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HBAC Birth Story - Homebirth After Cesarean

 

“Having a HBAC was really so special after a totally unnecessary c-section with my first. I’d love to spread the word that it’s possible. So many people think it’s not.

And Then There Were Four

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The last time I typed up a birth story it wasn't one I was super excited to share with the world. I'm eager to get this one down before I forget it since labor amnesia sets in quick and because this one could not be more different than the last. A friend of mine who also had a particularly difficult first labor said that when she had a second child she wanted a do-over. At the time I was telling myself that all that matters is getting a healthy baby and while I still believe that, I am very happy that things went the way I wanted them to this time. 

[ I am not sure I need to but I would like to stop here and warn any readers that since this is a blog entry about giving birth, there is some TMI. ]

Last Friday I was 39 weeks. It started like any other day since I became full-term, with me thinking "Will this baby come today?" followed immediately by "Nah, I have tons of time left" followed by a much quieter "...maybe."  

Because Thora's birth was such a mess and because I believe it was the four days in a row of acupuncture that my midwife sent me for before my due date that started my prodromal labor and not Thora herself, ready to be born, I was treating this time like it was my first time. Lots of people said that since Thora was born four days before my due date, this one would be early too, but I was telling myself just in case that I really didn't know when Thora would have come, had circumstances been different. This one could very well wait until long after my due date. I knew four or five other people who were all due around the same time as me and I kept saying they'd all be first, just so I wouldn't be disappointed if I went on to 41 or 42 weeks. 

So on Friday morning I didn't think anything of going to work like usual.  I had a lot to do, including dealing with three chickens I was fostering in my tiny shared work space. (Don't ask!)

Johnny, on the other hand, seemed to know something was up. The night before I'd had what I thought could be a little leaking of amniotic fluid. (Any expecting parent has to be familiar with the awful "here, smell this, is this pee?" ridiculousness) Even though he didn't say so, he was on high alert. That morning he drove me to work so Thora could see the chickens, and en route he announced that he was cancelling the plans he had with his friend for that night just in case the baby came. I told him not to be silly and encouraged him to go ahead because my due date was still a week away and who knew when he'd get to go out again. Likely that leak was nothing. But he insisted. 

At the office, I managed to knock out a few things before everyone else arrived. I did an interview and wrote up a document I really needed to get out. I exchanged emails and calls with a few people. All the while I was having contractions and they were pretty regular but mild so I didn't say anything to anyone, just kept working and waited for them to pass. Around 1 pm when we were discussing lunch options, I felt a sudden gush and ran to the bathroom. Knowing that only 8% of labors start with the water breaking, I wasn't exactly sure what I'd find but I did not expect to see a lot of bright red blood. A lot. I had also passed a clot the size of my pinky. It didn't look like a mucus plug, it looked like a blood clot. And sitting there, I passed another. So I completely panicked. I called my midwife who seemed calm but mildly concerned. A few minutes later she called back: she'd been able to get me an emergency appointment at the women's ultrasound office I'd been going to, which was up on Madison Ave about a fifteen minute walk away. She encouraged me to put on a pad so I could see how much I was bleeding and said I should call her from the doctor's office to let her know what was going on. I called Johnny, who wasted no time getting into the car and on his way.

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I threw my stuff into a bag and fled. As I waited impatiently for the elevator, a coworker and mom of three passed me in the hall. She took one look at my face, nodded and said "Oh yeah," in a knowing voice. "Good luck!" In my mind I was thinking "But I'm not in labor!" though I wasn't about to stop to explain.

Of course it was pouring rain so finding a cab was virtually impossible. Frustrated, I called Johnny again and reminded him that my first labor was during a blizzard and complained that it wasn't fair that this happens to us during horrible weather. Someone from my office accompanied me to the corner of First Ave with a big umbrella, trying to help me flag down occupied cab after occupied cab. There were a handful of other people doing the same and I ran in front of them, totally focusing all of my fear into anger at them for not seeing me standing there and giving me the first cab that pulled up.

Meanwhile Johnny and Thora were stuck in traffic on the FDR drive on their way to meet me at the ultrasound place. In the cab, my contractions slowed and my bleeding too. I could still feel the baby moving so I knew she was alive, but bright red blood is never a good sign in pregnancy so I was still very worried. I raced into the office and told them who I was. The woman at reception reminded me that I didn't have an appointment, that they were fully booked but would see me when they could. I reminded her as sweetly as I could that I was 39 weeks pregnant and bleeding a lot. Then I sat down to wait. My name was called not two minutes later and Johnny and Thora arrived about two minutes after that. The ultrasound showed that the baby and her heartbeat were fine, there was a lot of amniotic fluid, the placenta was intact, and everything was overall peachy. Both the doctor there and my midwife on the phone said they could not easily explain the blood, that they guessed it was either my mucus plug or a small placental abruption. My midwife ordered me to go right home. "Do NOT go back to work," she said sternly. How did she know what I was thinking?! She insisted I rest and check in with her in another hour or so. Feeling calmer, I apologized to the receptionist on our way out. She looked relieved. I thanked everyone for seeing me so quickly and we headed back out into the rain.

