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Letting Go: Dying To Birthing - The Key To A Very Real First Time Mama's Homebirth Story

 

My birth story is currently gathering a lot of attention, specifically around my thoughts on home birth, and the rawness of what I learned about myself.

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Disclaimer 1: This was my first pregnancy and birth experience. I say this because I know my feelings around my journey are so much a reflection of it being my first time.

Disclaimer 2: All birth is birth, and all people who birth babies are badasses. I chose a home-birth experience because it most reflected the journey that *I* wanted to have, based on my personal value system. Please don’t let my passion for home-birth make you feel that any other path is not as powerful.

Disclaimer 3: Don’t let my story shape your narrative of birth. Every birth is different, and pleasurable births are possible. In fact, here’s an interview I did about Orgasmic Birth just days before I went into labor. I believe that some mothers manifest the birth experience they need for whatever lesson they are walking at that time. I believe God is reflecting back to her in those moments the things her heart most needs to look at. For those that could use healing in regard to their birth stories, I highly recommend a Birth-Processing session with my midwife, Tiffany Hoffman, through Alchemist Movement's healing sanctuary. 

Disclaimer 4: I was blessed with a healthy pregnancy, and privileged with access to healthcare and a steady income, and this is what made me successful in my home-birth dream. Even though home-births cost about $10,000 less than hospital births (and that's without a C-section), they are rarely covered by insurance. I hope my story helps spread the gospel of birthing at home.

Act I: The Mind Fuck (36-40 Weeks Pregnant)

36 Weeks: You feel like an expert in pregnancy but a complete novice in labor/birth (for first time moms, at least). At this point in my journey, because the impending labor just didn’t seem real, the whole thing felt like an exam I was studying for but that there was a chance I might get out of. Like, you’re nervous for the test, but also the Professor has shared he might just cancel the finals and base your final grade on your most recent paper, or something.

39 weeks: The reality of your birth, which absolutely no one knows how it will unfold, is definitely just around the corner. Because I was planning a natural birth and natural induction, the whole thing just felt like a surprise party that I accidentally found out about; I knew a party was happening, but I didn’t know when or where. So every corner I turned (every strange feeling), every time I walked in the door (every new pain), I’m like, “Is this it? Is it happening now?” And then it’s not, and the mind fuck just continues. You know you’re at the end, but also you’re still going...

40 weeks: “The Surprise Party” is now all the time. Basically everyday I was sending group texts like, “IT’S HAPPENING.”... ”No wait sorry no it’s not, my bad everyone.”...  “OK NOW FOR REAL!”... “oh shoot sorry no it went away sorry.”

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Act II: It’s Really Happening (Labor begins)

On Monday of my 40th week, I kept thinking my water broke because I was constantly leaking fluid due to incontinence (#LoveRealLife). There are these swabs that test for amniotic fluid, and my midwife gave me a handful of them to take home because it just kept happening. (Did you know that only 8-10% of women’s waters actually break in early labor? Most don’t break until right before the baby comes out. The idea that water breaks early is just an overused Hollywood trope!) The reason it was important for me to know whether or not my water was still in tact was because I had tested positive for GBS (1 in 4 women do), and, in the case of my water breaking, I had 18 hours (or something like that) to get the baby out in order to keep his risk of infection low.

I went through several false swabs throughout the week, then...Friday morning, February 9th, at 8:30am I went to pee and felt a little rush of fluid. At this point I had every expectation of another false result, when suddenly, the tip of the swab turned a vivid blue/black. My heart did flip-flops. I texted a picture of the swab to my midwife, and within seconds she wrote back, “Yep. That’s a positive swab. Your water has broken.”

A strange mixture of both calmness and adrenaline washed over me. It’s really happening, I thought.

I walked out and told my husband that my water broke. We both felt grateful that our baby decided to begin his journey on a Friday, giving us a 3-day weekend to capture the experience (it seriously could NOT have been better timed).

Typically, labor starts naturally within 12-24 hours after your water ruptures. My birth team and I decided that if my labor hadn’t started by 6pm that night, I was going to drink a “castor oil smoothie” (a natural way to induce labor at home). I texted all my friends and we decided to have a “castor oil smoothie party”. I was nervous because I really wanted to let my body progress naturally without the smoothie, but I was also ready to get the show on the fucking road.

I went about my day as normal. I even got a text from a producer I work with a lot, and she needed me to record a voiceover for the film we had been working on. I wrote back, “No problem. My water just broke, so send me the script within the next couple hours and I can knock it out.” She replied, “Can I please screenshot this text and send it to our client? You’re fucking insane.” To which I replied, “No, I’m dedicated.” But also, early labor can be mentally brutal, so having normal things to do was always a part of my plan, anyway.'

I did the voiceover. I went for a walk with my husband. We kept having these mini existential crises like, “Babe. This is our LAST walk as a family of two. Next walk we take there will be a BABY.”

At 6pm, all my friends had gathered for our castor oil smoothie party. We had pizza and donuts and were ready to rock out in my living room. Then...the midwives showed up. Another mama had gone into labor, and they asked me to NOT drink the smoothie, because it can speed up labor REALLY fast, and they can’t be in two places at once. So, they ran a few tests on me (checked heart rate of baby, took my blood pressure, and gave me an IV of antibiotics as a guard against any infection from the GBS).  

The new plan was that they were going to rush off to the mom currently in labor, and then text me at midnight; if my labor hadn’t progressed by then, I was to drink the smoothie at midnight, giving them enough time to take care of that mama, and then get back to me.

I felt bad, like I had ruined my friends’ plans (this is a theme that would come up majorly throughout the next 22 hours). BACKSTORY: My midwife had been emotionally preparing me for 6 months, “You labor as you live,” she would tell me. What does that mean? It means that whatever emotional battles you fight in your life, THEY WILL ARISE TO THE SURFACE DURING A NATURAL LABOR! This is why having a natural labor was so important to me -- because it presents one of the most powerful opportunities to heal yourself of old patterns and wounds. It sets the space for absolute, total self-awareness and alchemy to occur. For me, that meant people-pleasing and trying to control everything, and then feeling really bad when I couldn’t. More on that later, though.

My friends, being the amazing humans they are, obviously didn’t care. We hung out and ate junk food, and my doula taught us some belly dancing moves. So, there we were, a bunch of girls, gays, and a pregnant chick, belly dancing in early labor on a Friday night. Around 10ish, it was clear that a baby wasn’t coming any time soon (contractions hadn’t even started yet), and so my friends went home, and I watched the clock, waiting for midnight and preparing my smoothie.

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At midnight, my midwife texted me, “Almost done here. Go ahead and drink the smoothie, if it feels right.”

