Birth from the perspective of a midwifery student (conference presentation)

A month ago I had the honour of making a presentation at the Ontario Student Midwives Conference at Ryerson University.  As a midwifery student, currently on maternity leave, it was a great opportunity to reconnect with old friends, and meet in-person virtual friends.  It was also a tough place to be given the tenuous position I have as an actual student (more on that another time), and given my topic.  I had submitted two proposals and both were accepted.  One, was an editorial piece I've been working on for a while but a presentation I didn't actually get a chance to make due to a mini family crisis when my 3 year old dislocated her elbow! The other, was this piece below, one that I cried when writing but somehow managed to get through without crying.  Though, I made many of my fellow classmates tear up. Keep in mind, this was written to be spoken, and to be listened to for about ten minutes so it is long and the tone may be a little different from my "blog" writing.

Being a midwifery student is hard work.  Maybe harder then we thought it would be.  Maybe not.  Those of us who are mamas have so much to re-learn, how to see things from the other side, how not to interject every five minutes with “During my births…in my pregnancy…when I was breastfeeding’  and those who aren’t mamas have to learn that they are not at a disadvantage so stop feeling like that and move on!  I do remember, in my first year, during With Woman actually, thinking, how amazing it would be to have all of this information before having a baby.  To be able to tap into all of these extra resources, and wealth of knowledge.  Um, yeah, not so much.

As I was preparing to write this presentation I spoke (aka, Facebook’d) with a few mamas from the program.  They had vastly different experiences from me and from each other.  Planned home birth.  Planned hospital birth.  Things went according to plan.  They didn’t feel like they’d had any amount of pressure or expectations as an MEPer.  Maybe it was just me then? And then I read an amazing paper by one of my classmates.  She had looked into the experience of giving birth as a birth professional.  Of the women she had surveyed, all of them a birth professional of one kind or another, many had felt that there was a certain expectation around the kind of birth they were going to have, felt that there knowledge both helped and hindered them, and that it was hard to not be in control. 

Now, I’m a planner.  To a fault.  But I had worked really hard at not having a birth plan, though every one does to a certain extent.  I felt I had learned a lot about myself, my body, the way I give birth, and my babies during my first two pregnancies and births and during this pregnancy.  Unbeknownst to me at the time, I would come to learn a lot more about myself.

My girls...and Mark like to dress up as Superheroes. And as a mama you feel like one. I obviously have an innate power, two really: the ability to incubate and nurture a human life inside my very own body and the awesomeness that is lactating boobs!

So when things went a little sideways with my planned home birth I felt like Supergirl faced with kryptonite. Actually no, I wasn't on the ground squirming in pain, I was more like WonderWwoman being harnassed by her own lasso. In case you don't know, that's her main weakness.

  

I initially though of this analogy to bring some humor to my story, keep myself from crying, but the more I thought about it the more accurate it seemed. As a mama-midwifery student aka Wonder Woman, it was my own knowledge that was tying me up and forcing me into the ambulance and to the hospital. From a midwifery student perspective, that was the ultimate villain's lair. But from a regular mama perspective, it was the extra knowledge, the extra help from fellow students, the "extra" that was tying me up and imprisoning me in my decisions.

You see, non midwifery types, still amazing mamas of three, Breastfeeding, baby wearing, loving their kids mamas, they did not understand why I was so defeated at having given birth in a hospital and having stayed there for 23.5 hours. They understood that it had not been part of the plan; but these women, whom I didn't know all that well, simply said " but you made the right decision for your baby. You didn't really have a choice. Not one where one or more of the outcomes would have been acceptable.". My friends, the students, they all had a lot of different things to say. Sympathy instead of empathy, sorrow instead of support, shock instead of agreement.

So why didn’t I have a homebirth? Poop.  I suppose the more appropriate way to say it, is that there was meconium.  A lot of it.  Thick, pea soup sludge seeping into the birthing pool. 

And the reason I had to stay at the hospital was a GBS positive screen with insufficient amount of antibiotics administered prior to delivery. And here’s what I have to say to my fellow midwifery students:  Stop.  Stop thinking about the odds ratios, the research, the facts, the myths, and the alternatives.  As your classmate, I know now, and knew then all of that information. But what I also knew, was that the institution I gave birth in had a mandatory 24-hour stay policy for mamas and newborns with a GBS positive screen or they would call CAS. 

CAS.  These three little letters.  Letters every parent – good or bad – dreads hearing.  Imagine, if you will, having just given birth to a beautiful, perfect little girl.  A beautiful birth.  An emotional high.  Conflicting emotions – the “wrong” kind of feelings are bubbling below the surface but you are pushing them down as you stare into the eyes – are they hazel?  Are they brown? – of your daughter.  Your midwives doing post partum things.  Your partner, leaning over you and your babe, kissing your head, pushing back your hair.  And all of a sudden arrangements are being made for you to stay overnight.  It doesn’t matter that the odds of your baby being affected by GBS are 1 in 300 to 1 in 1000.  It doesn't matter that you had some IV antibiotics.  You are free to go.  But if you check your beloved newborn out against medical orders, you will awake to Children’s Aid Society at your doorstep.  Now, consider again all of the informed choice, research, self-rightousness, strength, mama-bear protectiveness of not just your two older girls sleeping soundly at home, but of this new life you have never been away from.  And imagine, for a full minute, the idea of a stranger holding that baby and seriously considering that you are unfit.  

Being a midwifery student can really screw with your head and your heart sometimes and this was one of those times.  I knew my baby was fine, and safe.  I knew what to look for.  I knew the odds.  I knew my rights.  And I knew that my girls were going to wake up and be surprised at best, heartbroken at worst, that I wasn't there with the new baby.  But none of that compares to the even the most remote possibility of having to deal with CAS bureaucracy within the first 24 hours of my newborn’s existence.  I mean, honestly, I wasn't planning on letting the grandparents in the door!