We did go right home. My contractions continued, mildly. Johnny and Thora took a walk to Uptown Juice Bar, our neighborhood veggie restaurant, to pick up some dinner, while I tried to nap. By 5 pm or so we were timing the contractions but they seemed pretty stable at 5 minutes apart and lasting only 30 - 45 seconds. After Thora's birth, which was a full five days of contractions like that and two hospital visits during which I was checked and promptly sent home, I was determined not to be the boy who cried wolf a second time, so I kept telling the midwife it was no big deal, that I wasn't concerned yet.

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We got Thora to bed around 7 and settled in front of the TV for some Netflix streaming. I texted my sister to tell her I thought I was in labor. Then I sat on the birth ball and moaned and yelled my way through three episodes of Breaking Bad before Johnny told me that the contractions were obviously getting longer and more intense. I was still in denial because they weren't any closer together. I called our midwife again around 10 - a full 45 minutes later than she'd asked me to, she reminded me. I had a contraction as we talked and I tried my best to talk through it. I did not want her to have to come all the way here only to tell me I was having prodromal labor and then go back home. She said she was ready to go whenever we said the word, but I told her we were still fine. 

Oh the stupid things that go through a laboring woman's head. At this point I was thinking "What would a woman birthing with Ina May Gaskin do now?" I tried to channel the birth stories I'd read over and over in Spiritual Midwifery. These women would have made food, cleaned their RVs, worked in their garden, gone for a hike, hugged a tree, or gone to sleep. Remembering that with Thora I gave up pushing for a c-section because I was too tired to keep going after five days of being too excited about having a baby to rest at all, I picked sleep. I took a quarter of a Bendaryl and lay down. I knew that if this was really it, the contractions would not slow. But they did, to about 8 minutes apart.

I did manage to doze a little between contractions but they kept waking us both up and after an hour or two, they got more and more intense. By 2 am they were 2 - 3 minutes apart, lasting 90 seconds to 2 minutes. I was nauseous and restless and knew sleep was now out of the question. Benadryl or no, I was wide awake and in agony. Soon I was in pain even between contractions and I was suddenly throwing up and having to poop and everything else all at once. This was it. 

Johnny called Joan while I ran the bathtub. She'd been asleep but was instantly alert. The no-nonsense woman she is, she declared me to be in active labor and said she was on her way. Still not wanting to be humiliated for thinking I was in active labor when I wasn't, I was nervous that the bath might slow things down by the time she arrived. But it didn't. 

Between contractions in the water, I was fine. I sat there in the candlelit darkness and tried to relax. I could talk, even joke around a little. The contractions were painful as hell but in between them there was a minute of reprieve. Also they felt very different from the ones I had with Thora. Thora was posterior (meaning she was face up) and the resulting back labor was agonizing in a whole different way. At the same time, this was pain like nothing I ever knew. 

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Joan and her assistant S. arrived around 2:45. Joan checked me right away. 7 centimeters. She said "The rest could either be slow or fast but I'm thinking fast" and went back to making her preparations. There was no time, she said, to set up the birth pool. I was going to have the baby in the bathtub.

They started setting things up while Johnny sat with me and made sure I had water, Emergen-C, whatever I would drink. S, Joan's assistant, held my hand ("but only if it's not annoying," she reminded me) and helped me keep my sounds low and my shoulders low and relaxed. The pain got more and more intense and I got louder and louder. I surprised myself by how much I was screaming and howling and growling but it was what I had to do. Joan shrugged. "Some people just need to roar their babies out," was all she said. This kept on. I beat my hands on the lip of the tub with every contraction and screamed this guttural, totally insane scream. I was sitting cross legged, sort of like in lotus position, in the center of the tub, leaning over the middle of it. My head was resting on a towel they put on the lip of the tub and my hands were hanging over the side so I could remember to keep them unclenched. Rayna, my cat, was sitting right beneath my hands keeping a close watch on things. Johnny sat on the closed toilet seat and S sat on the floor next to Rayna. Joan left me to it for the most part, but came back in periodically to tell me I was doing great. I panted and screamed and shrieked and didn't believe her. "I don't think I can do this!" I heard myself whine. "You ARE doing it," everyone chanted, in unison, in response.