IF IT FEELS RIGHT -- those words seemed to stick out in bold on my text screen. Why did she text “if it feels right??” I wondered.

So I asked, “Why did you say, ‘If it feels right’?”

“Because you don’t have to drink it if it doesn’t. Does it?” She asked.

NO. It didn’t. It didn’t feel right. And I’ve never in my life, even as a professionally trained psychic (whatever that means, right?), *heard* something as clear as the “no” I got when I read her text. And this is why I am and will always be so in love with Tiffany Hoffman, my midwife, because she also listens to the Universe, and she knew to text me that.

I wrote back, “It doesn’t feel right.”

She said, “Great. Don’t drink it. Try to get some sleep. See you soon.”

The house was quiet. My friends were all gone. My husband was sleeping. I felt depressed because I JUST wanted to GET THE SHOW ON THE ROAD. But I couldn’t deny that “no” I felt/heard. It was just so...loud and clear. I went and laid in bed. There was no way I was going to fall asleep. What’s going on in there, I wondered to my baby.

At 12:30am my bff, whom I lovingly call “Wifey”, texted, “What’s going on?”

“Nothing, really,” I answered. “All the sudden I just got these really bad period-like cramps. I’m just laying in bed in the fetal position.”

“Be there in 10,” she shot back. She showed up a few minutes later with a heating pad. We went to my living room and I laid on the floor as the period cramps got worse. I was in the fetal position and she was cuddling me. Just typing this part of the story is making me super emotional. I’ll never forget that hour, just her and I on my floor. I texted my doula who showed up around 1:30am. My bff went to lay down in my bed to sleep, and my doula took over cuddling me on the floor, rubbing my head, talking to me about what was happening. The pain was gnarly, so my doula texted the midwives and said things seems to be progressing rapidly.

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The midwives arrived around 3:30am, I think. They had spent all night at that other birth. I texted my friends and told them to come back around 6:30am. My plan (which is laughable now) was to have all of my tribe present when the little King made his entrance. I had also made a private facebook group from which I was going to broadcast my labor live. Over the course of my final month of pregnancy, that group had grown to about 60+ people, all friends and family near and far. Again, my intuition screamed at me, “Don’t do it. Don’t broadcast this to that many people.”

I had been watching live births on a Facebook group called “BirthTube” for weeks, and felt really attached to the idea of letting all my favorite people be a part of this experience in such a modern way. But no, my insides were telling me not to. So, in the middle of a contraction, I created a new group with only a few people in it (parents, my husband’s family, and a couple of important friends that I really just wanted there). I also insisted on no one even knowing I was in labor, and flipped out when I found out my husband had posted in a small, private theatre group that my water had broken. For whatever reason, I could suddenly *feel* the energy of people thinking about us, and I then understood why mammals seek privacy when giving birth. I went from wanting all of my loved ones to know things had started, to not wanting anyone to know until it was over.

My mom, who was 3 hours ahead of us in Ohio, called me and said Azlan had come to her in a dream. That it was super real and that she had even seen his face. She said in the dream she was showing him off to our family, including my great-grandmother Orpha, who I’ve had an extreme psychic connection to since I was a baby (including talking to her in my dreams as a very little kid, and knowing things I couldn’t have otherwise known). My mom said in the dream I was walking around looking for donuts to eat, which was hilarious and validating because I was absolutely walking around eating the donuts my Wifey had brought over the night before.

5am: I got into the birth tub in my living room for the first time. You’re supposed to wait until the last minute to get into the tub, when you can’t handle any more pain,  because it provides so much relief. If you get in too early, it can make it less effective later. I was so convinced that I was so close to the end at this point and wanted to be in the tub. (More backstory: in 2009, when I met the man who would become my husband, I had a vision of a waterbirth in a living room, with him sitting behind me. This was before we were even together. This psychic vision was so intense that it actually made me go, “Hmmm...well, he IS kind of cute. I could see him being my babydaddy.” That vision then created the crush that then made me pursue him.) So, needless to say, I was convinced this is how my baby would be born, and I wanted in that tub.

While I was in the tub, my friends had the MOST INCREDIBLE jam session. They were playing worship music, and my favorite singer in the whole wide world was belting out my most favorite worship songs while my husband played piano. Then they had a drum circle, which was amazing to hear while in labor, and really helped me to tap into Earth energy. This whole part is so fuzzy to me, and I remember not being able to look at my friends because I felt so self-conscious. Turns out I only like the spotlight when I’m in absolute control of everything happening under it.

7am: I was antsy and annoyed that “nothing was happening”. I felt like I was disappointing people, that I was “taking too long”, that I wasn’t performing, that my friends were bored, that my birth team was annoyed. I was more worried about being a good host and was absolutely incapable of tapping into my own needs and focusing on myself. (Are you seeing now how all of my personal issues were arising in my birth, full frontal, completely raw. It was impossible to not be aware of them). My midwife 10000% warned me this would happen, and so I knew in my heart what was going on inside me. 

My birth team suggested that I get out of the tub and sit on the toilet for a while. By this point some back labor had started and I was miserable. It fucking hurt to sit on the toilet, but also I could see how SO many women give birth on toilets because of the muscle memory that comes as soon as you sit down. Like, I had so much trouble relaxing my pelvic floor and “letting go”, even in the tub, but the second I would be on the toilet, I felt comfortable relaxing “down there”. But also it fucking hurt to sit on a hard seat.

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I want to take a moment to talk about my doula, Allison, who was the most amazing thing to happen to my birth. I would never have another baby without a doula. I called her my shepherd, since that’s exactly what she was for me throughout my journey. While my midwives were busy charting and executing their medical role, and my friends were just trying to hold space, my doula never left my side (unless I asked her to). Every time I peed, every time I changed rooms, every time I cried..she was right there, affirming me, telling me stories of  other births, promising me over and over again that the pain would stop the very moment the baby came out.

At this point, I hadn’t been measured yet, and didn’t know how far along I was. Part of going the midwife/homebirth route is that they are very hands off. It’s all about trusting your body, trusting the mother, and trusting the baby. The medical reasons for not checking for dilation are because it GREATLY increases chances of infection (especially in cases where the water has already ruptured). It’s actually kind of crazy that this practice has become normal in hospitals because the research is all there of how much more risk it creates. The psychological reasons for not checking is because it can really put the mother in her head if she’s not “as far along” as she thinks she “should” be.

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But by this point I was going a little crazy and needed to be checked...for my own sanity. Again, the midwife journey is about honoring WHAT THE MOTHER WANTS, and guiding her to have autonomy in her choices. So, though many midwives discourage checking the cervix, when I was clear about wanting it, I got it. I decided that if I was anything less than 8cm dilated, I was going to send my friends home. So, my midwife checked me, and the result was 6cm. I started crying and finally admitted that I needed my friends to leave because I just couldn’t surrender. I am a people-pleaser, and a control freak, and there was zero chance I was going to be able to tap into my primal nature with anyone watching. I asked my doula to go tell all of my friends (except the one who feels like my big sister) to leave while I cried in that bathroom, grieving the loss of the birth I had so carefully “planned” in my head.