As I prepared for this presentation I was searching for images and I came across the cover for a children's book about homebirth. And I came across gorgeous waterbirth photographs including ones of mamas with all of their children clambering to look at the newest sibling. And looking at these images, breaks my heart.  Every. Single. Time.  And there is no excuse for it.  When I speak to my partner, when I go over my story, when I speak to other mamas who aren't in the midwifery circle, it’s not really a big deal.  I had a beautiful labour.  I had a beautiful birth.  But most importantly, I had a beautiful baby girl.  But the fact that I read that damn book every single night for months, watched homebirth videos, and practiced birthing sounds and positions with my girls – all for nothing, that breaks my heart.  And, you can argue that they are young so they are fine.  To which I say, my middle monkey, she had to be reminded that we got to keep our baby.  And my oldest monkey who saw the middle one born, was also heartbroken and angry and we had a good long cry about it together. It’s hard to hear about other people’s wonderful water births with their children present because I didn't get that.  But that’s the midwifery student in me.  The mama in me, is grateful for having three healthy daughters.

 Sometimes I think that I’m not going to ever fully get over disappointing my girls by not having a homebirth for them.  And then, Mark reminds me that my girls are six and under and that sometime much sooner than I would like I will disappoint them in what appears to be a frivolous way to me – like, saying no to an Abercrombit Fitch sweatshirt, or to party they want to go to – and that will be the moment that sticks with them not that they missed Baby C’s birth. So, while many mamas probably dread the conflict of the teen years, I say, bring it on, it will totally  help me heal!  

So what does it mean to give birth while an MEP student? And what doesn’t it mean?

• Maybe because I wasn’t in Clinical Skills with my peeps, it didn’t result in numerous belly palpations, pulse takings, fundal measurements or fetascope listenings.
• It did mean that during Bruce’s lecture when he put up the graph of oral contraception – the one explaining why you have to take your pill at the same time every morning – even if you just hosted the end of the year party and your children aren't home to wake you up - that 50% of the class will turn around to shoot you a knowing look, and laugh.
• It does mean that at least twice you will be told you are huge and you will wonder how a future midwife feels like that’s an okay thing to a pregnant woman
• It does mean that you have a plethora of information –far more than even a well educated mama
• It means that you have expectations of being with a midwife, most likely a doula, that you will not freak out, that you will not request pain relief,
• It does mean when you go for your ultrasound and the technician makes assumptions about your sexual orientation, your desire to have the baby, the man in the suit being your husband, you hear Nadya’s voice in your head gently reminding you how you should never ever make those assumptions.
• It may or may not mean that you will cook and serve a delightful vegan meal for a dozen or so of your closest friends and family who all invade your house immediately.  Personally I came home and crammed my belly full of braised pork shoulder curry and rice.  And a Strongbow. And didn’t let anyone in the door for 48 hours.
• It means that when you are stuck in the hospital bed checking your facebook, one of your school friends will notice that you are at the same hospital she is making rounds in and will be the first to visit you.
• It means you can argue with the pediatrician and convince her to let you leave the hospital early.
• But it also means the L&D nurse will call you “one of them” for not letting her bathe your baby.
• It means that when you are forced to make a quick decision, it’s no longer impulse nor even informed choice that is guiding you, but information overload, and graphic visuals, anecdotes,  facts and figures clouding your brain.  And that no matter which way you lean, someone you go to school with, will offer their unsolicited opinion telling you that it was a misinformed decision.  And they do so because of the information in their head, not as a judgment, but it comes out very much as a judgment and a sentence “Guilty of not fulfilling the MEP student edict of perfect home birth!”  "Guilty of allowing the institution to dictate what you could do!"  "Guilty of submitting to the will of non-midwives!” 
• It doesn't mean that any of your decisions would have been different. Because you are a mama first.
• It doesn't mean that you are at a disadvantage.
• It doesn't mean that you are being judged.
• It doesn't mean that you failed in some way.  Unless you know, you actually failed.  But despite my hormone addled brain, I managed to pull off decent to hey-not-bad grades in my courses!
• It does mean that you will receive lots of love from wonderful women who will make the trek all the way to Mississauga just to visit you and your girls.

Baby C is my baby Hulk.  That is to say, she’s a happy baby, until she's not.  (And you don't want to make her angry.) Which is to say she is perfectly healthy.  Ultimately, there is no guarantee that she would have been had I stood my ground and not gone to the hospital.  But just looking at her, while she nurses, or laughs, or yells at the floor for not letting her defy gravity, I can’t say that I would make any decision differently except for – and this is the most contentious issue – maybe, just maybe, planning on a hospital birth.  If I’d planned a hospital birth with my girls present then they would have been there for the birth.  But, that wasn't really the images and experience I wanted for them, for me, for us.  R has one homebirth under her belt already, and while L will never get to see a sibling being born at home, neither will Baby C just by being the baby.  But, I figure most of my friends and classmates are younger then me and a few of them will probably have babies of their own one day – so hopefully, they can witness that.  You don’t mind do you ladies? 

