Positive Birth Story – Beacon of Light

The following editorial and story are take from Birth Journeys – positive birth stories to encourage and inspire. This is a series of excerpts from Natasha’s story of her journey through antenatal and postnatal depression and many other challenges. This story is found in the “Special Births” section of the Birth Journeys book. The introduction below is provided to allow readers to make an informed choice before they read this story (and any story in Birth Journeys). I am particularly grateful to Natasha for sharing her story so openly with us, as I believe it is very important for women to see that others face incredible challenges in pregnancy and they are not alone.

Introduction:
This powerful story follows Natasha’s journey through antenatal and postnatal depression, her husband’s alcoholism, her marriage breakdown, severe placenta praevia, pelvic instability and her physical and emotional violation by a health professional. Natasha is faced with so many challenges that they seem insurmountable. It is hard to imagine how there can be any positives.

Amidst all these troubles, Natasha decides that her second birth will be different. She wants to have a positive, powerful, intervention-free birth this time. She wants to feel present for the birth of her baby and to give her baby a safe and healthy entrance into the world. Birth is something Natasha feels she has some control over.

Natasha chooses one-to-one care with a trusted friend who is also a midwife. This relationship is so important in bringing Natasha through the challenges and helping her to achieve the birth she wants. Her faith in God gives Natasha the strength and hope that she will make it through.

In the end, Natasha has the positive and intervention-free birth she dreamt of, hoped for and planned for. This empowering experience is a beacon of light and a memory to hold onto in an otherwise dark and incredibly difficult time of Natasha’s life.

Positive Birth Story – Beacon of Light
The story of my second son’s birth is both positive and heartbreaking. It is intertwined with my journey through antenatal and postnatal depression and the breakdown of my marriage. The three are so woven together that it is impossible to tell one without telling the others.

We were living on a station in the desert area of Western Australia. The station was run as a tourism business doing cultural awareness training for mining companies, as well as running camps for schools and youth groups. I had wanted to fall pregnant for a few months, but it hadn’t happened. We decided that the timing wasn’t right and stopped trying. We were having huge problems with our marriage.

I had been feeling quite nauseous for a week or so and my period was overdue, but I had put it down to the emotions and stress of our marital problems. One morning, while my husband was in the shower, I wondered if maybe it was due to pregnancy.

I did the test, and when the two blue lines appeared, I began to cry. My husband had threatened to leave for the hundredth time the night before, and I had given him a last chance to make up his mind. Now I found myself pregnant. Needless to say, it wasn’t such a happy moment.

I opened the shower curtain and passed the test through to my husband. He was unresponsive. To this day I have no idea what was going through his head. Despite the circumstances leading up to the pregnancy, he decided to stay. His uncle stated it quite clearly when he said, “You can’t leave now. You are having another baby.”

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Placenta Praevia
After my 19 week checkup and scan my midwife rang to say that my scan showed a low lying placenta. I would need to come back into town the next week for a checkup with the local obstetrician.

I was so nervous. I looked up ‘low lying placenta’ and read all this horrible stuff about placenta praevia that left me feeling very distressed. When we went back for our checkup, the obstetrician (who had a very bad bedside manner and left me in tears!) did an internal scan. He said that my placenta was smack bang over the top of my cervix.

Even if it moved, it would never move enough for a vaginal birth. He told me it was classed as grade 4 placenta praevia. He said that from 26 weeks onwards, I wouldn’t be allowed to be more than five minutes from the hospital as I could haemorrhage at any time. He also told me that I would be having a caesarean. All of a sudden, my dream of a natural birth was snatched from me. I went home and cried.

The next couple of months were spent researching as much as I could about placenta praevia to see if there was anyway I could have input into the caesarean birth. I hoped I could opt to be awake rather than under a general anaesthetic. Unfortunately, due to the severity of the placenta praevia, this was unlikely to happen.

I went back to the obstetrician at 26 weeks for another checkup. He did the examination and said, “Well, this is impossible, but the placenta is nowhere in sight.”

To this day, I can’t explain it. It was a miracle! I have the print outs from both scans: one showing nothing but placenta, one showing nothing but baby’s head. A scan at 36 weeks showed that my placenta was at the top and front of my uterus. Again, impossible.

I was stoked! My plans for a natural birth were back on track. I rang my midwife and asked if I could get the notes from my previous birth. This was one of the best things I could have done in planning for my second birth.

I went over the notes with her, and now I understood the chain of events leading to my first birth. I had gone into hospital too early. I was only 3cm dilated when we arrived. I had been having contractions all night, but they weren’t very strong or close together. The midwife could have sent me home, but I think she recognised how tired and emotional I was after being up all night, and she admitted me instead.

My labour was labelled as a ‘failure to progress’ and the midwife ruptured my membranes. This led to intense contractions, one on top of the other, without any further dilation. The pain was greater than I could bear, so I had pethidine. I was so heavily drugged that I felt like I wasn’t there for the birth. Even now, there are some things I can’t remember.

Now I was able to go over the things I wanted to avoid this time around. I didn’t want to have my waters broken, I didn’t want any drugs offered and I wanted to stay at home for as long as possible. My midwife was completely onboard, and I was confident that any decisions she made would be in line with what I wanted. I trusted that intervention would only happen if it was truly necessary.