Then all of a sudden everything changes. My growl gets deeper and I hear myself scream like I never, ever have before. It gives me chills to think about it now. "That sounds like pushing!" calls Joan from outside the bathroom. She is suddenly there, checking me, asking if I feel like I need to bear down. "I don't know what I feel," I say. I am hoarse and my mouth is dry and I'm starting to whine again. "I feel her in my butt now and it really, really huuurrrtttss."  Yep, she says, that's pushing. And then I am at my absolute least attractive, retching and vomiting and panting and feeling like I'm crapping my brains out and watching the water around me get redder and redder. I'm babbling like a fool, asking how soon I can get an IUD, asking if I am going to make it through this, begging for it to stop. My head is filled with wild images: I'm thinking of my birth mother who should be there with me but isn't, of long-haired hippies who don't feel any pain as they push, of how I am certainly waking our daughter, asleep in the next room, of how I am definitely terrifying our neighbors and scaring my husband from ever wanting to look at me naked again, of being split open, of living through this to meet my baby.

Joan is suddenly all business. She kneels down and makes me change position. "If you are going to have this baby here, you need to stretch out and lie down on your right side and hold up your leg like this." She holds up my left leg like this. She gives Johnny the job of holding it up even further and pushing it back against the wall of the tub. She lets out some of the disgusting water and runs more warm water in the tub and over me, saying now it's too cold for having a baby. 

And then I am gone. What takes over is this primal thing, barely human, screaming and roaring. From a million miles away, I hear "I can see her!" and "She went back in, but that's okay, she's stretching you so you don't tear" and I'm panting and and my voice is saying "I can't" and then I'm wailing again and there are hands on me that I push away and suddenly I feel a pop and I hear "That's the head!" One more howl and a huge push that takes everything out of me and the next thing I know she's crying in my arms and there's a warm blanket and a towel being draped over her and I am spent but I have my baby and I did it, just like the women in the hippie books and exactly how I always wanted, with my husband next to me and my daughter asleep in her room just ten feet away and we are all in our element in our home and I can't believe it. It is 5:33 am on Saturday, September 24. I have been in labor for over seventeen hours and I have pushed for only 23 minutes.

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Freyja Rae is teeny. She is coughing and sputtering. I count fingers and toes, look at her tiny face, pick some vernix out of her ears. I push out the placenta and then a few minutes later, I manage to cut the cord myself because Johnny doesn't want to, snipping Joan's finger in the process. I smile and apologize. She shrugs and says she's been cut worse. I ask her if this ever gets old for her and she says with a smile, "Nope. Never." Everything is quiet. Then at some point, I ask how in the world women go through this pain. Her answer is simple. "We can do it because it ends. No matter how long it lasts, it always ends." 

Freyja and I lie there together for a few minutes in the gross bathwater while I think that over. We are happy and exhausted and I'm thinking about Rocky calling to Adrian that he did it. Johnny snaps a few pictures and S snaps a few more.

Then Joan wraps her in another warm and dry receiving blanket and hands her to her father, saying she's not ready to nurse yet but that she needs skin on skin contact with Daddy, and then I am fading away and I'm gone. 

I smell ammonia and hear someone say "smelling salts." My blood pressure is so low they can't even get a reading, but the smelling salts are so awful they wake me up enough so I can turn my head away. This feeling is nothing new for me. I have low blood pressure all the time so when I am sick or weakened I always react by getting dizzy and feeling faint. I am not concerned, but Joan and S are. A peanut butter sandwich appears before me and a glass of some flavor of Emergen-C that I didn't pick out is shoved in my face and a straw stuck in my mouth. I want to be in bed, with the AC on, wrapped in a blanket snuggling with my new baby but I know I can't make it there so I take slow bites and sips and wait.

Gradually I regain strength. We drain the tub and I am able to stand long enough to rinse off in the shower while they make a bed out of a plastic tablecloth and wee wee pads, right there on the tiles. I lie down and as I do, I hear Thora, awake. Freyja is passed back to me and I latch her on for the first time while Johnny brings Thora right to us in the bathroom. She's not fully awake and is very unsure of what's going on. "Mama?" she asks dubiously.

I sit up and nurse cross legged on the bathroom floor while they set up a spot for me in the living room. Moments later, Freyja and I make our way over to the couch. S hovers and makes me eat and sip sweet tea while I nurse Freyja. Johnny is next to me cuddling Thora, who asks for a pinky. A blissful moment: I am with my family.

But I am tired. Joan examines Freyja and prepares to weigh her like a bunch of bananas. "Any guesses?" We venture a few, but we are all off. She is much smaller than her sister was, only 6 pounds and 12 ounces. 19 inches long. Head and chest circumference are both 33 inches. "She's symmetrical!" Joan laughs. Freyja is perfect. And since we are at home, nothing invasive happens. She hasn't been suctioned. There is no ointment in her eyes. Joan doesn't even clean her off. Instead she rubs what's left of the vernix into her skin and wipes her down with some olive oil. She grabs a onesie from the pile, a white one with a pink and black skull and crossbones, a gift to Thora from our friend Missy Church. I smile and say she's dressing her like a punk rocker. "For you, nothing less!" she smiles back.