9:30am: They suggested I try getting into bed. Again, I had a ton of emotions around this not being a part of my “plan”. My beautiful, wonderful midwife took it upon herself to move all the “affirmations” I had taped up in my living room to my bedroom. I hated those affirmations at that moment. “Fuck the affirmations,” I kept thinking. The only thing good about this part are how beautiful and raw the pictures are from my husband and my doula in bed with me.

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10am: I made Tiffany check me again, I was 8-ish cm.

11am: I tried to overcompensate for the guilt I was feeling about how long this was taking by showcasing a suddenly fresh and invigorated attitude. It became clear that the baby’s position was not great. He was head down, but the awful back labor and slow-ish progress also indicated that he may be mal-positioned. Luckily for me, my doula happened to be familiar with something called Spinning Babies, which is ALL about creating better births by creating better positioned babies. My doula had told me I should be doing these exercises throughout my whole pregnancy, ESPECIALLY third trimester. Here I was, with probably the only doula in town with this knowledge, and I didn’t do it. I assumed that because he was head down that I was totally good to go. I regret that so much, and if I ever had another baby, I would spend my entire pregnancy focusing on this aspect. But it was too late now, so all I could do was try to do some moves in the moment, including deep lunges up my basement stairs, and a weird upside thing that hurt so bad I only achieved one.

12pm: The back labor was so bad at this point, I was so miserable. The ONLY thing that provided relief was sitting slouched on my couch. But here was the kicker: every time I sat like that, I undid all of the progress from the lunges. I literally had to CHOOSE to stop doing the one thing that was bringing me any relief. And here’s why midwives are the heroes of our planet: they never told me that I had to stop slouching. They only suggested it. I remember Tiffany actually saying, “You can keep doing it, we’re not going anywhere, but it is slowing your labor down. We support you no matter what.” Can you fucking believe that?? A doctor in a hospital would probably be like, “I’ve got a golf game at 4, so you need to hurry up.” But here was my birth team, letting me have my journey. I just don’t have words to capture how incredible, humbling, and boundary-pushing that was.

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1pm: My contractions stopped. WHY. GOD. WHY. Emotionally, I knew God was challenging me again and bringing up my people-pleasingness. It was KILLING me knowing that my midwives had come from an overnight birth. I knew they hadn’t slept yet. I knew that I had called them too early. I felt like I failed them, that I should have known I wasn’t as far along as I thought, and that they could have gone home to sleep after the birth from late Friday night. I kept begging them to go take naps in our guest room. And I kept apologizing that I was “taking too long”. I seriously was so triggered by this aspect. It was almost as unbearable as the physical pain. And no amount of loving affirmation from them that everything was fine would help.

Anyway, midwives can’t administer pitocin to stimulate contractions (outside of the hospital), so they used herbal tinctures and nipple stimulation via a breast pump, which are known natural stimulants.

It wasn’t working.

4pm: No urge to push yet and really pissed off about it. I was crying and begging Tiffany to “tell me when it would be over.” I felt like I could handle the rest of the journey if someone could just FUCKING TELL ME how much longer it would be! Even if someone was like, “You’ve still got 8 more hours of this shit,” I would have been like, “Awesome. Someone start the clock.” But not knowing how much longer I had was existential torture like no other. Was it 2 more hours? 5 more hours? 2 more days?!?! The physical pain mixed with the emotional distress of not knowing made me want to die. It was sometime around here that I asked for a gun so I could shoot myself. (Dramatic, I know. But I was NOT planning on this back labor, and I was NOT planning on it taking this long.)

At this point my lovely brother stopped by to take our senior dog for a walk. I remember that he walked in, and so casually and genuinely said, "You're still in labor?"

I. almost. murdered him. He will never live that down.

5pm: More lunges, more stairs, more resisting the urge to recline on the couch, more crying, more begging, more praying and pleading and bargaining with God. One thing that I swear worked is that I kept bargaining with my baby and making deals with him that if he wanted to be born at home, things needed to progress.

6pm: My husband took his third nap. I remember telling myself that I would be very supportive of him napping because he would need his rest and should seize it when he could, but oh my god I was SO FUCKING ANNOYED by this time and resented him for even being able to sleep at all. I’m only noting this because it’s funny and true.

Also, at the time, we decided to discontinue my IV. This was another moment of intuition where I could simply FEEL that I didn’t need it, and that my baby and I would be okay without it. Also, there was something about that contraption being lodged in my hand that was seriously holding me back. I can’t quite describe it but I felt so free when they finally took it out.

Asynclitic

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6:30pm: Midwife noted that the baby felt asynclitic, which refers to the position of a baby in the uterus, such that the head of the baby is presenting first and is tilted to the shoulder, causing the fetal head to no longer be in line with the birth canal. This would explain the excruciating back labor and slow progression.

7pm: I asked to go to the hospital. All the passion I had for having my baby at home was gone, and I just wanted it out of me. Despite there being absolutely no medical concern for me to transfer (heart rate, blood pressure, etc), I had so much fear that I just wasn’t going to be able to do it. My contractions had stopped. In my head I felt like I wasn’t progressing. And though the pain was insane, it was more that no one could tell me when it would be over, and I just wanted to give up.

Of course my midwives supported whatever I wanted to do, but they also knew I was fine, so they encouraged me to understand what transferring would mean, and I realized that it wouldn’t really solve any of my problems (as it was probably too late for an epidural, plus I would have to deal with checking in, etc). The idea of leaving the energy of my home and dealing with the energy of a hospital seemed absolutely impossible. My midwife actually bargained with me, which was a BRILLIANT move on her part. She said, “Let’s check you again, and see if you’ve progressed in dilation. If you have, we should stay.”

I loved that idea and started bargaining again with my baby. I prayed to God and to my baby, “If you want to be born at home, mommy needs you to have progressed past 8cm.”

I laid down to let her check me. I was almost 9cm. We were staying home.

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8pm: I started pushing, laying down in my bed, even though I didn’t really feel the urge to. Pushing laying down is literally the worst thing I’ve ever felt in my life and I cannot believe anyone has babies this way.

9pm: My contractions felt really inconsistent but I wanted to keep pushing. Pushing for that long and feeling like no progress is being made is absolute hell. At one point my midwife gave me a "focal point" of "where" to push by pressing down on my perineum. Not only did it actually feel really good, but also it helped IMMENSELY with the pushing. Highly recommend. I remember begging her, "DO THE FINGER THING AGAIN!!"