I had no fears about the birth. I was surrounded by stories of family who had birthed naturally, and I knew that with the right support, I would be able to have a natural birth this time. My body would do what it needed to. I know that things don’t always go according to plan with birthing, but to me the actual birth seemed to be the one thing that was within my control.

Antenatal Depression

The rest of my pregnancy was a blur of emotions. Between my failing marriage and depression, it was one of the hardest times of my life. My husband would often leave me out on the station alone for the weekend with our first son and no car while he went into town to drink. At first I loved the isolation, although looking back now, I would say this was the beginning of my antenatal depression.

I felt like I should be the happy, glowing pregnant mother, but I was far from it. I spent many nights crying, wondering how I would be able to look after my newborn baby when I could hardly look after myself. I felt nothing but impending doom. I was fearful, worried and scared that I wouldn’t be able to cope. I didn’t want to think about the baby inside of me. It was as if I tried to block it from my mind. There was no bonding with the baby, not in the beginning and not in the end.

When I was finally diagnosed with antenatal depression, I was relieved. Up to that point, I had been feeling foolish. How could I have postnatal depression when I hadn’t even had my baby yet? I hadn’t heard of antenatal depression before.

I was referred to counselling for antenatal depression and it helped immensely. My midwife made regular home visits (in the capacity of friend more than midwife), and I got extra support from my parents and my best friend.

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After the Birth

We stayed in the birthing room for around two hours before I finally had a shower and moved to the maternity room. This quiet time together was very important. Later, my parents came up to the hospital with our other son. He took to his brother straight away. He was calling him “My bebe” and didn’t want anyone else to hold him.

Even though much of my pregnancy and my baby’s first year of life has been lost in a blur of depression, I can clearly remember those first few happy hours. There were times during my pregnancy when I had felt so bleak and in the blackest hole. Reading my bible, praying, or attending church were completely out of the picture. Often I would just cry out, “God, help me!” and that would be enough to get me through the day. I held onto the faith that God would bring me through this. I truly believe that it was God’s strength that upheld me throughout my pregnancy.

We called our baby Hezekiah. It means ‘The Lord is my strength’.

I felt so proud after Hezekiah’s birth. I had been supported in my decisions for the birth and had managed to give birth without pain relief or intervention. I was completely present throughout the birth and not wiped out with drugs. I learnt that I could trust myself, my body and my ability to birth a baby.

I felt that even if the rest of my life was falling apart, I could share my birth story with others and be proud of it. My birth was the most positive birth I could ever have wished for, with a beautiful baby boy as a result. How could I not be proud of myself? During my dark moments, I clung to this like a person overboard clinging to a life buoy.

Read the rest of Natasha’s story in Birth Journeys.

Read other positive stories.

Read more about antenatal depression on the Positive Birth News blog here.

For information and support in Australia:

PANDA: http://www.panda.org.au/practical-information/about-postnatal-depression/27-antenatal-depression

Beyond Blue: http://www.beyondblue.org.au

Black Dog Institute: http://www.blackdoginstitute.org.au/public/depression/inpregnancypostnatal/babyblues.cfm

Depression and Pregnancy

Pregnancy is usually a time of great joy, mixed with feelings of uncertainty and perhaps fear at the great unknowns of birth and motherhood ahead. Some women face an additional challenge during pregnancy as they struggle with antenatal depression. While postnatal depression is well known and screened for in post birth check ups, antenatal depression remains unheard of and often goes undiagnosed. In Birth Journeys Natasha shared her challenging journey to a positive birth including her diagnosis with antenatal depression. Read some sections from Natasha’s powerful story “Beacon of Light”

Laura Chapman shares a special guest post on depression in pregnancy

Removing Fear of Childbirth May Reduce Depression

When you are fearful of childbirth, it affects your experience of delivery. However, recent research also shows that this fear increases your risk of postnatal depression. The study from Finland, which involved more than 500,000 women and published in the journal BMJ Open, found that women who had not previously experienced depressed mood were most likely to suffer from depression in the weeks after delivery if they feared childbirth. However, the anxiety surrounding delivery may contribute to the low mood experienced by some of us during pregnancy as well.

Understanding antenatal depression

While you probably know about postnatal depression, you may not realise that similar feelings can occur during pregnancy; you may think that any change to the way you feel is simply down to the pregnancy hormones and the other changes occurring to your body. However, a report published by the Australian Institute of Health and Welfare in 2012 showed that 3.7% of mothers experienced depressive symptoms for the first time while pregnant and other studies have shown that as many as a fifth of us may be affected by mood disorders during pregnancy. So you are far from alone if you suffer from low mood before the birth of your baby. A lot of factors contribute to antenatal depression, but worrying about childbirth and how you will manage afterwards are likely to make matters worse. Hearing about positive birth experiences will help you to feel more at ease, but if you think you might be depressed, it’s best to see your doctor.

Getting help

By asking you a range of questions about your feelings, your doctor can quickly assess whether you have depression and with this diagnosis they can discuss the treatments available. If you are worried about taking antidepressants, some are known to be safe during pregnancy, but a number of effective drug-free treatments are available if you have mild depression. For instance, exercise is known to do wonders for your mood and talking therapies are beneficial for many women too. If you have an interest in complementary therapies, you might like to try acupuncture, which studies show is both suitable and effective for treating depressive symptoms during pregnancy. Receiving treatment for antenatal depression, whichever treatment you choose, will help you to have a healthy pregnancy, keeping you and your baby safe.