An open letter to Deb Matthews, Ontario Minister of Health

This past Friday marked two years since Ontario Midwives started negotiations for a new contract with the Ontario government. They started talks almost six months before their contract expired. The end date of the contract came and went at 11:59om March 31, 2011.
Did the midwives abruptly stop catching babies? No.
Did they transfer care of their clients? No.
Did they stop taking clients due after that day? No.
Have midwives, in fact, gone on to catch 25,000(!!!) babies and care for them and their mamas? Yes.
Have midwifes rallied to support refugee healthcare? Yes.
Have they faced obstacles and red tape when trying to gain practice privileges in hospitals across the province and yet continued to care for as many pregnant women as their limited numbers allow? Yes.
Have midwives rallied and successfully petitioned for birth centres in Ontario because that is what their clients need and want? Yes.
Have midwives saved the provincial government thousands of dollars in healthcare costs by supporting low risk births at home; supporting women and their families in successful breastfeeding; providing postpartum care to mothers and babies? All proven methods of health cost savings measures and long term positive effects? Yes.
Have midwives cut back the number of clients they accept or their 24-7 availability? No.
Have midwives changed their model of care to support more clients for more billable hours in order to manipulate the system? No!
Midwives in Ontario continue to provide care to women, newborns, and their families at the utmost professional level with knowledge, compassion, and integrity.
Midwives do not bring to the table the personal costs of their profession, their passion; but rather, they are asking for a fair and just evaluation of the work they do, the positive impact they have, and in politico speak: the effect they have on the bottom line!
On Friday, a social media campaign was launched to ask you, the Ontario Minister of Health to resume negotiations and come #backtothetable with @ontariomidwives. Photographs of babies born without a contract, pregnant bellies due without a contract, and midwifery students getting ready to enter the workforce without a contract were sent to the minister via twitter. Over 140 retweets plus 130 original tweets were sent in addition to countless emails, Facebook messages, and the viewing of a photo gallery video peaked at over 1000 by the end of the weekend.
And your response, which can only be interpreted as trite at best, passive-aggressive at worst, was a tweet sent late Sunday saying "Thx 4 tweets.Midwifery is catching.Birthing centres and even more midwives providing care to moms, dads, and babes."
Really? Really? You (Deb Matthews) take two minutes to send a tweet that your PR team probably drafted and then resent because it promotes midwifery in some lame backhanded way and point out that birthing centres are coming? Did you even read ONE of the messages that was sent to you? I mean for pete's sake they were 140 characters or less!! And they all said more or less the same thing, which was, to reiterate: GET BACK TO THE TABLE and renegotiate the long expired contract for Ontario midwives. This is your domain is it not? Mr.McGuinty's resignation is not a factor here, because let's be honest Deb Matthews, you are not the Liberal party's next provincial leader. And if you were, perhaps having 500+ midwives, their clients, their partners, their clients' partners (and FYI, that's partners not just "dads"!), and families, and all of the current and hopeful midwifery students...having all of these people on your side because you managed to finalize a new contract, might be a good thing. I'm just spitballing here, but that seems like a significant number of people to have on your side, or the side of the Liberal party in general. Or, maybe you thought it was ok because those 25,000 babies born since the contract expired can't vote yet. But that's a pretty significant number of babies who won't be there to kiss for an election photo op!
Get back to the table Health Minister. You wouldn't work under uncertain conditions, our doctors, nurses, orderlies, and administrators don't. Ontario Midwives deserve the same amount of respect and compensation. Passion and dedication motivates midwives to work; please, show a modicum of both for your ministry of which midwives are an essential part.
Oh, and for the record, sending a tweet on a Sunday night isn't going to fly under the radar. Technology is odd like that, it's available 24-7. Much like midwives.

My Breastfeeding Story aka My Battle With My Boobs

Off the top (ha!), I will say, that I’m not here to judge.  Every mama does what is best for her and her baby when it comes to filling that baby’s belly so he or she can grow strong and healthy.  And I empathize with that paralyzing feeling of guilt that you are possibly making the wrong decision, regardless of what that is.  And it’s a pretty awful way to start out mamahood, second guessing your choice of milk and worrying about it.  But I’m not writing about that (today).  Instead, I’m going to tell you about my battle with my boobs.

Stories about breastfeeding are much like birth stories.  You generally only hear the horrible ones along the lines of “my baby wouldn’t latch properly and screamed at me and I nursed until my nipples were cracked and bleeding”.  And when I was pregnant for the first time, I heard a lot of those stories, often accompanied by some small piece of ridiculous advice or presumption such as: you should vigorously rub your nipples with a washcloth to get them ready; you have darker pigmentation so it won’t bother you.  Well, the first is a bad idea simply because vigorous nipple stimulation releases oxytocin which can start labour.  And the second bit, is based on science but I am here to tell you did not ring true.

Throughout my pregnancy with R, I kept waiting for the giant pregnancy boobs.  I bought a soft bra in a bigger size to grow into; I wore tight t-shirts and asked my partner if my boobs looked bigger.  I did not.  They did not.  This was a true physiological sign that something was going to go amiss with breastfeeding.  No one caught it.

The fact that I was ripped off the gigantic pregnancy boobs was actually not the first sign that breastfeeding, or rather milk supply, was going to be a problem.  The first sign would have been that I have PCOS (polycystic ovarian syndrome).  But neither my GP, who is awesome, nor my midwife, who is awesome, nor my naturopath recognized this potential barrier.  None of them caught the lack of big boobs as a sign, and certainly none of them mentioned that my bottoming out iron was going to be a problem for milk supply.  (Low iron had other concerns that were addressed).

Shortly after her birth, R latched with no problems.  She pretty much stayed there for the better part of six months.  I kid you not.  The first 48 hours, she nursed in my arms contentedly sucking up all the immune system building colostrum I could give her.  We nursed sitting up and lying down.  But her third night, she got hungry.  And then she got angry.  And Mark and I felt hopeless.  R latched and wouldn’t let go, she sucked away for about twelve hours straight until our midwife came for a home visit and squeezed my breast and re-positioned her and counted wet diapers.  I was reassured that my milk would come in soon and that my baby was getting what she needed.  I found that very hard to believe given the yells that would come forth when the milk did not.  I cried.  Mark held me.  He couldn’t hold R because she would just get angrier and then be harder to settle down.  My parents wanted to visit again and when they did my mother got angry with me for something and my father made me feel guilty about it.  So, yeah, not helpful.  Mark’s older kids were with us that night and feeling displaced so he had to spend time with them and all I could do was lie on our bed, tears streaming down my face as I desperately massaged my breasts and murmured to my baby girl. This would become an all too familiar routine.  That night, the fourth night, my milk came in.  I knew it came in, because I woke up to R gulping away.  I was flooded with relief and spent the night staring at my beautiful baby girl who drank with wide eyes looking up at me. 