9:30pm: My husband and my friend are standing at the side of my bed, watching me push. I would push with all of my might, and nothing would happen, and it was so depressing. Then, one time I pushed, and while I personally didn’t notice anything different, my husband and my friend both GASPED at the exact same moment. They had just seen the head emerge at the very back of the canal. Watching them react was exactly what I needed. The only tragic thing was that I thought it meant I was so close to being done! Little did I know I still had an hour left of pushing.

Somewhere around this time, while pushing with all my might, my midwife reached inside and executed a “manual rotation” to try to get his head unstuck and in line with the birth canal. It was quick, and though the moment in general was chaotic, I 100% remember thinking it was the most badass thing I had ever witnessed. It was also what changed the game, and made the rest of my journey possible. I reflect on this moment a lot when thinking about how expert my birth team was, and how heartbreaking it is when “the establishment” does not take these women seriously. The brains, skills, and spirit it takes to be a midwife is very super-human, while at the same time is the essence of humanness. (If you haven’t seen my performance called “The Passion of the Midwife”, you can watch it here)

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10pm: I started squatting at the foot of my bed. This also hurt like a bitch, but it was so much easier to let go. I realized how much I hadn’t been letting go fully because I was afraid of peeing and pooping. Of course I was squatting over chuck pads, but there was still so much self-consciousness around this aspect. If you want to have a natural birth, I recommend practicing this somehow. 

Anyway, I somehow stopped caring, finally. Like, seriously stopped caring. I would grab the edge of my heavy oak-framed bed and PULL it toward me while simultaneously squatting and yelling, and fluids just starting flowing. There was blood and poop coming out, and my birth team would switch out those pads quick as lighting, and I never saw anything. But damn did it feel good! All the poop and blood meant we were close and it was the most motivating thing ever. It turns out the thing I was most scared of was actually the thing I most needed. Birth is so, so strange and beautiful.

Again, my contractions had stopped, and my team was constantly doing everything they could to get them going. My midwife said, “Your contractions stopping are a sign that you are tired,” (which made sense because I had been up for two days at that point without sleep). That scared the shit out of me. There was absolutely NO FUCKING WAY I WAS TAKING A BREAK. So, I lied, and said that they had started again. And every minute or so I said I could feel one coming out, and I’d bear down, squat, pull on the frame of my bed, and push, stand up, and repeat. It seemed like the baby wasn’t really making it any further down the canal.

10:28pm: I had just come up from squatting and bearing down. I remember my midwife said, “Ok, let’s take a little break,” or something like that. Whatever it was exactly, all I remember was yelling, “NO!!!!!!”, and with that I squatted down, and pulled on the frame of my insanely heavy bed. I remember thinking, I don’t care if I explode. I don’t care if I die, I’m not stopping pushing until this is fucking over. 

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Suddenly, I felt this burning. It’s called “The Ring of Fire”, and it’s the burning sensation felt as the mother's tissues stretch around the baby's head. (It’s very similar to sticking your fingers in your mouth to stretch your lips and pulling as wide as you can.) I yelled, “I FEEL THE BURNING THING!” To be honest, it felt really good in a really weird way, and for a SPLIT second I had a glimpse of what orgasmic birth must feel like. 

Tiffany said, “KEEP GOING!!” She was in her infamous squatting position, twisted, looking up inside of me from below. My husband was also laying on the floor on the other side, looking up, best seat in the house. (He was so cute, not afraid of absolutely anything the entire journey. The midwives even commented on how grounded and calm he was the whole time.)

The poetic thing about birth is that you have to die. Like, you get to this moment where you are SO over the pain, that you legitimately no longer care if you die pushing the baby out. You just want the pain to stop, so you push until you die. You split open, you let go of everything (literally) and you pray for death. And then BAM. In a single MOMENT the excruciating pain just...stops. It’s not gradual; it’s sudden. The pain is just over...and there...is your baby. The death becomes life.

The moment that my death turned into birth was accompanied by a *splat* that I’ll never forget. Mr. Azlan Rey Taglieber did not come out gradually, as I had seen in so many birth videos, where the baby crowns slowly, and gently just fallllllls out. Nope. Not Azzy Rey. He came out in what can only be described as a quantum moment. And just as my doula had been promising, with that splat came instantaneous relief. I remember my midwife catching him like the true professional she is and handing him up to me, bent over at the side of my bed. The next thing I remember is her yelling, “SHORT CORD, DON’T STAND UP!” So there I hunched, holding this THING in my arms, and mumbling, “It’s over. It’s fucking over. I did it. I can’t believe I fucking did it. I did it. I did it. I did it myself.”

When the cord situation was handled, they laid me on my bed and covered Azlan and I in blankets. He never cried. Not once. I remember he was lying belly down on my chest and at one point he lifted his head up and scanned the entire room, looking everyone in the eye like the freakin’ Terminator or something. It was psychedelic and wild.

The moment he was handed to me.

The moment he was handed to me.

This is me looking up at my bff and whispering, "It's over. I did it." You can STRAIGHT UP SEE those #OxytocinVibes in my eyes.

This is me looking up at my bff and whispering, "It's over. I did it." You can STRAIGHT UP SEE those #OxytocinVibes in my eyes.

The most beautiful, candid picture of my husband the moment he became a father.

The most beautiful, candid picture of my husband the moment he became a father.

Everything from there was a blur. The oxytocin rushed in, and while the midwives did their thing (which was beyond fascinating to see) I remember staring at my bff Heather at the foot of my bed, and she was crying (and snapping these amazing photos), and I kept whispering to her, “Mama, I did it. I did it. He’s here. It’s finally over. I did it.”

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They had me “birth” my placenta, which I never remember learning ANYWHERE in all my education. It’s the most wild, sensational feeling. Like birthing jello. They properly cared for it so that it could be made into placenta capsules by this amazing local doula.

Everything was so calm, and we know we were blessed to not have required any further medical procedures. The home-birth experience, when as healthy and smooth as mine, is very hands-off. There was no rush. There was no unnecessary separation. They allowed his cord to stay connected until it turned white. My midwife stitched my one, small tear in the comfort of my bedroom. We were laughing, joking, crying.

My doula fed me an ice cold cherry coke she found in the fridge (sorry, Amanda), and it was THE MOST GLORIOUS THING I HAVE EVER TASTED IN MY LIFE. I freakin’ chugged that thing. I’ll never forget that cherry coke.

The midwives told me that they couldn’t leave until I peed at least once, and that sometimes it can take a really long time and multiple tries. I remember thinking, I’m gonna rock this for you ladies. I’m going to pee quicker than anyone has ever peed as a small token for having had a 22.5 hour labor. 