Read Laura’s Guide to Living with Depression During Pregnancy at Psych Guides:

Living With: Depression During Pregnancy

Birth leaves an imprint on mothers for life

Wise words from Justine Caines OAM in the foreword for Birth Journeys. The moment of birth and the hours and days that lead up to it are dismissed by many in our society including mothers.

While the Birth Journeys book steers clear of birth politics as much as possible and leaves it to each reader to draw their conclusions and make their own well informed choices, there is a clear message from Justine’s foreword that is carried throughout the book – through the introduction, birth stories, story editorials and information pages: “birth matters and how you feel matters – don’t let anyone tell you otherwise.”

You only need to ask your mother, your aunty, or your grandmother about her births to see the impact birth has had on her. Even as she denies the importance of birth and comments that she doesn’t know what all the fuss is about, the emotional and mental impact of her birth experiences is written on her face and betrayed in her voice. A family member told me she didn’t see why people thought birth mattered so much…and then went on to share her birth stories. She spoke of pain, frustration, fear and pressure put on her, the sense that she had failed and couldn’t give birth. Her feelings of disappointment and anger were still strong more than 40 years after her first birth.

How do you have a positive birth? One that leaves a positive imprint on you? A good place to start is reading the journeys of other women who have been able to have positive births to see what is possible and learn from their stories.

Birth Journeys contains 29 detailed, beautiful and powerful positive birth stories chosen with input from midwives, doulas and mothers to be. It also includes information from Australia’s midwives, doctors, doulas and birth educators including Assoc Prof Hannah Dahlen, Dr Sarah Buckley and midwife/academic Rachel Reed.

The latest special is 50% OFF the ebook until Jan 2nd 2014. Download the ebook from www.birthjourneys.com.au for just $7.50 AU.

What if you are reeling from a bad birth? A “bad” birth may look “normal” or “good” from the outside while on the inside it has left you feeling sorrow, pain, disappointment, anger, guilt or hurt in some way. Birth trauma can be from any kind of birth where you have felt frightened, unsupported, in danger, unheard, or violated. If a mother is hurt or cut down in the process then the birth outcome is not optimal.

Reading stories of women who have healed from bad experiences, or who have explored their feelings as they have prepared for a more positive and empowering birth next time is helpful for many women. The message of Birth Journeys is “YES your feelings are valid. And healing is possible. You don’t have to feel this way forever.” You may have been let down by carers who did not keep you feeling safe, loved, respected and heard. You may have been set up for a negative birth by our culture of fear of birth and denial that birth is important for parents as well as babies. You may have been let down by a system of care that failed to provide the best care for you as an individual. Whatever reasons or lessons are revealed by your story, a different story is possible next time. Birth Journeys shares many stories from women who have walked this path too – each with a sensitively written introduction so you can pick and choose the best stories for you.

A good place to begin your journey to healing and a positive birth next time is talking to Melissa and Debby from www.birthtalk.org and getting hold of their book “How to Heal a Bad Birth” when it comes out soon. Melissa and Debby also wrote a piece for the Birth Journeys book on how to heal from a traumatic birth.

What You Really Need to Know About Labour – and where you’ll find it

Positive Birth News

When we are uncertain or facing something new, we often turn to guide books and people that tell us what to do, lists of tips, books that tell us what to expect and make everything seem black and white, straightforward and under control – predictable. A predictable birth would be nice, wouldn’t it!

But how far will this knowledge really go in preparing you for your own unique labour and birth? Not far enough!

When I was preparing for my first birth I focused on learning about pregnancy and labour from experts, guide books and the hospital antenatal class. I wanted to be well prepared and give my baby the best beginning possible. I read some birth stories (in Ina May’s clasic book Spiritual Midwifery but they were a little too alternative and hippy for me at the time. Never having experienced labour I found it very hard to imagine…

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Guest Post: Paid Menstrual Leave?

Wow! Amazing progress Russia! Certainly agree with the author though – the conceptualisation of menstruation that this is based on is not empowering and doesn’t reflect a deeper understanding of what menstruation can be.

Such a revolutionary change this would be and such change it would demand in the way women are treated and the way women feel and are understood. But only when it comes from women because women have changed the way they see menstruation and see themselves. Currently most women might think this was either unneeded or would result in more workplace discrimination and more making fun of women.

Can’t see any of this happening under our govt in Aust for many many many moons! But I don’t think we are yet ready.

So I choose to try to plan my own months around my needs and we teach our sons about these needs from a young age with an attitude of respect and acceptance.

Talk Birth

Paid Menstrual Leave – it’s time!  

by DeAnna L’am. Reprinted with permission.

“A Russian lawmaker has asked parliament to give women two days paid leave a month when they menstruate… Mikhail Degtyaryov, a member of the nationalist LDPR party, wrote on his website “During that period (of menstruation), most women experience psychological and physiological discomfort. The pain for the fair sex is often so intense that it is necessary to call an ambulance”… Scientists and gynecologists look on difficult menstruation not only as a medical, but also a social problem…” ~ Standard Digital, August 2013

Fascinating! Lets look at how good things are turned on their heads, yet again, to result (unsurprisingly) in women’s dis-empowerment.