But R and I would have a tougher than expected breastfeeding road.  She was a lazy nurser.  I say that with love, affection, and humour (now.  Not so funny then).  She would nurse for less than ten minutes and fall asleep. When she woke up, she’d do the same thing on the other side.  I tried rubbing her head and her feet.  At some point, more desperate measures were recommended in order to ensure she was taking in enough milk, and I had to rub her with a cool, wet washcloth.  She didn’t like that.  My nipples cracked.  My nipples bled.  My nipples healed.  I called La Leche League for advice, grateful that I had had the foresight to attend a meeting while pregnant so I at least knew the lovely woman I was speaking to.  I called my midwife who came to visit.  R was gaining weight slowly but steadily and she was a long baby so she looked like a scrawny monkey.  Gradually her cheeks got fuller and her body a little plumper. 

But at just over three months old, she hit the expected growth spurt and became angry baby again.  She was attached to my nipple all the time.  All.The.Time.  Mark and I were already used to the fact that she was in my arms all the time and that wasn’t really a problem for me.  I was on maternity leave and she was my only baby.  But at three months it was different, and when I went to pump milk to give Mark a chance to feed our baby, I ended up with plugged ducts and full blown mastitis. 

Mastitis is a breast infection.  It is horrifyingly painful to nurse through it and worse to not nurse through it.  Your skin burns and swells on your breasts.  Touch is excruciating.  Cold shivers and hot flashes set in as does a fever, the shakes, and fatigue.  This is not the medical textbook definition I’m providing you with, it is what I experienced.  All while my baby would struggle against my breasts, flailing in my arms, and not settle no matter what I did, forcing me to change position, walk around, and cry – a lot.  I spent several days completely topless with her in the baby wrap trying to nurse upright from a rocking chair.  I sought the attention of a very sensitive massage therapist  who managed to  help ease some of the pressure and start the fluids moving and draining. 

When I recovered from that I realized that I had very little milk coming in at one time.  After months of only nursing for five to ten minutes at a time, my body was only producing enough milk for five to ten minute spurts.  Except now R was starving and wanted to nurse much longer.  This was compounded by the low iron, the hormone imbalances from my PCOS;and the three month postpartum hormone (mal)adjustments and so I ended up on a prescription for Domperidone that I took for over a year because every time I tried to wean myself off of it, my milk supply would go down.  Now, I have no scientific proof, but I am pretty sure that my horrifying weight gain once I went on the ‘scrip can be mostly attributed to it.

Before I started the prescription, which was offered various suggestions on how to increase my supply.  Primarily, to lie down skin-to-skin with my little girl, increase my fluid intake, and decrease my non-mama duties.  I took this advice happily.  I tried breast massage before every nursing session and hand pumping as my daughter nursed. I was advised to drink fenugreek tea.  It started leaking out of my pores and I reeked.  I mean, I sincerely stunk.  I couldn’t cope with it.  It was bad enough to be going through massive hormone upheaval, to feel desperate to feed my child, but to smell awful too – and my partner could not disagree – was horrifying to me.  At the time, midwives in Ontario could not write a prescription for Domperidone, and the Jack Newman clinic was too far away for me to reasonably get there, so I consulted my GP who provided me with a prescription but not a ton of advice on consequences and how to build up and wean off the pills.

The time that passed between getting the Domperidone and my milk supply increasing seemed like months.  I couldn’t go anywhere or be near anyone. I felt like I was failing my child.  I felt that somehow because I wasn’t producing enough milk for her; I wasn’t being a good enough mama.  I missed my cousin’s wedding because I just couldn’t bear to be around people while my child cried and wanted to nurse.  People like my parents who would have wanted to hold her and “comfort” her resulting in a more irate and now frightened baby as evidenced by every single visit when they would take her out of my arms and walk away and she would scream.

R and I went on to have a very successful breastfeeding relationship.  One might venture to say, an overly successful one as when I wanted to wean her, I couldn’t.  And when we did, at 2.5years old it was because I was crying with pain from sensitive nipples as I was pregnant with L.  R wasn’t getting any milk anymore at that point, it was just comfort.  And I wanted to at least preserve some of the good memories of breastfeeding.  We did.  I have a lot of good memories and I have a strong, beautiful, smart six year old girl who still sleeps with the soft pillow I used to tuck under my head when lying down to nurse her.  It was a long trip, both ways, but well worth it.

Must we talk about that magazine cover again?

Last week I decided that I was NOT going to write about the Times Magazine cover.  You know the one, with the 4 year old kid in camo pants standing on a chair to breastfeed.  The reason I wasn’t going to write about it was because neither did the magazine.  The Time article is about Dr.Sears and attachment parenting of which extended breastfeeding can be a part of.  So why give more virtual ink to a cover (im)purely created to expose a breast and sell magazines, stir up controversy and sell magazines, use misdirection and sell magazines?   After all,  I thought that the Huff post did an excellent job critiquing the cover:  http://www.huffingtonpost.com/lisa-belkin/no-i-am-not-mom-enough_b_1507550.html  But I wouldn’t have started a blog if I was content to let other people do all the talking and writing, albeit more eloquently that I.

I’ll say upfront that my initial reaction was that it was pretty awesome to have a breastfeeding mama on the cover of any non-parenting magazine.  And I have no personal objections to the appearance of the mama on the cover.  Though I know some pretty stunning mama’s and I’m sure any one of us are just as cover worthy!