Johnny gets up to dress Thora. I help her on with her shoes and give her a big hug and kiss. Johnny brings her downstairs to our neighbor to hang out with her two girls for the morning and I throw on a shirt and get into bed with my new daughter. Joan hugs me and tucks me in. I hear Johnny come back in and he joins me a moment later, closing the bedroom door behind him. We hear cleanup noises in the rest of the apartment, and a few minutes later, the front door opening and quietly closing, as we three drift off to sleep.

I did it!”

Mama @thewriteaimee

Photo credit to @db4johnny (my spouse)


Was your birth upsetting or traumatic? Do you have more questions about processing your birth and need help healing? Arrange some time to chat with me. I’d love to answer your questions and help you heal and get yourself back - I have a program specifically got you, that can also include this revolutionary and last natural healing modality called Clarity Breathwork.  Helping women heal from birth trauma is one of my passions and areas of expertise. So is preventing it in the first place.

This is why excellent childbirth education is a must, why planning for your birth is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want - so you can ROCK your birth!

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of preventing birth trauma is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!

I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.

 

Beautiful Home Birth Story of Baby 5: Keys to Transforming Fear

 
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“The birth of Ezra was one of redemption and renewed faith in letting go and letting love be our covering. The whole pregnancy I had to ignore toxic fear, and just believe that he was going to be okay and we were going to be okay. With my four previous births, I delivered naturally, at home with a midwife and at a birth center in Norway where my husband is from. Each birth is story written in my mind, body and soul as a testament of faithfulness, strength and lessons discovered through seasons and growth ... separation and fulfillment. Somewhere in the practice of ignoring fear, I became ready for a birth that til this day, I'm at a loss for words on how to describe other than that I was so present that I could anticipate his decent, and catch him in a little less than two hours.                   

On December 3rd, the kids, my husband and I were doing what we had for weeks leading up to that day, preparing to meet the baby. For the kids, preparing was coloring pictures for the baby, talking about him and folding a handmade blanket over and over that my seven and six year old had made for him. For me it was cleaning, resting, eating a good meal and resting some more, going on walks, drinking herbal teas, watching the lunar phases and talking with my birth team. For my husband it was preparing the pool, helping with the kids and cleaning. On the morning of the third he picked up an early dinner for the two of us from our favorite Indian restaurant and when he came home, we sat down to eat. When I stood up, my water broke and we looked at each other with shock. It was 4:15 in the afternoon and this was it! 

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I texted and called the birth team, my family and our friend who was going to keep the younger kids. Gathering the kids, getting into more comfortable clothes and Gaute filling the pool up, I had quickly progressed to contractions that were 3-6 minutes apart… deep, piercing and I would soon have to stop and go into a separate room to cope quietly as the friend arrived to bring the kids to her house. Anelyn stayed with us and I just knew that the baby would be born within a couple of hours. The midwife, Bethany, my friend Amber who's a doula and photographer and a midwife's assistant arrived soon after I had texted. Shortly after they arrived and checked on the baby, I got into the pool to labor through the deeper contractions. So close. 


The sun was going down, the water was warm, as the contractions came, in my mind I whispered and thought comforting and peaceful thoughts… ‘This is good, it's okay, I'm okay, this is good, I love you, baby, you're doing it, I'm doing it, you will be here soon, breathe, he'll be here soon.’ I said that it would be, ‘Just a couple more contractions.’ Sure enough, two more contractions and he was presenting, I reached down and pushed 1,2,3 and he was in my arms. I just wept and wept... It was 6:04 pm and he was in my arms, so perfect and peaceful. I wept a tears of joy and pure shock that I was gifted such a beautiful and empowering birth, I looked at my husband and his face was glowing with tears, my daughter was leaning over to get a look at her new baby brother that she prayed for, a dear sweet baby to love. The birth team surrounded us with love, supporting, documenting, celebrating and serving so peacefully. This was the Birth of Ezra.

Thank you for your powerful and inspiring work and allowing moms share our stories.”

Rockstar Mama: Christan R @mommareveur 

Awesome Photographer: Amber Rhodes IG @amberdenaephotography and @amberhodes 

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There are so many wonderful ways to transform fear so common today, and have a beautiful empowering birth at home, in a birthing center or hospital. Excellent childbirth education and preparation in advance are crucial, and a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want. 

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of having a birth of your dreams is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.