Indeed, a paid monthly Menstrual Leave would be an honoring, empowering option for women worldwide. Yet proposing it for all the wrong reasons diminishes us, and our cyclicity, to “

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Positive Birth Story – A Gentle and Welcoming Caesarean Birth

Planning Our First Birth
We had planned a homebirth for the birth of our first child. At first my husband wasn’t terribly keen on the idea, but we spoke about the benefits for both of us to receive continuity of care and support by one midwife. I didn’t want to be ‘just another woman having a baby’ to the hospital staff, with my husband barely figuring in the equation.

Once we met our midwife Marie, there was no going back. When I knew I was pregnant, we spoke on the phone and we talked about the need to ‘own our births’. This was important to me, because I did not want to be controlled by hospital policy. I wanted to have my feelings and wishes respected. With an independent midwife, the emotional, mental and physical welfare of myself, my husband and our baby were considered with the utmost importance.

Giving birth in a hospital was not out of the question; there would be no hesitation if the need arose. But continuity of care with someone that knew us and truly cared about us was our priority and we couldn’t get the kind of care we wanted in the hospital. In the end this continuity of care is exactly what made the birth of our son a positive experience, even though his birth was everything I did not want.

Phe and baby Donald[/caption]

I started reading Ina May Gaskin’s books Guide to Childbirth and Spiritual Midwifery before I was even pregnant and they got me so excited about being pregnant and giving birth. I just wanted it to happen NOW! They were so positive and made birth seem so normal, yet monumental and incredible at the same time. Thankfully I got pregnant very easily and it was a very breezy pregnancy. I had no morning sickness, although I was ridiculously tired for the first few months and fell asleep as soon as I got home from work every day.

I was fit and continued with Pilates twice a week up until the week before I was due. Watching my tummy grow was exciting and I felt great. We saw Marie every four weeks and then weekly as the due date approached. We only had one ultrasound at 20 weeks for curiosities sake, as we wanted a peak at the little person growing in there.

During Marie’s visits she felt my stomach to assess baby’s position and we would listen to the heartbeat and just chat over a cup of tea. We discussed fears, hopes and concerns about the labour and birth and how we could work together to ensure we felt supported by each other. Ultimately I was really looking forward to labour and just getting to experience it all.

Something Unusual
Each appointment when she looked at my stomach, Marie would shake her head in amazement at the strange shape my stomach made; it was so lopsided! As we knew I had a bicornuate uterus[1] uterus she suspected the baby just preferred being in one side rather than the other, but was still vertex. Indeed at 36 weeks baby was Left Occiput Anterior[2], textbook perfect.

However, at our 38 week appointment Marie was having trouble figuring out what position the baby was in. She decided that if we were still having trouble at the 39 week appointment we would have an ultrasound to ensure we were properly prepared.

So at 38 weeks and 6 days we had another appointment and baby was giving Marie a hard time again so an ultrasound was scheduled for that afternoon. During that scan we discovered the baby was transverse[3]. Spine down, head in the right horn and feet in the left. The ultrasound also showed an exceedingly long wall (septum) extending down the middle of my uterus.[4] It was a pretty upsetting result!

That evening, Marie reviewed the scans and the report and contacted Dr Ken at the Foetal Medicine Unit in our city. He arranged for us to see him the next day. Marie would come with us. At the appointment, we had an ultrasound that confirmed what we had seen the previous day. We then had a 4D diagnostic scan which showed that the septum was not as big as first suspected and it was decided to attempt an external cephalic version (ECV) to turn baby. It was quite quick and not too uncomfortable and baby’s head moved down with relative ease.

Ken arranged for us to come back and see him on the Friday to reassess. By Thursday however, I knew that baby had reverted back to transverse and at the next appointment this was confirmed. Another ECV was performed and baby again went head down with ease. But again within hours, I knew that baby had moved back!

Ken was such a lovely doctor. He truly empathised with us as the situation unfolded during the week leading up to the birth. He was softly spoken and gentle and always very respectful. Not only to Tim and myself, but also to Marie, as he recognised that she was our primary caregiver. He did not to try to ‘take over’ at any stage, but consulted with Marie and ourselves at every appointment.

We had another appointment on the following Monday and this time we discovered that baby was again transverse, this time with head on the left and feet on the right. I remember Ken just looking at Marie with a really sad expression and he left it to Marie as our caregiver to break the news of the need to perform a caesarean. As the due date was the Wednesday and the baby was in a very unstable lie, we decided to deliver the baby by caesarean the next day. I think all four of us, Ken, Marie, Tim and I felt pretty devastated.

While we were in Ken’s office getting all the paperwork underway I asked him if he would be able to perform the operation. He told me that his shifts meant that he would not be able to. The upside that day was that we were able to arrange to have my aunty (a midwife) to be the supporting midwife in the operating theatre. Ken personally called Aunty Rozzie to tell her that I had asked for her and together they arranged for her to be in theatre as the assisting midwife. My mother also drove up to be with us for the two weeks after the birth to help. We knew that I would not be able to do much after the surgery for some time.