My issue with the cover wasn’t of the photograph but the blaring, hugely inaccurate and downright rude headlining question “Are you mom enough?” 

To which my response is: “Are you new?!?!”  Seriously, how “new” do you have to be to dare to ask that question of any mama? 

Simply  getting out of bed every morning to provide your child with everything – that’s EVERYTHING-he or she needs to thrive physically, emotionally, and socially in this world  is being “Mom enough”  All of this, ALL OF THIS while braving the intrusions of those who do not have you and your child’s best interests, when they voice their opinion on breastfeeding is being “Mom enough”.  Especially if you manage to hold back and not punch that stranger in the face for feeling like you needed yet another unsolicited opinion.  

Did I breastfeed my girls until past the age of two?  Absolutely.  Was it completely my choice or did my toddlers bully me into it?  Absolutely.  Do I think that makes me more of a mama than my mama friends who didn’t breastfeed at all?  Not on your life.  Do I think that makes me less of a mom than my mama friends who breastfed their babies longer?  Not on your life.

Whether you adhere to attachment parenting or not.  Whether you believe it takes a village to raise a child or not.  Whether you have an ever supporting partner like I do or not.  Breastfeeding is a very personal choice because its a personal commitment that is made easier by "public" support regardless or where you land on the decision. But the bigger personal commitment is the one to do everything you can to make sure your baby knows how much you love them from the time they are born and beyond.  Being “mom enough” doesn’t mean letting your child climb up on a chair to breastfeed.  It means being able to crouch down and give them a hug whenever they – or you- need it.

Home birth at it's best: The story of L's birth three years ago

It was about this time (8:40pm) three years ago that my water broke all over my bed.  I was watching an episode of The Wire with Mark.  R was hanging out with her aunt in the other room watching a movie on the laptop and playing with the new fairy sticker book Mark had bought her just for this very day.  It was L’s due date and I’d been having some mild contractions throughout the early evening.  I’d called my sister and Mark before their work day ended to let them know, that despite the odds (of having a baby on their estimated due date) it seemed like I was about to go into early labour. 

My sister came by and Mark came home with fresh fruit and fruit juices as per my request.  I gave my midwife the heads up but she didn’t seem overly committed – given that my labour with R had been 36 hours, there was no rush especially considering I didn’t feel like I was in labour.  I played with R, I puttered, I ate dinner, I showered, I settled in for a night of TV on DVD watching and warm kisses with Mark.  And then I was hit with a pretty big contraction and started to climb off the bed to work through it and my water broke all over the bed.  The bed I had not yet made up with the double layers of bed sheets and plastic sheets for our planned home birth.  We paged Chris our midwife again and she said she’d head over to see where things were.  Mark filled the birthing tub and I drank some juice, talked to R to let her know we were definitely having the baby soon and climbed into the tub. 

Getting into the birthing tub was such a blissful experience for me.  During my labour with R, we didn’t have one and the only place I’d found any relief or comfort had been in the shower but that had still not been great.  Climbing into a pool of warm water provided me with a cocoon of heat and safety.  I genuinely felt like I’d managed to carve out a safe and private space for my labour.  The birth pool was set up in our living room, there were two soft lit lamps on, a music mix playing on low on my iPod, and not a clock in sight.  (I had unconsciously created an environment the exact opposite of my labour with R.)  R came running through the house to pour some water on me, rub my back, and then ran back to hang out with her aunt.  Her aunt who wanted to stay as far away as possible from the whole “birth thing” as she put it.  Being present for someone else’s labour is clearly not for everyone but my sister is the best aunt one could ask for and it was very generous of her to be there given her feelings on my nudity, blood etc.

My midwife and her student arrived shortly and set up all of their things and wanted to check me.  I reluctantly got out of the tub and let them do so, asking spontaneously that they not tell me how far along I was.  R came back to the living room where we’d covered our couches and floor with old but clean sheets and towels, and fed me ice chips.  After dealing with my midwife and the student being horrified we didn’t have a pile of postpartum supplies in a special box (I swear they were obsessed over the fact I didn’t have 8 receiving blankets and a baby hat in the living room but still in the closet about 12feet away- our old place being small.)  I climbed back into the birth tub and moaned “open” out loud, rocking in the water on all fours for what can only be described as bum labour.  With R, I had twisting cramping, rolling never fully ending contractions.  But this time, everything was happening in behind and it was actually something I could cope with, work through, and quite honestly, wasn’t too bothered about.  Mark poured warm water on my back, wiped a cool cloth on face, fed me juice and ice chips.  He was an incredible birth partner.  I don’t know how he managed to do all of that in a way that made it seem like it was happening simultaneously and in exactly the way I needed it to. 

Just before 10pm Chris asked me to come out of the pool so she could check me again.  She wanted to know if it would be okay for the student to check afterwards.  I didn’t want to get out of the tub but if I had to, I didn’t mind the student checking as well.  So I lay down on the couch, Chris told me I was at around 8cm and then I got hit with a wave of contractions and I told her and the student to get out of my way and that I needed to stand up to work through them.  It seemed so much harder and faster.  I started to panic.  I was standing and Mark was holding me, and the student was encouraging me to climb back into the birthing tub because I was screaming that I thought I had to go to the bathroom, and that I didn’t know what was going on and R was in the room and started to cry so my sister took her away.  And then I felt a burning sensation.  I put my hand between my legs and much to my surprise…I felt a head!  I had gone from “about 8cm” to baby crowning in the time it took me to stand up and take a few steps.  The panic and screaming had only been about 90 seconds long as I went through transition.  I really wish my midwife had explained this to me; however she wasn’t in the room and it happened insanely fast. Knowing this, being able to explain it to myself, helped me focus. I was flooded with relief and everything became crystal clear.  “Mark!  That’s her head!  That’s our baby’s head!”  I said excitedly.  I happily (yes, happily!) called for R to come back, promising her that I was okay, that our mini monkey two was coming right now. Meanwhile, baby’s head was descending rapidly, my midwife was across the room still on the phone with the backup whom she had been telling I was at 8cm not that I was actually giving birth!  I now had two hands on the head and was laughing from the very pleasant sensations of birthing.  I wouldn’t necessarily go so far as to call it an orgasmic birth; but it was tickling!  R was watching from the arms of my sister, both wide-eyed, for different reasons.  Mark was holding me as I stood. Encouraging me and later he would admit to thinking he was going to have to drop fast to catch our baby because he didn’t think Chris was going to walk over to us in time.  But she did and knelt in front of us and said seriously and rapidly that I was going to have to do some movement as the shoulders were sticky.  “Ok!  What do you need me to do?”  I asked and in an instant I had one leg propped on the couch and out came baby L.  I honestly don’t think Chris thought I’d be able to move that fast into such a position.  I went from 8cm at 10pm to holding my baby at 10:08pm. 

