • The midwife told me about this amazing thing called side-lying nursing. Since sitting up, even with the support of the bed, was so painful, this ended up being a life-saver. Or at least a breastfeeding relationship saver! I learned to use 2 pillows and support my "down" arm along with my head to help my physical healing process and facilitate nursing.
  • I had a pediatrician who totally supported breastfeeding. He watched my son nurse at each of his first few appointments.
  • I went to a La Leche League meeting as soon as I was able and one of the leaders watched me nurse and gave me some tips.
The point is that I whipped out my boob to anyone who seemed like he/she would have some educated or experience-based advice to offer me. I threw my modesty out the window and switched my whole focus to nursing, especially since my surgical experience might statistically hinder our success rate.

Even with all this help, I had a bear of a time and still sometimes struggle. But I still love seeking nursing support!

What are some things that other moms did post-surgery to facilitate the breastfeeding relationship?

Saturday, May 8, 2010

Mother's Day!

This will be my first Mother's Day with an external child. Last year, people wished me happy Mother's Day and bought me cards, and I felt a bit like a sham for basking in that glory and lapping it all up. If only I knew!

This year, I didn't pay very much attention and assumed the holiday was May 16. That's when my husband and I made some plans to celebrate. When we found out I got the date wrong, we kept our plans the same since I'll be home in Central PA visiting my own mother this weekend!

But, when I return, I'll be celebrating Mother's Day in the following way: I will sleep until 10am. Or I will at least remain in my bed until that time. My husband is in charge of all diapers, solid foods, and baby entertainment until that lovely hour. And if someone wanted to carry some breakfast upstairs to me, or a cup of tea, that would just be icing. It's a huge fantasy. (I am trying not to think about the mess I'll find downstairs when I emerge from my cocoon)

What are your plans for the weekend?

Thursday, May 6, 2010


A few months after my delivery, when I was trying to get my working life back in order, I started researching birth trauma and recovery from birth trauma. My investigation led me to Sharon Storton and Solace for Mothers.

Sharon, who lives in California's Bay Area, has supported mothers for over twenty years as a mental health professional, lactation consultant, doula, and childbirth educator. She helped found Solace because she heard from too many women like me, women who had these awesome babies but birth experiences that left them feeling grief, confusion, anger, and/or traumatized. And then they felt silenced when they tried to talk about it. "Culturally, women are told, 'hey! You have a healthy baby!' [Birth trauma] is really something we're not 'allowed' to talk about if the baby lived," she says. "It's so hard on moms."

The solution Sharon (along with Jenne Alderks and Jennifer Zimmerman) built was an online, mother-to-mother support group for women who have survived traumatic childbirth: Solace for Mothers. Nobody in there will tell a mom to just be grateful for her healthy baby. What I found so comforting about this resource was that the online community was ONLY for mothers who had survived birth trauma. There was a separate forum for supporters (loved ones, friends) and health professionals, but the online group was purely for women like me.

According to Sharon, Solace sprang from a need she noticed in her office. Women, she noticed, felt unheard and unlistened-to. "Birth is saturated in fear," she told me, "Fear with tests, providers have fear of being sued." She described a scenario I've seen again and again, where women are lead to believe they are in life threatening situations (which they may or may not have been) and the fear builds and builds until the birth experience becomes terrifying for many mothers.

Afterward, women seek someplace safe where they can express their feelings, their fears, where someone will listen. In my experience, Solace is definitely this place. I was welcome to just read the experiences of others until I felt ready to share. I had a place where other mothers would validate and affirm my experiences.

Why is this so helpful and effective? Sharon tells me, "healing comes from repairing identity, which means being able to have a range of emotions and not being told there is a deficit in you for having these emotions." In other words, on Solace, there is no blame.

In a world where even our language blames mothers (whose failure to progress? Whose pelvis is dis-proportioned for the baby's head?), Solace has mothers reminding other mothers that their bodies did not fail them,the work they're doing is hard, and that no matter what, somebody out there has truly heard them.

If you experienced your childbirth as traumatic (and only you can define whether your experience traumatized you!), please consider Solace for Mothers, or suggest the site to a friend who might be struggling to cope with a birth experience. Through solace comes strength, and that's something every mother needs!

Finding ICAN

I had it all planned out. I was going to have an amazing, empowering natural childbirth. I had a cd of birth mantras. My husband was a trained and awesome labor support partner. My mom kept a bag packed in her car, ready to zoom out here and talk me through a fast and easy labor, just like she had. I read books. I took classes. I skipped all the "crap" about c-sections because I wasn't having one of those and didn't want to let the idea take up space in my energy field.

So, 18 hours into my wonderful, natural labor, my posterior baby was in trouble. He passed meconium (lots and lots of it--enough so that the midwife grabbed the OB on duty at Magee). His heart rate dropped and stayed at 40 (my midwife told me infant heart rates average 120...they typically do emergency c-sections at 90). Twenty-seven minutes later, my baby had been surgically removed from me, I was drugged with all kinds of crap, and I was about to enter into a depressed, traumatized, and fragile mental state.

So much for empowered birth warrior. I spent weeks sobbing for hours, wigged out on Vicodin, reeling from confusion, and struggling to mother a baby whose diaper I couldn't change since I couldn't sit up or walk on my own.

I didn't know that it was ok to feel the things I was feeling, or even have real words to describe my perspective. I didn't know other women experienced this, too, and I didn't know where to turn.

And then a google search led me to ICAN-online, where there was an article about the emotional impact of a cesarean. I cried again when I read this, but not in a bad way. I felt relief wash over me. I felt my bones settle and my tense shoulders relax. The women in the article articulated exactly what I was feeling. Their words gave voice to my pain. It felt like a miracle to read.

I kept reading. I learned about a thing called a VBAC. I learned there was an international community of women who will support me through the coping, mourning, grieving process. I found ICAN.

Now, in addition to the online community, I have access to a local ICAN chapter: ICAN of Southwestern PA. We've had 3 meetings so far, where mothers gather to share their birth stories, share their VBAC stories!, and support one another. As I gear up for mother's day this weekend, I want to thank ICAN for giving me the gift I needed most as a new mother: hope.