  “Anne Margolis was my incredible midwife. She is practical, science-based, and vastly experienced, but most importantly, she’s an awakened woman here to light the path to your most joyful self. Anne is the incredible midwife who taught me, through this process, how to midwife my own patients’ rebirth experience. Her own educational course is a deep but manageable dive into her accumulated wisdom, packaged for your journey. Forget your childbirth class, and take steps to your most empowering experience. If you are thinking about conception, pregnant, or love someone who is, take it from me that her wisdom is life-changing.Yours in the truth.”    — Dr. Kelly Brogan MD

“Anne Margolis was my incredible midwife. She is practical, science-based, and vastly experienced, but most importantly, she’s an awakened woman here to light the path to your most joyful self. Anne is the incredible midwife who taught me, through this process, how to midwife my own patients’ rebirth experience.
Her own educational course is a deep but manageable dive into her accumulated wisdom, packaged for your journey. Forget your childbirth class, and take steps to your most empowering experience. If you are thinking about conception, pregnant, or love someone who is, take it from me that her wisdom is life-changing.Yours in the truth.”

— Dr. Kelly Brogan MD

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!

I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.

 

Things You May Find At Your Midwife's Office

 

The list below shares with you 15 wonderful things you may find during prenatal care visits with midwives, especially those who practice in relatively small group private practices, out of hospital - in free standing birthing centers and home settings across the United States. Other countries may have slightly different models, but authentic midwifery practice shares many common core philosophies of care, so I suspect there would not be much difference.  They are:

  1. Time – as in actual time for connecting and developing a relationship with your midwife; so that you can ask your questions and speak about your concerns. Time for the midwife to ask you the questions she needs to make assessments about your health and wellbeing, so she can best guide and support you.

  2. Continuity of care - the midwife (or one of the 1-2 partners, if in a small group practice) you see during your prenatal visits will most likely be the midwife who attends your birth.

  3. A big heart - your midwife will give you every ounce of her heartfelt knowledge, expertise and care for you and your baby. You may just feel so close with your midwife after a while, she is like your best big sister or wise friend, and her office is a safe space for you to share, laugh, or cry about anything.

  4. Education - your midwife will teach you and your loved ones about your body, what’s happening, what to expect along your childbearing journey, and what you can do to make it easier, healthier, more positive. This includes diagrams and models of pregnant moms and babies, placentas, umbilical cords, membranes and pelvises. Your midwife might just have a mirror for anatomy lessons of your own body if you are interested....like in seeing your cervix.

  5. Tea and healthy snacks for everyone.

  6. Inspirational quotes, affirmations and art about pregnancy, giving birth, breastfeeding, baby wearing and parenting.

  7. Pictures of graduates on the wall and/or in photo albums.

  8. A collection of thank you notes and birth stories (I call them love letters) in collages and/or scrapbooks.

  9. Midwifery and holistic health text/reference books and a lending library of books and movies on pregnancy, natural childbirth, breastfeeding and newborn care.

  10. Enough seating arrangements for the whole family and even some friends, as well as toys and books for the little ones.

  11. Hands - your midwife’s hands are skillful both in their assessment AND the supportive touch they offer.

  12. Tools - all the supplies and knowledge of how to use them, that could possibly needed for your journey. These include equipment such as blood pressure cuff and stethoscope, fetoscope, Doppler and gel for checking baby’s heart rate, scale, measuring tape for assessing the height and growth of your uterus, and lab supplies for checking your blood, urine, screening for infection and pap smear AND so much more! If she uses an exam table, the stirrups will be covered with oven mitts, and it will probably have a nice comfortable and decorative sheet and pillow on it, with a stool for climbing up and down or for the little ones to be involved.

  13. A boutique, where you can buy needed items like supplements and natural remedies, books, affirmation cards, birth kits, and rent a birth tub.

  14. Office and birth assistants - your midwife may also have students, apprentices, and even have a doula or two to choose from; she may have space to host childbirth classes, pregnancy and postpartum support groups, prenatal and postpartum yoga, parenting groups and all sorts of relevant helpful workshops and community events.

  15. Needed medical and midwifery knowledge and clinical skills; and she will also be familiar with and use a variety of holistic, alternative and natural modalities that can help you during and after pregnancy, birth and beyond.

As you go about choosing your midwife and planning for your birth, you might want to ask yourself what is important for you from the above list. Does your midwife or obstetrician offer some of these things, or what you feel you want and need?  Start writing down your questions and your preferences now in a journal, so when you meet her - you have them handy. My online Love Your Birth course will not only help you prepare for having optimal health in pregnancy and beyond, but will also help you to hone in on your own inner calm, joy and strength, as well as empower you with ways to speak your voice, and ideally avoid unnecessary interventions, medications or surgery. It will guide you get clear on what you really want, and make informed decisions given all your available options.

 

Healing VBAC Birth Story

 
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“My first birth was a natural birth gone wild - my sons leg came out after 24 hours of natural labor - - so this VBAC was soooooo healing for me!!!!