I sat down on the couch as our baby was placed on me.  They couldn’t actually bring our baby all the way up to my breast because the cord was so short.  R was right beside me at this point and as she had wanted, she got to tell me that the baby was a girl.  Mark told me that R just kept checking on me and when he asked what she was doing she said “Waiting to see the placenta come out too.”  Eventually it did and it took a while – they had to remind me to focus on pushing and massaged my uterus too.  But I was so enthralled with our new baby, I didn’t pay too much attention.  I did see the placenta which we kept in and actually not only froze but moved with us to our new place for burial.

Mark dressed little L in the clothes R had picked out for her.  We had a shot of bourbon.  We impatiently waited in bed, where we’d relocated after my shower, for the midwives to leave.  It seemed to take forever when all we wanted to do was lock the door and go to sleep.  R climbed into bed beside L despite the fact that her own bed was actually attached to our bed, she wouldn’t leave her baby sister.  And in the morning when she woke up and found that Mark had moved her, she climbed right back over him and put her arm protectively, lovingly, and gently around little L and it has pretty much been there ever since either literally or figuratively – and I hope it’s always there. 

While I truly believe any birth that results in a wonderful new addition to the family is the perfect birth; I will admit that little L’s birth was about as midwifery home birth perfect as one could hope for.  

Birth Centres Come to Ontario

I woke up at 5am this morning.  Not unusual for a mama of a newborn; ironically, baby C was sound asleep.  This actually worked to my advantage as I dragged myself out of bed, and proceeded to try to make myself relatively presentable for the public.  I have a love-hate relationship with having my photo taken.  I pretty much hate it unless I can “art direct” it or delete it.  Oh, and I prefer if you only take my photo from the boobs up, preferably after I’ve been to the salon and spa.  But with a mere twelve hours notice, “the public” was going to be lucky if I didn’t have spit-up in my hair.  Not that I want to further promote that stereotypical image of a new mama, just that my baby is quite fond of projectile spit ups whether I burp her or not.  It’s just a fact.  

So up at 5am, makeup on, a slapped together outfit that was not photo—worthy (But the only thing I can manage given the weather and the four piles of laundry still to be done as my resident laundry-doer aka partner extraordinaire Mark, has been in bed horribly ill since Friday night and I’ve been the sole source of entertainment, rule-enforcement, household duties, and nourishment of both body and soul)  my three girls dressed in matching black outfits, baby nursed, promises of takeout breakfast made, school lunch and bag packed for R, and out the door we headed.  

We arrived on campus just before 8am and thankfully snagged a parking spot right in front of the building.  I was warmly welcomed by our first midwife who caught R and L(barely, but that’s another birth story), at St.Mike’s and at home respectively. The director of our program and several members of the AOM greeted us enthusiastically as well.  It was odd being told that my trek to the event was heroic.  I had figured, I was going to be up anyway! And really, if you are going to talk-the-talk, then walk-the-walk.  Or in my case, drive through rush hour traffic with three girls under the age of six, and to show your support for other mamas and their midwives, and love every minute of it!

I was one of three from my cohort of midwifery students, though there are many others there, and one of maybe eight or ten mamas with baby-in-arms.  Our photo was taken repeatedly and all I can think about that now is not "wow, I should google us and see if we made it onto any major media outlet" but rather "holy crap, I was sweating so profusely under the press lights, my pants were falling down, my shirt was riding up, and my hair was inflating – what a picture that is going to make."  Oh, and if we did end up on TV, that’s me just to Mr.McGuinty’s right, nursing my baby while she’s in a sling.  So, that would officially make it so that not just everyone I know will have seen my breasts, but possibly hundreds I don't know.

One of the things I noticed while there was that various people kept ushering us closer to the front because “make a good picture.”  I’m sure it’s meant as flattering, and I really don’t mind, but I wonder what that means.  Is it because my girls have bright smiles, and are matching outfits with their baby sister in untraditional black?  Is it because I’m both midwifery student and midwifery client?  Or is it because I’m brown?  And frankly, I suspect it’s a combination of all three with an emphasis on the latter.  Midwifery clients in Ontario tend to fall into one of two categories:  upper middle class and white or non-white and so new to the province they don’t have a health card yet but can still receive free care from a midwife.  I am neither, my girls are varying shades of butterscotch, and yes, we look pretty damn cute.  And so if our "look" unintentionally broadened the image of a midwifery client, than I'm okay with that too.