AND I DID. I peed right away, and shouted, “I PEED!” And they cheered from the other room.

The next thing I know, it was probably 3 am, and Tiffany was tucking the 3 of us into bed. She kissed my head and turned out my light as she let herself out of my house. The last thing she said was, “This is your last chance to get a really long stretch of sleep.”

And that was it. I was a mother. 

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I listened to the stillness of my mostly-empty house for what felt like a really long time. Writing this now, almost a year later, I don’t actually remember if I ever slept. But I do know I didn’t leave my bed, my favorite place on Earth, and now the holy site where I gave birth, for almost 2 weeks. It was more glorious than anything I could have designed myself.

Looking back and examining the motifs that showed up in my journey, I realize that this birth for me was about letting go of what other people thought of me, and, recognizing that I can do things myself. Where many people struggle with asking for help, I think I struggle to believe I can do things on my own. I have a tendency toward codependency, often believing that I need other people to accomplish my goals (more so professionally than personally). The light side of this trait is that I have a talent for bringing teams together, and my matriarchal role is often the glue holding things together, as well as the air stoking the fire in the passions of other people’s heart. The shadow side of this trait is that I forget I’m enough on my own-- that I, too, am worthy of being produced, not just being the one who is producing. Like all codependents, I avoid looking at myself by focusing on others. Now I know that when I focus on myself, I’m capable of producing life.

Amen.”

Jessica @reverend.levity

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This is why excellent childbirth education is a must, why planning for your birth and the unexpected challenges that can arise, 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.

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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, however it unfolds!

It’s wonderful alone, a great refresher or adjunct to any other course!

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“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

— Kelly Brogan, MD

 

Should I Have an Ultrasound?

 
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If you’re worried about ultrasound safety, good for you! You should be. The use of ultrasound in pregnancy has become almost a given. Most women in the US and Canada experience at least one ultrasound during pregnancy. Some experience several. There are certainly appropriate situations for the use of ultrasound, but a healthy pregnancy isn’t one of them.

If, after weighing the pros and cons of an ultrasound, you decide to have one, that’s entirely within your right. What’s important here is to make an informed decision rather than just exposing you and your baby to high-frequency sound waves as a matter of practice.

Is Ultrasound Necessary?

The answer to this question really differs from person-to-person and even situation-to-situation. When a health care provider recommends ultrasound to a pregnant woman, the FDA recommends that mom speaks with them to understand why the ultrasound is needed, what information will be obtained, how the information will be used, and any potential risks.

Medicine is big business. There is significant financial incentive for obstetricians to recommend ultrasounds to their patients, as they can bill many hundreds of dollars to insurance companies for each use. According to the Center for Disease Control (CDC), over-use of technology is one of the major reasons for the rise in healthcare costs.

More and more modern obstetricians have been trained to use ultrasound in place of hands-on skills to evaluate the health of the pregnancy. They use it to evaluate fetal growth and position in the third trimester, which can often be assessed by hands-on examination. They also use it to date pregnancies, which can typically be done with a little detective work.

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Ultrasound is often used to determine whether a baby will be too large to be birthed naturally via the birth canal. However, ultrasound has been shown to be an inaccurate measure of birth weight. Further, our pelvic bones are joined together with ligaments that allow the pelvis to widen enough for birth to safely take place - especially when supported in upright and asymmetrical mobile positioning. This is true in almost every case, even when the mother is especially small or the baby especially large.

There are some situations in which an ultrasound is warranted. For example, bleeding in pregnancy or a serious abnormality that requires immediate or high risk hospital care. Or if mom has very irregular or absent cycles during breastfeeding, providing no real guideline for gestational age. Sometimes, if mom has a lot of anxiety about the health of her pregnancy and baby, a normal ultrasound mid pregnancy can provide some reassurance - while still not a guarantee.

The American Institute of Ultrasound in Medicine advocates for use of ultrasound solely for medical purposes, and never for things like keepsake images. And the American College of Nurse-Midwives’ position is that “Ultrasound should only be used when medically indicated.”

What Do We Know About Ultrasound Safety?

Ultrasound waves have the potential to produce biological effects on the body. They can heat bodily tissue, as well as produce small pockets of gas in bodily fluids or tissues (known as cavitation). The long-term consequences of these effects are still unknown.

Dr Sarah Buckley provides an extensive article in which she weighs ultrasound safety. In it she says,

“If there is bleeding in early pregnancy, for example, ultrasound may predict whether miscarriage is inevitable. Later in pregnancy, ultrasound can be used when a baby is not growing, or when a breech baby or twins are suspected. In these cases, the information gained from ultrasound may be very useful in decision-making for the woman and her carers. However the use of routine prenatal ultrasound (RPU) is more controversial, as this involves scanning all pregnant women in the hope of improving the outcome for some mothers and babies.”

Dr Buckley goes on to say,

“Studies on humans exposed to ultrasound have shown that possible adverse effects include premature ovulation, preterm labour or miscarriage, low birth weight, poorer condition at birth, perinatal death, dyslexia, delayed speech development, and less right-handedness.”

Despite its rampant use, there has not been sufficient testing for ultrasound safety - especially concerning routine use in healthy pregnancy. In fact, there has been very little testing at all since the 1980s even though the FDA allowed exposure limits to increase by 8 fold in 1992.

It’s important to acknowledge here that technology is often assumed safe until proven otherwise. Just a couple generations back, it was general practice to x-ray pregnant mothers. Sounds crazy now that we know more about the dangers of x-rays to the developing fetus, but back then it made perfect sense.

As Dr Kelly Brogan states, “Multiple Cochrane reviews have demonstrated a lack of perinatal mortality benefit for routine ultrasound in a normal pregnancy, and an increased risk of cesarean section with third trimester screening. A review of outcomes literature condemns ultrasound when used for dating, second trimester organ scan, biophysical profile, amniotic fluid assessment, and Doppler velocity in high and low risk pregnancies.”

While our reasons for using ultrasound are typically focused on healthy pregnancies and healthy babies, there has been virtually no proof that more ultrasounds in a population equate with better health. In fact, false positives of congenital malformations are not unusual. Sadly, this has lead to more invasive testing and abortions misunderstood to be medically necessary when there is nothing actually wrong. At the very least, this puts undue stress on momma, partner and baby.

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In my opinion, technology has put distance between mommas and care providers. In situations where a midwife historically would take a literal hands-on approach to mom and baby’s health, technology now allows for a disconnect where mom is sometimes never touched by her birthing support team. My belief is that this impersonal approach can do just as much harm as the technology can.

The over-use of ultrasound also undermines a woman’s trust in her healthy body’s ability to grow and birth her healthy baby, as modern day families are putting more and more trust in technology over themselves.