I still cry thinking about both births!” Kimberly Spair of Reclaimers of Health

Here is a glimpse into my birth story, written by Birth Doula https://philadelphiabirthdoulas.com/ 

VBAC baby girl arrived on November 9 after 48 hours birthing!! (Vaginal birth after cesarean!) Past her October guess date it began November 7 at 8 pm and after exactly 48 hours of unmedicated birthing, Hypno-baby Braelyn Mae arrived our world at 7:55 pm naturally at 9 lb 4 oz. After over a day of consistent pressure waves (contractions) exhausted still at 4cm, mom released her emotions and fears about a repeat cesarean. Her first birth was scary and traumatic. She expressed her fears and replayed trauma of her first birth with us. We honored her, we reminded her that this is a new beautiful birth, and that she was doing it.

Birth was filled with beautiful intense emotions, physical challenges, consistent counter pressure, and mom continued to change positions, in and out of the birthing tub, using her natural instincts and accepted every suggestion to birth her baby. Mom pushed for 4-5 hours and then her moment was here… she reached down and their beautiful baby girl was in her arms.

“Fear is what got me through. I was MORE afraid of a c-section and more trauma. My birth was extremely hard-but not traumatic! I guess I can say “old fear” because I had very little fear of going naturally.” She shared and released her fears with us although what WE saw throughout her entire birth was fear that she overcame with COURAGE, STRENGTH, DETERMINATION, AND CONFIDENCE.

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It was an honor and joy to be part of this special family’s beautiful birthing. They mean so much to me. We were fortunate to have a calm, supportive environment and to work with an incredible midwife. All birth is beautiful, all birth is unique. Going on 6 years as a doula this birth experience was truly unique to any birth I’ve had the opportunity to support. I can’t possibly describe this 2-day birth in an announcement. One strong mama! Mama, You inspire me and I thank you for inviting me in to be a small part of your pregnancy and birthing journey. So proud of you. You did it! Thank you for sharing your birth as I know you inspire many other families. Congratulations to a very special family of four. #VBAC #Hypnobabies #unmedicatedbirth #VBACaccomplished #VBACthat #wowbirth #ilovewhatidoula

Was your birth upsetting or traumatic? Do you have more questions about processing your birth and need help healing? Arrange some time to chat with me. I’d love to answer your questions and help you heal and get yourself back - I have a program specifically got you, that can also include this revolutionary and last natural healing modality called Clarity Breathwork.  Helping women heal from birth trauma is one of my passions and areas of expertise. 

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This is why excellent childbirth education is a must, why planning for your birth is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want. 

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of preventing birth trauma is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.

In looking for that supportive birthing space I talked about earlier, seek care providers and settings that have a low intervention rate (low rates of medical interventions like inductions and epidurals, low rates of cesareans, etc.)—their practices are more likely to be in line with your goals.

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!

I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.

 

Understanding Epidurals and the Benefits of a Natural Birth

 
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We’re discussing the pros and cons of epidurals! What is their place in the medical world and should they be as commonplace as they are?

Modern medicine today encourages epidurals like water. This doesn’t make epidurals inherently bad - they are simply being misused and overused. It is time we tell the truth about epidurals. Physician, neonatologist and researcher Dr. Michael Klein, points out in his three part Science and Sensibility blog analysis of the evidence

on epidurals, “Women need to be accurately and completely informed of their choices for pain relief in labour before they can provide their true consent. No matter how well intended, epidural analgesia increases the likelihood that women will have a variety of other interventions, especially if the epidural is given without specific medical indications….When used routinely as a first line agent, epidural analgesia can create problems that could have been avoided.”

Epidurals can be literally life-saving in a dire situation when a cesarean birth or medical induction of labor is needed, and there are times when they are indeed warranted, but there are serious concerns about their use in a childbirth process that is proceeding normally and healthily - when their risks outweigh their benefits.

I will hopefully give you an enlightening look at the different sides of epidurals, including the situations when they are very necessary. You making an informed decision for yourself, is what’s important here. But do your research.

Learn more about the intricate process of labor and delivery, as well as what your mind and body are doing during each stage, the purpose of its sensations and how to best cope with them. I go into this thoroughly in my online Love Your Birth course. The more you really understand what is going on, the less you will fear it, the more you will trust and lean into it. And know your strength and capabilities. You’d be surprised at what you’re able to withstand and overcome!

It is crucial to prepare for coping with natural labor, even if you think you will want or need an epidural, as you will still have to experience parts of labor, it is not always an option depending on your health history, the anesthesiologist does not often come right away, and the epidural does not always work adequately.

How do Epidurals Work?

An epidural is an injection of a large needle in the lower back that pierces the covering of the spinal cord. Medications are injected through a tiny catheter threaded through the needle, into space surrounding the spinal cord and then they infuse the nerves nearby. These medications consist of usually a regional anesthetic and an opiate.

The anesthetic drugs temporarily block the sensory nerves which usually create the numbing and this, in turn, inevitably blocks the motor nerves with some degree of paralysis. The opiates are included because they increase the effectiveness of the anesthetic, allow for less dose required, while working to decrease the blockage of motor nerves at the same time.