That afternoon Marie and Aunty Rozzie discussed how the caesarean could be made as calm, loving, and respectful as possible. They helped us put together a caesarean birth plan:
• Tim and Marie were to be with me for the entire procedure, including pre-op and recovery;
• No one was to announce the sex of the baby; we were to be able to discover for ourselves;
• Immediate skin to skin and breastfeed opportunity after the birth;
• The baby was not to be separated from me after the birth at any point;
• The placenta was to be retained so that we could see it afterwards and keep it if we so desired;
• The theatre was to be as quiet and lights as dim as possible for the moment of birth.

For the rest of the day and night I was angry and inconsolable. I sat for an hour in the bottom of the shower that night crying. I was broken hearted. Despite having a great pregnancy and positive attitude about birth, my chance to give birth naturally had been taken away. I was never to know what contractions or labour felt like.

Caesarean Birth
On Tuesday morning, Tim, Mum and I went to the hospital to meet Marie and our little baby. I was still angry and upset, and even refused to have Mum take a photo of me the day our baby was born, despite taking a photographic record of the entire pregnancy. When I had to change out of my clothes in triage into the surgery gown I broke down into tears in the change cubicle. After such a breezy nine months and feeling so prepared and excited to experience labour and birth, having to put on tie-up paper underwear for a caesarean section was like the ultimate smack in the face.

The triage nurse was so lovely and caring though. She hugged me and told me she understood how confusing and disappointing it all was. Tim and I hung out together waiting to go in to theatre while Marie and Rozzie were preparing together. We found out that Ken had changed his schedule around just so he could be there for me. That made me feel so cared for.

Once I was finally in theatre it was incredibly emotional. After the epidural was in, I found it difficult feeling so physically disconnected from the birth. I could feel my legs being manoeuvred and knew a catheter was being put it. I tried not to cry and Marie was with me, getting me to focus on her rather than the necessary unpleasantness. She was a physical, mental and emotional support the whole time.

Ken, Aunty Rozzie and the theatre staff told us what was happening and constantly checked to make sure I was feeling all right. Marie was able to photograph the entire birth so I also have an incredible record of how it unfolded.

Time was strange during the operation. I felt tugging and pulling. There was the buzz of all the staff in the operating theatre…and then quite suddenly a beautiful little boy was held up over the partition for us to see.

No one told us what he was; we got to discover for ourselves. No one whisked him away, but instead he was placed on my chest with his face against mine. There was so much encouragement and joy from the midwives. I blew gently in his face to help him take his first breaths. I remember smelling him for the first time and it was the most beautiful creamy scent I will never forget.

Aunty Rozzie then took him away to clean him up and Tim was able to cut the cord. Once he was brought back he was never taken from me again. He attached straight away and didn’t stop feeding for over two hours.

Looking at the incredible photos Marie took of Don’s birth while I write this still makes me want to cry. The operation itself is quite amazing to see and I can tell Ken is grinning like crazy behind his mask as he lifts my tiny baby up for me to see for the first time. I remember constantly being asked if I was OK or if I was uncomfortable. Everyone knew what our birth plans had been, so they made sure that despite our baby having to be born via caesarean, it was as good as a caesarean could be. The birth was as caring, gentle and respectful as possible. It was not rushed, it was not an ‘emergency’ and my husband, my baby and myself were looked after to very high standards. Ken came to visit me the night after Don was born to see how I was and to tell me “You can birth vaginally next time. You will do it”! He was a genuinely caring and gentle doctor.

Healing
For a long time afterwards, despite having a beautiful boy and a ‘good’ caesarean birth, I still felt like a failure. I felt like my body had let me down. I felt cheated and that I hadn’t really given birth as I did not feel a single sensation during his birth, or one contraction to let me know that my baby would soon be here. I felt let down by myself and just very confused.

Some people kept telling me that I needed to “Get over it” as I was fine and Don was fine and “If you were in Africa you’d both be dead”. But Marie completely supported me in my feelings of disappointment and grief for what I didn’t get to have. She did not allow me to wallow, but she never once made me feel that my hurt was unwarranted. She let me vent and be angry and upset, but she helped me relinquish those negative feelings as well.

As time moved on and I was able to talk things over with Marie, my sister who has had two caesareans and two VBACs, and other friends, I saw that it was a positive experience and one to be cherished. Even now I wish I could go back and do it again, just so I could take more of it in and see my little boy being born all over again. It was positive because I had the best care in my midwife. I know that if I had gone though the public system, or even through a private obstetrician, I would not have received the same level of support or respect that I received from her. Terms would have been dictated and I would have had little to no control over events. She was as sad and disappointed as I was that things didn’t eventuate the way we had originally planned, but she also had a positive attitude that I definitely needed as well.

Despite being born by caesarean birth in hospital, Don’s birth was an amazing day that I wish I could experience all over again. We were cared for, loved, respected and consulted. He was delivered by people who loved him before he was even born; people who couldn’t wait to meet this crazy little personality that had refused to head in the right direction! His first moments were shared with our wonderful midwife Marie and his Great Aunty Rozzie. Sadly Rozzie died less than two years later, and just three days before the birth of my second child. I am forever thankful for sharing something so precious with someone so special to me.

Ultimately Don’s birth paved the way for an amazing achievement: the breech HVBAC (a vaginal breech birth after a caesarean – at home) of my little girl 20 months later with Marie as my midwife. Adwen is now three months old and her big brother loves her to pieces. If Don’s birth hadn’t been what it was, her birth would have also probably been very different.