Alternatives to Ultrasound

We do not fully understand the effect of directing loud sound waves at baby so frequently, but it does alter DNA in the test tube and there is strong evidence to show that any damage done is cumulative. So, if you must have an ultrasound, keep it as brief as possible and limited to as few as possible. If all is well and you know your cycles or date of conception, but you really want one, do it mid pregnancy…and of course, make sure to request a keepsake picture of your baby.

A doppler is an ultrasound device that can detect fetal heartbeat as early as 10-12 weeks, depending on the device, the location of baby, and position of mom’s uterus. It is used for each prenatal visit in many obstetrical care offices and clinics. If you want to minimize ultrasound exposure, ask for the fetoscope.

A fetoscope, which is similar to a stethoscope and works to amplify baby’s heartbeat, can be used in place of ultrasound or doppler after around 20 weeks gestational age to listen to the fetal heartbeat. It can also help assess baby’s position in later pregnancy.

When baby starts to move regularly, especially in the third trimester, I teach fetal movement awareness and kick counts. Basically, babies sleep a lot, especially when you are busy running around; but they tend to get up and become active after you eat and when your’e resting. Become aware of when and how often your baby is most active and take notice of your baby’s typical daily patterns of movement. An active baby, moving as much as usual, is a sign of fetal health and well-being. If you did not feel your baby move as much usual on a given day, eat food that has previously stimulated lots of fetal activity - usually carbohydrates like a peanut butter and jelly whole grain sandwich or cereal and nut milk - plus have two glasses of orange juice and a cup of coffee; recline in 30 - 40 minutes and count at least 10 separate kicks, body shifts, punches in the hour. Most babies will produce more than that in a few minutes, but if you are not feeling 10 separate moves in that hour, call your provider.

For most of history we did not know we were having a boy or a girl until the birth of our baby. There is something special about the surprise. But for those wanting to know the sex of their baby, blood tests are now available and are actually more accurate than ultrasound for this purpose.

Your Choice

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Medical interventions like ultrasound often play into our fears and turn us away from our intuition. We have come to have less trust in the process and believe that we need to rely on technology to assure us that our babies are safe. As mommas, we have thousands of years of the birthing wisdom of our elders that we carry in our DNA. Is that less reliable than a relatively new, under-tested technology when all is well?

Midwives typically use touch and hand skills in place of technology like ultrasound. As a wholistic and integrative midwife that specializes in healthy pregnancy, I always give the option for ultrasound, and discuss the pros and cons with each family in my care. Some opt out of all unless there is an issue or complication when the benefits outweigh the potential risks of sonogram. Some do want one to confirm they have a baby in the uterus with a heart beat before it is too early to tell in the office, and a basic scan between 18 -22 weeks. For those birthing at home, some want just this mid-pregnancy ultrasound to check baby’s anatomy and that the placenta is in the right place, so they are reassured there is nothing detected that warrants birth in higher risk hospital setting.

As midwives, we do not fix what is not broken. We instill trust in the pregnancy and birth process, and have confidence in a mom’s ability to do it.

Learn more about how you can date your pregnancy,  as well as have a holistically healthy journey and birth with confidence.

 

RhoGam Shot in Pregnancy

 

Risks and Benefits of RhoGAM

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Many expecting parents have questions about whether or not to get the Rh immune globulin (RhoGAM) shot if the momma to-be is Rh-negative. This applies to a small number of women, but it is extremely important for them to be armed with all the information prior to making a decision.

If you are among the roughly 10 - 15% of people who are Rh negative, your pregnancy could be affected if your baby is Rh positive.  In this situation, obstetric providers often recommend RhoGAM.


However, it’s not always that simple. If you’re not sure you have all the information for an informed decision, you’re in the right place. Below are some frequently asked questions and points to consider.

What is the Rh factor?

The Rh factor is a protein that can be found on the surface of red blood cells. If your blood cells have this protein, you are Rh positive. If they do not have this protein, you are Rh negative. This is the negative or positive after your blood type: A, B, O or AB. It is simply about different normal variations in red blood cells. For example, you can be A positive or O negative. The negative or positive is your Rh factor. A pregnant woman will get a blood type, Rh and antibody screen as part of the routine prenatal blood tests; if she is Rh-negative, her antibody response will get tested several times as indicated throughout the pregnancy to check for Rh sensitization.

What is Rh incompatibility and sensitization?

Rh incompatibility is when the blood of a fetus is Rh-positive but the momma’s is Rh-negative. In this situation, if baby’s blood gets into mom’s bloodstream, the mother creates a defense system against the different type of blood; it is perceived as foreign by her body, even though it belongs to her baby. She will react against it by making anti-Rh antibodies. When a pregnant mother makes antibodies against the Rh factor on her baby’s red blood cells, it is called sensitization. Once a mom is sensitized, it stays with her forever.

This rarely causes complications in a first pregnancy, as the primary immune response takes time to develop and initially produces IgM antibodies that are too large to cross the placenta. However, it could be dangerous in future pregnancies for the fetus or newborn baby, when the secondary immune response is more rapid and the body has made smaller IgG antibodies that easily cross the placenta. Once these antibodies can cross the placenta, they try to destroy the fetus’s red blood cells.

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How can Rh problems affect the fetus during subsequent pregnancies?  

Rh sensitization can lead to a wide variety of mild to serious health issues in a fetus or newborn of the next pregnancy. The main concern is a severe type of anemia in the fetus, in which red blood cells are destroyed faster than baby can replace them. Red blood cells carry oxygen to all parts of the body. Without sufficient red blood cells, the fetus will not get enough oxygen, and this can result in hemolytic disease of the fetus and newborn causing jaundice, brain damage, heart failure and death.

How can my fetus’s blood get into my bloodstream?

During healthy pregnancy, a mom and her fetus usually do not share blood, thanks to the placenta that keeps the fetal and maternal blood circulation separate. But sometimes a small amount of blood from the fetus can mix with the mother’s blood. Typically, there is no mixing sufficient enough to risk sensitization unless there is are complications like miscarriage, placental abruption or previa, abdominal trauma, or an invasive medical/surgical procedure like chorionic villus sampling or amniocentesis, abdominal surgery and even ultrasound. 

Sensitization is usually associated with a rapid and large volume of fetal-maternal blood mixing. The most common time for Rh-positive fetal red blood cells to enter mother’s bloodstream, is during childbirth, though it can occur at other points during pregnancy - mainly in the third trimester.

Traumatic and difficult births with a high level of invasive procedures increase the likelihood for baby’s blood to mix with mom’s. So can certain routine interventions including use of the synthetic drug Pitocin to induce or augment labor, local or regional anesthesia, forced directed pushing, clamping the umbilical cord too early, pulling on the cord and putting pressure on the fundus to hasten delivery of the placenta.