The Cons

The true downturns of using an epidural occur in a birth that is perfectly healthy and normal are many, according to the research. This will then lead to a cascade of other risky and dangerous interventions just by taking a drug in which there was no need in the first place. In fact, epidurals increase the risk of requiring a C-section, especially when given too early - but there are plenty of other reasons for this.

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According to Dr. Kelly Brogan’s research, there’s been a 60% rise of C-sections since 1996. A study has shown that a prolonged second stage of labor is the main reason for most C-sections. This prolongation can be directly linked to the use of epidurals, for many reasons, including a mom’s decreased ability to push effectively and her needing to be in supine positions that make birthing more difficult, as it goes against gravity and pelvic capacity is at its smaller dimensions.

Related: The Unnecesarean Birth Story - How It Might Have Been Prevented

What happens after this prolonged stage? A myriad of interventions to “help” induce the birth: “food and drink restriction, immobilization, IV fluids, bladder catheter, medications to augment labor, and continuous monitoring.” All of these will only encourage the need for even more intervention, like vacuums, forceps, episiotomy and increased probability of more severe perineal tearing into the anal sphincter and rectum, or major abdominal surgery. All medications, invasive interventions and operative deliveries risks birth trauma and injury to the baby as well as the mother.

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Epidurals prolong all stages of labor. They increase the incidence of fever for mom, which leads to IV antibiotics in case of infection that most likely is non-existent. Antibiotics disrupt the microbiome and lead to all the associated health risks of interfering with the healthy balance of bacteria within the body for both mom and baby. It can also lead to signs of fetal distress, which then lead to other interventions from needing oxygen to emergency surgical delivery.

This drug administration does upset the normal hormonal balance during labor. While the very nature of an epidural is to alleviate at least some of the pain and so easing a good chunk of stress, some stress during labor is actually quite good for both mother and baby.

Cortisol (the stress hormone), for example, lessens mom’s exhaustion; it gives the mother energy to push, and heightens her euphoria and sense of excitement—a big part of the natural birth experience which we’ll get into a bit later—and this euphoria actually increases bonding with the baby. For the baby, the healthy “stress” of being born turns many biological processes on during the whole birthing process, like the breathing instinct at birth, which eases transition to adjusting to life outside the womb. No surprise that babies may need more assistance to breathe.

There are so many effects that also take place in the aftermath of the birth since an epidural is a narcotic that’ll pass from mother’s circulation, through the placenta into the baby’s bloodstream.

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Evidence supports risks to the baby from epidurals, that include reduced muscle tone, poor feeding, jaundice, withdrawal, and sensorimotor impairment. Epidurals have been linked to failure to establish breastfeeding and this is not to be taken lightly, as breastfed babies have much healthier outcomes and less health risks than formula fed babies. Newborns also can get a fever and increased heart rate from the epidural, without having an infection, but separation from mom and extensive work-up in the neonatal intensive care unit ensues for evaluation, including blood tests, spinal tap, and precautionary IV antibiotics.  Renowned childbirth educator Penny Simkin highlights that “epidurals can result in short - term subtle neurobehavioral effects, such as irritability and inconsolability and decreased ability to track an object visually or to shut out noise, bright light. There are no data on potential long-term effects....Decreased infant responsiveness may lead to long-term consequences for the parent-infant relationship... (risking) labels of “difficult child” or “incompetent mother” (self imposed or by others).” 

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The mother can experience some annoying but distressing side effects - mostly from the medications entering her bloodstream and/or administration error, like itching, nausea, shivering, spinal headache, residual numbness, tingling and weakness, backache, as well as alarming side effects, like difficulty swallowing and breathing, rare permanent nerve damage, convulsions, respiratory paralysis, cardiac arrest, and even death. Evidence based care expert Henci Goer points out in her ongoing evaluation of risks and benefits of maternity care, that epidurals cause, “Somewhere between 1 in 1,400 and 1 in 4,400 women to experience a life-threatening complication.”

This is some very scary stuff! And yet, epidurals aren’t so much the problem as are our society’s tendencies to consider them such a benign and advised common practice for the majority of laboring women.

Epidurals necessitate hospital birth, and eliminate the home and birth center option, which are associated with better health outcomes physically and emotionally for mom and baby, when it comes to low risk healthy childbirth. Dr. Klein poignantly elaborates on the concerns that epidurals have medicalized birth so much so, that they increase the demand on the nurse to pay greater attention to the technology of all the resulting interventions, and consequently have less time, experience and skill to provide needed hands-on and emotional support for the laboring woman.

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Disruption of the normal hormones of labor with epidural use can cause the laboring mom to feel detached from her own childbirth process and to becomes more of an observer than a participant. Studies indicate that women who had an epidural may have had less pain, but were most dissatisfied with their experience even up to a year later. The provider and nurse can no longer assess labor progress by observing the mother and must rely on the monitor - which makes the experience more impersonal - and vaginal exams - which are invasive and increase risk of infection. Use of epidurals and the anesthesiologist alone raise the cost of care, and it increases exponentially with the cascade of hospital interventions that result.