Donald was born 6 September 2011, 3:19 pm, measuring 7lb 2oz (3.2 kg) and 49cm in length.

Phe lives in Canberra with her husband Tim, two children Donald and Adwen, and two puppies, Oberon and Hermione. Her days are mostly spent at home looking after all four little ones, and trying to make sure Donnie doesn’t terrorise the puppies too much! She loves gardening and cross stitching and as many catch ups and coffees with friends as possible.

Glossary
[1] A bicornuate uterus is has a heart shape with a deep indentation in the top middle, making two horns. It is possible to have a normal pregnancy and labour with a bicornuate uterus, however it is also common for the baby to settle in an unusual position such as bottom down (breech) or transverse. In some of these cases the safest option may be to have a caesarean birth. http://pinterest.com/pin/371617406723121402/

[2] LOA or Left Occiput Anterior is considered to be the most favourable position for babies to be in for birth. LOA means baby is on your left side with the back of their head facing towards your belly, their back is aligned with your belly. Occiput means head (specifically the back part of the head), anterior means front (your belly).

[3] Transverse babies lie across the mother’s belly. Unless the baby turns a caesarean is considered the safest birth in this situation. http://spinningbabies.com/baby-positions/all-positions/sideways

[4] A septum is a muscular or fibrous wall extending down the middle of the uterus http://pinterest.com/pin/371617406723121454/

Pregnancy – a time to be celebrated, honoured, adored and adorned!

Pregnancy – a time to be celebrated, honoured, adored and adorned!

I was privileged to attend a ‘baby shower’ for an Indian couple a few years ago and I was deeply moved by the incredible reverence and honour bestowed upon both the father and mother-to-be at this ceremony and celebration. The mother-to-be was joyfully decorated with henna and brought special foods to eat and drink. There was dancing and singing, laughter, music, plenty of prayer, chanting and moments of silence and reflection. It was a momentous occasion, lasting an entire day. This special event matched the enormity of birth and becoming a family.

In our mainstream western culture we do not give our mothers and fathers-to-be this beautiful and powerful preparation for birth and parenthood. Typical baby showers can be quite surface level with the greatest care given to matching invitations, party decor, fabulous cupcakes, a beautifully presented table of food and amazing gifts – all beautiful and joyful things! We tend to show our love through these kinds of details. There’s nothing wrong with a baby shower and they make women feel really special and pampered. But what if you wish for something different to this? What if you wish for a gathering that will help you to feel strong, beautiful and ready for birth and parenthood?

Alternatives
You may choose to give yourself or a pregnant friend a celebration like a “Mother and Baby Blessing” or a “Blessingway”. It may be a baby shower with one extra element of ceremony or bonding. It may be for both you and your partner – dads need honouring and support too!

One alternative or addition to a baby shower or a blessing is to invite a circle of friends to make beautiful birth art together. Enjoy an afternoon of creativity and fun making a positive, empowering and joyful memory together. If you have a doula you may wish to invite her too and she will help to establish a positive, welcoming and accepting mood. If you have a friend who understands you and your wishes for birth you may like them to help you organise this gathering and set the mood for the day.

Some ideas:
• Sculpt mothers, babies, pregnant bellies with clay. Air hardening clay is available in craft stores.
• Create prayer flags for your birth with words and images. Squares of calico cloth and paint, fabric markers, scraps of material and embroidery thread are all you need.
• Make collages with positive affirmations, pretty papers, paint, drawings or magazine pictures,
• Paint mini canvases or a large positive affirmation banner
• Let them paint your belly
• Paint a belly cast together
• Make a keepsake book for mother and baby with positive wishes for both
• String a necklace from beads chosen for you by your friends
• Make a jar full of positive thoughts and quotes that you can turn to when you need a boost before and after birth
• Collect rocks and paint them with words, patterns and images of love, birth and life
• Allow your friends to pamper and adorn you with flowers, hair brushing, massage, and dress you with beautiful beads. Everyone could be pampered and adorned. (make sure any essential oils or herbs used are safe!)

Give your friends a candle to light when they hear that you are in labour. You may like to choose one person to let everyone know by text message. There is an incredible power in the shared lighting of a candle and shared awareness that a close friend is labouring. The candle seems to focus attention and allow us to “send” love, strength and well wishes to this mother and her baby in labour.

Making pregnancy and birth art is all about harnessing your creative spirit, unleashing your intuitive knowledge and tapping into collective memories to make a tangible record that we can turn to for strength, reassurance and inspiration. Just as our birth stories collect and share the memories of many so that the mother to be can take these into her mind and her memory as though they are her own; so does the sharing of art. These symbolic and deeply personal creations can feel as though they capture a little piece of each woman and her strengths, her love, her support and her conscious desire for this birth to be peaceful, welcoming, safe and beautiful. This is a powerful and wonderful gift.

If this all feels too extraordinary for your circle (and I do understand! It felt a little too extraordinary when I was pregnant but I would do it now without hesitation!) then why not invite friends for a cookup instead to help make meals for your freezer. Ask everyone to bring ingredients and a recipe. Shared cooking creates a positive and connected feeling amongst you and you will benefit from this practical as well as emotional expression of support after the birth of your baby. And you never know, after a shared cookup your friends may well feel ready to embrace something more!