A gentle birth process with minimal intervention and time allowance for the placenta to separate provides a reduced risk of significant mixing of blood between mother and baby.

While not a guarantee, planning for a natural undisturbed physiologic pregnancy and birth may certainly help prevent the mixing of fetal and maternal blood that leads to sensitization and hemolytic disease.

Can you tell if the baby is Rh-positive?

There is a new noninvasive blood test, which can detect fetal blood type using a blood sample of the pregnant mom. It is said to be highly accurate, almost as reliable as the conventional test, that uses a blood sample of the newborn after birth. It is almost, but not 100% accurate; and it is not available everywhere or covered by all insurances.

I recommend dad getting his blood type and Rh factor tested. If the father is Rh-positive and the mother is Rh-negative, there is about a 75% chance baby is Rh-positive, and providers will probably recommend RhoGAM. But if both parents are Rh-negative, baby will also be Rh-negative; in that case, there is no risk of Rh sensitization, and no need for RhoGAM.

What is RhoGAM?

RhoGAM is a drug made from human blood plasma, that prevents the mother from making antibodies against the positive Rh factor in baby’s blood. It is given via intramuscular injection, to prevent the immune response of sensitization against baby’s Rh positive blood, and subsequent hemolytic disease of the fetus or newborn in future pregnancies.

 
What are the benefits of RhoGAM?


RhoGAM’s effectiveness has been demonstrated in multiple studies around the globe. According to Dr. Murray Enkin et.al of A Guide To Effective Care in Pregnancy and Childbirth , one of the widely respected and authoritative founders of evidence based care, RhoGAM given after birth reduces the rate of hemolytic disease from 15% down to 1.6%.  RhoGAM administration prenatally in the third trimester has been shown in studies to further decrease the incidence to 0.06%.

The administration of RhoGAM medication to Rh-negative mothers is thought to be a major achievement of modern obstetrics by many in the medical profession. Before RhoGam’s introduction into routine practice in the 1970s, hemolytic disease of the newborn was a major cause of serious illness, death and long term disability in babies.

RhoGAM does not typically benefit firstborn babies unless the mom who is Rh negative has previously experienced a reaction to a mismatched blood transfusion, an abortion, miscarriage or ectopic pregnancy untreated with RhoGam.  

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When is RhoGAM recommended, and why?

For women who are Rh-negative, health care providers routinely recommend a shot of RhoGAM around 28 weeks of pregnancy and then again within 72 hours after birth, in order to protect the baby of a subsequent pregnancy.

Providers must decide about the RhoGAM shot and its dose based on how likely it is for the baby to have Rh-positive blood, as well as how likely it is for the baby and mother’s blood to significantly mix during pregnancy and birth.

Is there controversy around RhoGAM?

This standard approach is not without its critics, especially regarding its routine use during pregnancy, in which only about 1.5% of Rh negative moms with Rh positive fetuses develop antibodies and become sensitized against the baby’s positive Rh factor. Risk of sensitization is significantly higher after birth. Administration of RhoGAM postpartum is much less controversial, where benefits of the medication more clearly outweigh potential risks.

“The problem with routine prescription of prenatal RhoGAM is that many babies who are Rh negative like their mothers will be exposed to the drug, and there has been no systematic study of the long term effects of this product in babies.” - Ina May Gaskin

 “RhIG is not given for the direct benefit of the recipient or even her current fetus. The only beneficiary will be an RhD-positive fetus during a subsequent pregnancy (although the woman would also benefit in the event of a wrongly typed transfusion during the time of birth). Furthermore, prenatal prophylaxis unnecessarily exposes the 35% of fetuses who are RhD-negative to RhIG. These babies are at no risk of RhD sensitization. RhIG is completely unnecessary when a baby is the last child in the family. In the absence of clear answers to these pressing questions, the routine use of RhIG assumes that the birth process for RhD-negative women is inherently flawed.” - Anne Frye

Reliable research and meta analysis of the studies on benefit and harm of routine use of RhoGam in pregnancy are still limited, especially as it relates to who, when and which dose is needed, as well as its cost effectiveness.

Some argue that there may be other factors that contributed to the marked decline in severity and prevalence of perinatal morbidity and mortality associated with Rh incompatibility and sensitization, and medicating healthy pregnant women undermines those who trust the inherent wisdom in the natural process of childbearing. That being said, the issue remains an issue which, still today, impacts babies of pregnant women who are Rh negative.

What are the risks of RhoGAM?

Despite excellent results, the medication retains an FDA Pregnancy Category C: “Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.”

The known possible side-effects to RhoGAM include local swelling inflammation at the site, skin rash, body aches and sometimes hives. Infection from the blood product of modern preparation is rare, but still a possibility.

Expecting mommas should also keep in mind that standard RhoGAM preparation in many countries contains the mercury compound known as thimerosal, which has a litany of health risks.  However, pregnant mommas can request the use the mercury-free RhoGAM, if it is available where they live. In the United States, RhoGam is said to be mercury-free, although it may still contain traces.

So, is the RhoGAM shot absolutely necessary during pregnancy? 

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This is a hard question to answer for each individual person, on a blog.  Although much of the research is compelling, it is dated, was largely funded by the pharmaceutical companies and it is not without bias, flaws and some conflicting conclusions. For an eye opening text analysis of the data though 2001 and guidance from a traditional midwifery perspective, check out “Anti-D in Midwifery: Panacea or Paradox? 2nd Edition”, by Sara Wickham.

As always, pregnant mommas should empower themselves with knowledge and talk with their provider to fully understand the benefits and risks of all medications unique to their situation. 

I encourage my clients to take great care of themselves, be well-educated on their health-related issues, and to be in tune with their bodies.  While I aspire to provide evidence based information about medications and recommended treatments, I also know that there is much we do not know, and I am wary of routine medical and surgical interventions in a healthy natural process Too often they are widely used before sufficiently evaluated or harm has been identified. I feel informed and empowered moms are best able to make decisions for themselves.

Understanding that the vast majority of woman who are Rh-negative will not become sensitized during pregnancy, as it is rare that mixing happens until birth, is an important consideration when balancing the risks and benefits of using a pharmaceutical therapy while pregnant.

If you are Rh-negative and baby’s dad is Rh-negative, no, you do not need the shot. If baby’s dad is Rh-positive, and you choose to refuse the shot in pregnancy, you may still need it later if you suspect bleeding or another reason for sensitization, or if you change your mind. If you have done your research, you believe you are low-risk, and you do not feel comfortable with the shot while pregnant, do not let a provider pressure you. 