So, when are epidurals medically appropriate? In an urgent or concerning health situation when there are serious complications, but not in a normal, healthy, natural birth. They can be also psychologically appropriate, in individual cases.

The Pros

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One of my founding philosophies in helping women to have a safe, healthy and transcending birth experience is that a birth (of any kind, in all settings!) isn’t a medical procedure—it’s a natural and miraculous process of life. It’s not in and of itself a dangerous crisis.

That being said, I’d like to affirm that an epidural has its place in childbirth.

When a labor isn’t proceeding normally, when there’s a prolonged or arrested labor or the mother is experiencing exhaustion, extreme pain and/or anxiety, the compassionate use of an epidural could be the answer, and can enable her to relax, rest and progress to vaginal delivery. There could be a real medical need for medications to help induce or augment labor, which make labor sensations much more painful.  As a last resort, an epidural can help relieve the pain and stress from an emergency situation.

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A woman suffering from preeclampsia, for example, who receives an epidural anesthetic, will likely not have a prolonged second stage of labor. Epidural tends to lower blood pressure, which is a benefit in cases of hypertension.

An epidural could also be an advantage during a major operation like a cesarean;  in most cases, it carries much less risk than general anesthesia and is a great alternative to being unconscious from the high doses of those medications.

Epidurals can provide relief or reduction of pain without impacting mother’s mental state. Since birth by C-section is still a birth, an epidural can help the mom stay fully alert and pain-free during this operation. She’ll be involved, fully capable of holding and bonding with her baby even after a C-section operation, as opposed to being put out from a general anesthetic.

Keep in mind that I’m speaking of C-sections that are necessary because of endangering complications and serious issues. This is not the same as C-sections that are caused by epidurals themselves like we spoke about before. Cesareans in and of themselves are supposed to be the last resort, and indicated for serious life threatening health problems —the fact that we have them more and more often in America and that they are treated as a normal procedure during a labor is a sore reflection of our society’s ideas of pregnancy and birth.

Related: How to Plan, Have, and Rock Your VBAC

How do You Prepare for an Epidural-Free Birth?

 Photo by @senhoritasfotografia

Photo by @senhoritasfotografia

Not only is a natural birth the healthiest way to go but science is more and more discovering ancient truths about birth.

The women who come to me want to have their pregnancy and labor in their own way and they don’t want to numb themselves to the healthy and normal sensations of giving birth. It is, in fact, your own birthright as a woman to have this right of passage into motherhood. The women I work with want to feel that empowerment and the high of successfully bringing their child into the world on their own.

Understanding what your body is capable of can begin to give you the confidence you need to begin planning your natural birth. My Love Your Birth course can help you prepare for the entire process from beginning to end. You’ll equally learn how to cope with and handle labor pains...so much so that you can love your experience no matter how challenging. The right preparation really begins with a shift in mindset, not just about labor but in what your body is capable of doing.

“In labor, such high-levels [of beta-endorphins] are released and help the laboring woman to transcend pain, as she enters the altered state of consciousness that characterizes an undisturbed birth. In the hours after birth, elevated beta-endorphin levels reward and reinforce mother-baby interactions, including physical contact and breastfeeding as well as contributing to intensely pleasurable, even ecstatic, feelings for both.” -Sarah Buckley, MD.

 Photo by @senhoritasfotografia

Photo by @senhoritasfotografia

My rate of successful women having natural births is 93%--the other 7% of cases had complications that required medical attention or surgical intervention. But, in over two decades practice as a homebirth midwife, I’ve never once had  transfer a mother to the hospital for an epidural or any other pain medication because she couldn’t cope with sensations of normal labor. Never once! It is not that women who come to me have different bodies. It has more to do with how well they prepare themselves in advance, their attitudes and mindset, and how they are cared for and supported during birth.

Women are able to do what comes naturally when they are prepared, supported and encouraged to follow their own desires for their birth. Women have been giving birth naturally around the world since the beginning of time. Today we interfere more with it, and sometimes we get in our own way. Have faith that your body and nature both have your back—they were designed to know what to do! We just need to step aside. That takes advance preparation in the modern world, as well as care providers and settings that will have the same philosophy and expertise.

The physicality that is required to give birth has been compared to the performance of an endurance athlete! There’s an inherent strength in every woman to go beyond what she knows herself to be capable of. And when she does that, she is darn proud of herself; she has discovered her strength and capacity she can draw on for the rest of her life.

Learn as much as you can about what that is, about yourself and your body. The pride and joy that a woman experiences after giving birth naturally is overwhelming. So many mommas are overcome with their own capability to bring their child into the world.

Don’t deprive yourself of the sensations and transcending experience. You are able and you are supported!

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I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby. For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)! I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here.