Why does it matter?

“A New Birth Culture
Imagine if our culture told us that birth was one of the greatest things a woman might ever do. Imagine if the stories and images we were exposed to taught us that labour (and all birth) is an incredible and transformational experience, a rite of passage into motherhood. Our family and friends would celebrate and honour us. We would be surrounded by supportive and caring women as we embarked on this new experience.

Naturally, we might feel nervous and anxious about the momentous task ahead of us, but we would be well prepared. We would believe and trust that we could do this and have the reassurance of medical assistance to help us if we needed it. With a different perspective on birth right from the start, we would enter labour ready to work with our bodies to birth our babies. We would feel excited, curious and eager for birth and all of its unknowns.” ~ from the introduction to Birth Journeys – positive birth stories to encourage and inspire.

Holding a rich and meaningful blessingway or baby shower may be a wonderful and empowering step towards creating this vision of positive birth for yourself or a dear friend or sister.

A Positive Caesarean Birth

If you wish to emerge from your baby’s caesarean birth feeling positive then it is wise to take ownership over your baby’s birth. This means speaking up for what you want and do not want and placing yourself in the hands of people you trust and feel safe with.

Consider what your wishes would be for a caesarean birth when you are doing your birth preparation and planning. Then you will have the opportunity to communicate your most important desires for a caesarean birth with your place of birth and carers ahead of time. This doesn’t mean dwelling on the possibility of a caesarean, it just means considering and documenting what would make this type of birth as positive as possible for you, your partner and your baby.

Most of us like to avoid conflict. We are used to being told what we should or shouldn’t do by health professionals and we are in the habit of giving over our power and ownership to others in medical situations. Although it may be very challenging for you (it is for me!), your baby’s birth is an opportunity to begin advocating for yourself and for your unborn child. Through your experience of birth you can set the scene for future interactions with doctors, dentists, health nurses and teachers where you are a strong advocate and an expert in your needs and the needs of your children.

There are options for a caesarean birth that may not be offered to you as they are not standard care in most hospitals. Although a caesarean is surgery, it is also the birth of a baby, a mother and a father. Even in an emergency, this surgery can be performed with gentle and respectful intentions, with consciousness that this is a birth and it is a special day.

Based on many women’s stories and the work of retired US obstetrician, Robert Oliver, MD, board of directors of APPPAH, the Association for Pre and Perinatal Psychology and Health, these are my suggestions for turning a necessary caesarean into a positive and beautiful birth.

Not all of these are going to be possible for a mid-labour emergency caesarean or in every individual situation, but they are possible and achievable. Reading positive caesarean stories and asking questions of other women will help you to discover that the smallest things can make all the difference to your baby’s birth.

Robert Oliver MD writes about his experience with positive caesarean births: “It is our intention to maintain the mother’s control of the events. She must at all times feel she is important to and guiding the birthing, regardless of the emergency and the operative procedure.This also goes for the baby in a spiritual and metaphysical sense. Ideally the obstetrician and labor room personnel will honor these two people most strongly.”

Preparing for Caesarean Birth
It is OK to feel disappointed, sad, or angry before and after your baby’s birth. Seek an empathetic listener (eg, your doula or midwife) who will not dismiss your feelings, ‘jolly’ you along, or diagnose you with depression before you even have time to grieve the birth and meeting with your baby that you had hoped to experience.

If you feel ready and you have time to prepare for your caesarean birth, read positive caesarean birth stories so that you are familiar with what will happen and what the birth may feel like. These stories will also give you confidence to ask for what you want. Talking to other women will also help you to find out what products there are that may make your recovery easier. (There are three positive caesarean stories in the Birth Journeys book.)

Meet the surgeon and anaesthetist beforehand with your midwife and/or doula to discuss your birth plans and hopes.

Ask that your baby be placed on your chest before weighing, cleaning and paediatric assessment, unless absolutely necessary. Weighing and cleaning are not emergency procedures that have to happen the moment your baby is born – they can wait – but we tend to accept that they take place immediately after birth. There are many possibilities like this that are not widely discussed or offered.

Ask for delayed cord clamping so that your baby receives all the cord blood and oxygen from the placenta while they adapt to life outside the womb. A recent review of studies showed that delayed cord clamping provides longer term health benefits for your baby as well as supporting them as they begin to breathe. A lotus birth is possible with a caesarean birth and it ensures that your baby is not taken away (although baby may be held rather than placed on your chest) before the placenta is birthed.

Ask for the lights to be dimmed and the surgery to be a little warmer than usual for your baby’s birth. This is achievable and it will make your baby’s first moments in the world easier and the birth environment more pleasant for you too.

Ask for talking to be quiet and gentle with attention focused on you, your baby, your partner and this birth. One common complaint couples have after experiencing a caesarean birth is that medical staff carried on with their own conversations ignoring the presence and the feelings of the key people in this important event. Perhaps some surgeons and theatre staff have this habit because other ‘patients’ would not be listening in and they may not be aware of how it makes many couples feel.

Discuss your intentions for breastfeeding and how you will be supported after the caesarean birth. Identify how will you be helped to breastfeed, especially if there is a reason why you are unable to breastfeed your baby for the first few hours. Remember that skin to skin contact and allowing your baby to explore and find your nipple by themselves is a wonderful way to initiate breastfeeding and reconnect with your baby after a separation.