  

I gave two interviews supporting birth centres – a long and hard fought victory for women in Ontario. If I'd had time to clear my foggy brain a bit, I probably would have been able to speak to how the road to achieving a commitment to fund birth centres was very similar to my mini-adventure getting from the 905 to downtown TO at rush hour with three girls:  an alarm going off, stumbling through the darkness, waking up fully, thankful for the prep and planning the night before, working hard to maintain a sunny disposition despite obstacles including but not limited to a lack of support and limited vision, illuminating my path with headlights, and then ultimately a warm welcome into a room of familiar faces and unfamiliar ones all smiling at me and my babies. But, I'm not that articulate on the spot. And instead said something along the lines of this : While I myself, don’t need one, I think of women who live in extended family situations or tiny apartments with no space for a birthing tub, or who simply need the security of a more official space that is not medicalized, perfunctionary and oozing illness the way a hospital does.  I’m hoping to be one of the privileged midwives to work at one in a few years.  


I’m not sure if we’ll end up on any of the news reports of press clippings, it’s been my experience that the media tends to choose one family to focus on and the baby that Premier McGuinty was holding up in the air, or the family of six kids probably “trumped” us but I’m not a media hound and so I don’t particularly care either way.  I went to show my solidarity and support for midwives, birth centres, and the women, babies, and families that will benefit from this great step.    


And yes, it was also pretty cool to write “press conference with the Premier and the Health Minister Deb Matthews” on my five-year old’s late slip under “reason”. 

Here's baby C, looking exhausted after all that time maintaining her image in front of the media, as a reminder of why it is so important to support midwives and mothers: healthy babies

Here's the link to the official release:http://www.ontariomidwives.ca/press-releases/page/midwives-welcome-opportunity-to-lead-new-birth-centres-in-ontario

What do you think of birth centres coming to Ontario?  Would you have used one/would you use one? 

C's Birth

My labour started around 7pm.  I’d spent about an hour earlier bouncing on the birth ball and reading birth stories from Ina May Gaskin’s Guide to Childbirth while watching my girls play.  When I thought about it, I did some nipple stimulation just to see what would happen…I’d had some stronger stretchy pains in the truck to and from downtown.  We’d gone  for lunch at Salad King just because I wanted to and felt like that wouldn’t happen again for a few months. 

After dinner I had more strong stretches but still irregular.  Just in case, Mark & the girls reinflated the birth pool, I left a message for Dixon and changed bed linens while Mark crushed ice and froze grapes.  We moved our laundry basket of dark towels, blue pads, IV supplies and sealed olive oil downstairs.  Clothes and diapers for baby were already on the main floor along with receiving blankets and a heating pad.  The girls were over-tired and so we put them to bed telling them new baby may or may not come today & that Dixon would wake them up if I was giving birth.  They fell into a deep sleep within fifteen minutes and stayed that way for 11 hours. 

As we were settling the girls, I had a really powerful, long lasting contraction.  And then another medium one at 8:15 and then around 8:30 I had one so strong I had to stand up and breathe deeply through it, involuntarily pushing and it lasted a minute.  That was when Mark told me I should page the midwives.  I wasn’t certain given the randomness of it all but the fact that for the last 45 minutes I’d felt like I had to poop but didn’t and that I was feeling “pushy” I knew it wouldn’t hurt to call.  I just didn’t want to get everyone and everything in place and be told I was at 3cm and not very thin and that this could go on for days…which would have been fine, I just didn’t want to think it was time and then be disappointed, better to underestimate how far along we were.  But I called Amy and we went over details and she was positive, excited, and asked that we just stay on the phone for a few contractions.  The first two were no problem, the third I had to put down the phone, grip the table while Mark pushed on my tailbone, and moan through while saying that I was pushing but knew I shouldn’t be.  Amy gave me strict instructions to NOT take a hot shower and to NOT stimulate my nipples but to go lie down and drink some water until she got here.  Mark started filling the pool, Dixon called back and said she was on her way, I lay down and just kept thinking “open” while listening to our baby having mix on the iPod from when we were having L.

Amy arrived around 9:30pm, asked if she could check me and we were pretty excited at being at 8cm! I’d been secretly hoping for 5cm, but 8 – really?  A few strong pushy contractions and I was at 8!!!  My waters were bulging so baby’s head was still high and once they broke I’d go down to 7cm but contractions would become steadier and we would progress.  So I walked up and down the stairs, drank some juice and water and watched the midwives make Mark run around looking for something to hang the IV on…something they had failed to mention as a result, the IV was started at 10:30, with the wrong kind of lock, I climbed into the birth pool where I was comfortable and wouldn’t have to see a clock.  Before hand, I’d leaked some fluid on the floor which tested as amniotic fluid but may have been pee.  Mark rubbed my back, Dixon took pics, and Amy checked heartbeat. She suggested we break the waters fully to keep things moving and we agreed thinking that it would help, I was doing well, and waiting would only make me tired. I was on all fours, not stressed about the contractions, Mark feeding me grapes and ice chips and making me laugh by saying “Loose lips mama”, and kissing me.

And then…there was meconium.  Thick, abundant green, sticky sludge that was passing over our baby’s face and nose.  Our baby who was still at +3 while I was at 7cm but pushing through contractions now.  And Amy told me we had to transfer to the hospital.  I knew all the reasons why – respiratory therapist to intubate if necessary with the neonatal expertise as opposed to EMS just doing it quickly to save a life but not thinking of later consequences; avoiding pumping oxygen through a face mask which would further push down any inhaled meconium; avoiding meconium aspiration syndrome which is life threatening and results in prolonged hospital stay.  But I also knew that because of the GBS positive screen they wouldn’t let me come home and that not only were my girls going to miss the birth they had been preparing for since August with me, practicing sounds, letting us know about wanting to cut the cord and hold new baby’s hands, wanting to tell us if it was a girl or a boy…but that they also couldn’t get to see her right when they woke up.  But I couldn’t refuse a transfer based on emotion and I couldn’t let myself ask for them to be woken up to come with us.

And if I had thought to be so selfish, they would still have missed the birth and Mark would have too for even though Dixon offered to drive our truck there, she didn’t know where to go,  The girls would have had to be woken up (a task unto itself!), dressed into coats and boots, buckled in and driven then parked, unbuckled, and walked through the hospital to labour & delivery and get past the nurses to our room.  Meanwhile, I had our baby within 15 minutes of getting there.

I wish I could say it was a blur but the memories are quite acute.  I remember struggling to get half dressed, telling Mark where the hospital bag was, I remember crying about having to leave my girls but refusing to put them through the trauma of possibly having to see a medical team intubate their new baby.  I remember walking to the ambulance and praying it was no where near the time when my parents would be driving to/from church.  I remember being petrified of being wheeled on the gurney and I remember Mark turning ghost white when they told him he couldn’t sit with me but had to sit up front,  I remember telling them not to use sirens until we were well away from my house and I remember Amy trying to explain that yes labour was imminent and no that wasn’t why we were transferring and no it wasn’t ok for the attendant to catch the baby the whole point was to be near a neonatal specialist.  I remember panting through pushes to not give birth in the ambulance and I remember just feeling exhausted and not wanting to do it anymore when we were finally in the room.  I was sad.  And then they sent Mark away again to do paperwork even though Id been preadmitted. 

And I’m so grateful my girls slept through that and that I had a warm caring person at home with them who offered to bring them after the birth if we wanted.  But I knew I wouldn’t ask that unless it happened much closer to morning.  I wouldn’t have wanted them to see me being rolled into the ambulance.  Mark says it was incredibly hard for him to have to see that and he knew we were going to be ok and that he was coming with me.

As soon as Mark was by my side holding my hand, my contractions came on stronger again and Amy asked if she could check me during one and she did and there was blinding pain.  It was Amy widening my cervix.  This was to allow our baby space to descend over the next few contractions but then much to everyone’s surprise our baby started crowning.  Our backup midwife didn’t even have her gloves on yet!  At first I thought Amy was still checking me and I begged her to move her hand but then I realized it was our baby.  I had to push her out slowly, as there were no warmed oil compresses ready for me.  And after her head was born I had to pull up my legs and push with everything as her shoulders were sticky but not dystocia.  Later, Amy would tell me “You birthed so beautifully.  You had incredible control on your pushing; I’ve only seen that with an epidural.  And you showed such strength pushing her shoulders out.  She came into position so quickly it was unexpected.  Your girls would have missed the birth even at home from how fast she was born.”

At 12:01am on Sunday morning, our 8lb3oz, 21 ¾ inch long baby girl C was born.  She yelped, opened her eyes and roared.  The RT apparently walked into the room, heard her yelling, saw her squirming and deemed her healthy and left. C was placed on my chest as soon as she was cleaned up a bit.  I held her to me and Mark held me and we stared at her, kissed her, kissed each other, and stared some more.  C was tired after all that yelling and hungry!  She was rooting as she lay against my exposed skin; and when I moved my nipple closer to her mouth she latched like a champ and started suckling and swallowing immediately.  While we may not have been at home, C knew “home”  and reminded us what it was all about as she gulped noisily nestled against me, gripping Mark’s finger.

It was so difficult watching Mark leave and keeping a smile on my face.  Our first night apart in six years.  I wanted him to be able to hold our little girl her first night, but it technically wasn’t night and she stayed in my arms as I scowled at the night nurse who tried to get me to put her in a bassinet from the 70s and told me she would be safer  there- out of arm, away from my heart, my warmth , my breathing, and my smell just a few hours after being thrust into a cold, spacious, loud, smelly, bright world,  Really?  And it would help us bond, help my milk to come in  and prevent my getting depressed how?  So C napped in my arms, suckled when she wanted to and soothed me with her softness and delicious smell.  I napped on and off but the baby crying all night beside us from being alone in a bassinet kept me awake as did the paging, and the nurse checks.  The nurse who examined C and I worked on rote. Not computing we’d just had our vitals taken and a physical once over; nor that reaching to push my breast into position was highly uncalled for as I’d said Id successfully breastfed two girls and that C had already latched and nursed twice

I texted Mark just after 7; the girls woke up and called me at 8 – I had a cheerful voice because I was happy to hear from them.  My heart was aching for them but in reality, they didn’t have a concept of how long I had been away from them with C – it could have been all night, or it could have been just an hour.  They packed up a bunch of stuff, picked up McDonald’s because apparently all $240 for a room in the hospital gets you for breakfast is Cheerios, a slice of cheese and a cup of tea.  Clearly, I skipped the Cheerios, downed the milk, and ate the cheese.  At ten my family arrived and clambered onto the bed, saying “hi new baby”.  We both got hugs and kisses and smiles.  Mark had told them about the birth, I told them a bit too.  They held their sister, kissed her, snuggled her, and me too.  They spent about 6 hours with us, sharing in my crappy lunch, going for a walk to get me ice water, going to Tim Horton’s, and watching a movie on the netbook.  All the things we would have done had C and I been home and in bed. 

After they left, I felt empty again, hollow from the loss of our planned home birth and bonding in bed together trying to remind myself that we HAD just  bonded in bed together. 

Twenty-four hours later we’d finally be truly home, in our bed together – all five of us by dawn. I thought it would be hard to fall asleep but after a hot shower, hot food, and a Strongbow, I settled down with our baby between us; our girls asleep on a mattress on the floor in the same room, and slept for five hours straight – which felt like twelve.  I’d never been happier to wake up before the sunrise and be able to watch all three of my girls wake up and greet each other and the day with love and excitement.

It's been seven weeks and one day since C was born and today was the first time I've been able to write, read, and talk about being in the hospital without tearing up.  I'll never get that chance again, to have my girls at a home birth for their sibling.  But that's not a loss they feel, and it's one I have to get over because ultimately, I made the right decisions for all three of our girls and unless you've been there, you can't tell me otherwise.  But, I'd love it if you could agree with me, because, I really do need that.