Caesarean births are sometimes linked to difficulties in establishing breastfeeding so consider finding the supportive friends and professionals now before your baby is born. It is easier to reach for support if you have already made contact before the birth.

You may wish to discover your baby’s sex for yourselves. You may like the doctors to welcome your baby by name. Ensure you make your wishes clear so that this special moment meets your wishes.

Use honey not vinegar to get what you want. If you are worried about dealing with potential conflict, try words like these: “It is important to us that… How can we work together to…” Eg, if you are concerned about your baby being taken away immediately after birth you could try words similar to “It is important to us that our baby is not separated from us. How can we do things so we have our baby in our arms straight after the birth?”

This may seem to be giving the power to find a solution to the doctors, but you are actually telling them what your concern is and what outcome you want. I’ve not had to use this method in maternity care, but I have used it in the operating theatre and recovery ward with my children to get what I knew they needed and it really works! Honest and respectful communication with the right person goes a long way.

On The Day
Have your partner place their hands on your belly or speak to your baby in the time before the caesarean birth begins. Your baby knows their daddy’s voice and this can help your partner to feel involved and connected with your baby and the birth.

Before the birth begins, ask to take a moment to welcome your baby and give thanks for their life and the wonderful care and the gentle hands of everyone in the room that will receive your baby into the world. If you would normally pray or say a few words before something momentous takes place then surely the caesarean birth of a baby fits this category. I believe your wish will be respected if you frame it as a need to give thanks, say a prayer or a blessing before your baby’s birth.

If saying something aloud is all too much, then ask for a everyone to share a moment’s silence to give thanks. Taking this small but very personal action will send a very clear message about the way you want this birth to be – respectful, gentle and calm. I have not read of this in any birth stories so you may be pioneers if you try this – be sure to let me know what happens!

Focus on your baby and visualise sending them reassurance and love. Let your baby know that it is safe for them to be born this way and that you are in control of what is happening. Talk or sing to your baby in your head or quietly – keep focused on them and their wellbeing and imagine them coming out into the light and the air. This will help you to feel involved and in control of the birth of your baby. By keeping calm, you support the wellbeing of both yourself and your baby. If this is not for you, use other methods such as counting backwards to help you keep calm.

Have a doula or familiar midwife in the theatre focused on your care and wellbeing. You’ll benefit from having someone there for you and your partner.

If you prepared for birth with hypnosis or meditation methods you may find these are still very useful during the birth. If you have prepared using breathing techniques or counting methods these amy also be helpful for you. (See the links below for hypnobirthing specifically for caesarean birth.)

If you are unable to hold your baby post-birth, your partner can hold your baby against his bare chest with a blanket over them both, or even inside his shirt. Your baby will be kept warm and will love this close contact with daddy.

Remember it is your birth and your baby’s birth not just an operation. Every aspect of this birth may be performed with an intention to help, to care and to show respect for you, your baby and your partner. You deserve this.

Some links you may find helpful before and after a caesarean birth:
Caesarean birth plan: http://www.birthtalk.org/PlanaPosCS.hhtml
Hypnobirthing for caesarean birth: http://www.hypnobirthingaustralia.com.au/preparation-for-caesarean-birth-cesarean-c-section/
What a caesarean is like: http://www.birthingfromwithin.com/cesarean
Birth Rites on positive caesareans: http://www.birthrites.org/caesarean.html
Love letter to mothers who have birthed by caesarean: http://thestir.cafemom.com/baby/131563/a_love_letter_to_csection
Words that heal – why language matters: http://www.huffingtonpost.com/brandy-ferner/words-that-heal-cesarean-birth_b_3722185.html

No matter how you birth or how your baby needs to be born, you deserve this treatment.

Breastfeeding in Pregnancy, Labour and Beyond

This is an information piece in published in Birth Journeys,  by Leonie MacDonald

Often mothers who become pregnant wonder whether they can continue to breastfeed their baby or toddler throughout pregnancy. In most cases, it is perfectly safe and even beneficial.

During pregnancy, your milk supply may remain unchanged, diminish, or change to colostrum, especially towards the end of pregnancy. Colostrum is the first milk a newborn baby drinks. It is a clear yellowish liquid, very rich in vitamins and antibodies. It will do no harm to your breastfeeding child, although it may have a laxative effect and they may dislike the saltier flavour. Your supply of colostrum will not be used up by breastfeeding during pregnancy.

Your baby or toddler may wish to continue breastfeeding for comfort regardless of your milk supply. There are also immunological benefits of breastfeeding that continue even if your breastfeeder is not feeding very often or receiving much milk.

You may, however, experience sore nipples ranging from tolerable to very painful. Limiting the length of feeds or spacing feeds out can make this pain more manageable for some mothers. Heat or cool packs held to the breast before feeding can reduce the discomfort. Heat packs can also encourage the flow of milk. Sometimes the pain is only present at the start of the feed and then disappears.

Breastfeeding during labour is also possible and safe. Stimulating the nipples (through breastfeeding or through manual stimulation) can increase oxytocin and strengthen your contractions. It can be used to move your labour along in a natural way.

Some mothers will decide to tandem feed after birth. This means breastfeeding a baby and their sibling. The two do not have to be at the breast at the same time – any combination can work.