According to those who advocate a gentle birth process with minimal intervention and time allowance for the placenta to separate, there is usually less risk of significant mixing of blood between mother and baby. But mixing and sensitization can certainly still occur during healthy natural birthing. Traumatic, highly interventive and difficult births increase the likelihood for fetomaternal hemorrhage and sensitization. So can certain routine interventions including ultrasound, use of the synthetic drug Pitocin to induce or augment labor, local or regional anesthesia, forced directed pushing, clamping the umbilical cord too early, pulling on the cord and putting pressure on the fundus to hasten delivery of the placenta - anything that possibly disrupts the delicate physiology of placental separation or cause tiny fetal blood vessels to rupture and bleed. Planning for a natural undisturbed physiologic birth may certainly help prevent the mixing of fetal and maternal blood that leads to sensitization and hemolytic disease.

If you are feeling overwhelmed, or do not even know what questions to ask, I can help you! Check out my number one international best selling book Natural Birth Secrets and my online course - an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!

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If you need more personalized guidance and help navigating these and other tough decisions, you can arrange a consultation with me, bundled with my online course. Or I invite you to choose from a variety of services I offer to the global community. Rock Your Journey To Motherhood is my most comprehensive, supportive offering for pregnant mommas anywhere in the world.  You will have personal access and guidance from me as we co-create your joyful journey from pregnancy to postpartum healthy bliss.

 

Birth Story of Redemption

 

“Redemption: Koen James

Stalking your Instagram and drooling over all things Birth!

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I wanted to share my story:

After experiencing a hospital birth and an at home intervention free birth I have such a deeper connection with my body and the things it is capable of. I find myself being in complete awe over what the woman’s body can accomplish by watching, scrolling, and reading stories into the wee hours into the early morning. An indescribable feeling.

Those who attended the birth of my first born would tell you it was unforgettable in the worst of ways. Two years ago, I was riding passenger on the way to the hospital to be induced. My husband and I discussed during our drive how delighted we were for our lives to change to a family of three to avoid the anxiety we felt. After a short ride we arrived to small talk and routine work: readying IV's, retrieving a catheter, sterilizing the area, the whole nine. Luckily I was contracting on my own the use of pitocin was unnecessary and went directly to breaking my water. Before leaving my room my doctor quickly questioned me about the need of an epidural. Although my pain was fear driven, I was young and naive, I insisted.

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Seconds after receiving the epidural I was reaping it's effects. I became so nauseated I couldn't bare to speak. I was begging for relief as they injected a dose of phenergan into my IV. Little did anyone know I was severely allergic to the medicine. I couldn't see. I couldn't talk. I began to black out. I woke up for a split second patting my chest in hopes to convey something was wrong. My nurse was frustrated unaware of the situation she got two inches from my face yelling "USE YOUR WORDS" repeatedly. All I could do was grab her arm with a frail grip before passing out again. My condition was worsening when I awoke for a second time. I remember looking up to my husband holding my hand, telling me it would be okay, as he began to tear. Everyone was being rushed out of the room as a team of doctors scrambled through the door. I didn't know it but my heart rate was dropping.

 Awake for a third and final time, it was over but now it was time to push. I was exhausted and still confused, I thought the oxygen they had me on was their attempt to put me to sleep. In between surges, with what little energy I had left, I was fighting to remove the mask. Two hours of nodding in and out, I remember asking if it was almost over. Anything that could have gone wrong, did. I was ready to be holding our baby boy. A tiny six pounds and twelve ounces, he was finally here. Relieved we're both okay, I still look back and break a little inside unable to recall the birth of my first child. 

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Once we became pregnant for the second time we knew, wherever we delivered, we would not opt for any interventions. It wasn't until the third trimester we started weighing out our options of where we would welcome our newest addition. I knew I didn't want to be in the same environment I was with my first, scarred from the experience we lived previously. It wasn't until then we discussed a home birth. No pokes and pricks, being in the comfort of home, I wouldn't have to find a sitter for our son, it appeared to be a dream. This is what I wanted. 

It was a day after my due date when my water broke as I was laying our son down for a nap. I immediately alerted my midwife, Rebekah, who was attending a birth of another mother. I then called out to my husband and informed him we would have a baby soon. We went about the rest of our day normally, trying to do the odds and ends in order to prep our house for birth. I continuously encouraged my husband to get as much rest as possible before going to bed myself.  

I was filled with mixed emotions as I attempted to close my eyes. Although this was my second birth it was very much my first. I didn't know what to expect as I had no previous experience other than reading what I could online. I woke up early Sunday morning with consistent contractions. I began timing them before I carefully crept out of bed trying not disrupt our son to go wake my husband on the couch. I could tell he had gotten little to no sleep. As I started to explain I needed his help timing my contractions he told me he didn't go to bed until five that morning.. it was three. Nodding in and out we averaged my contractions two minutes apart while lasting thirty five seconds. 

Keeping my midwife updated she decided it was time to head my way. They arrived just as the sun was making an appearance through the trees. She had brought along some back up, Paige a student midwife, as the rest of her team was still with laboring mother before me. As we got aquatinted my contractions stayed two minutes apart while lengthing in time. I was checked at five centimeters when Rebekah asked if I felt comfortable with her leaving to attend her previous engagement. I gave her the thumbs up as I tried to get comfortable for the labor ahead. 

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I was stretched across the couch when Paige encouraged me to get into a more baby friendly position to help descend him further into the birth canal. I put a pillow under each knee and squatted down while leaning over the seat cushions. I could feel my contractions intensifying as I was overcome by intolerable back pain. My husband would try massage me while Paige squeezed my hips, but it was doing more harm than good. I couldn't be touched. All I wanted to do was lay down. 

I crawled back up on the couch surrounding myself with pillows in every direction to give my body some ease. With each wave I would reach out to my husband and pull on his shirt until it passed. I had been laboring in the living room for a short couple of hours, since my midwives arrived, when I decided I wanted to try a new method of comfort and relax in a hot bath. Before stepping into the water, Paige checked me in between six and seven centimeters. She called Rebekah to inform her of my progression. Minutes away from reaching her destination she asked if she needed to turn around. Since my dilation appeared slow Rebekah continued on her drive.

My son was still asleep in the room next to me when I got into the bath. I immediately turned on the cold water. I was refreshed with the cooling sensation through the marathon my body was running. At this time my contractions were now a minute or more long. The pain I felt in my back had me paralyzed. I could do nothing but scream. I managed to wake our son from the howls I released through each surge. As much as I wanted him there I knew I couldn't comfort him like he wanted me to, so we quickly called for reinforcements. My husband attended to his side while Paige poured water over my forty week belly and reminded me that I could do this. I wasn't in the tub for ten minutes when I told her I needed to push. No one was expecting me progress the way I had. She asked me slightly confused "You need to push or feel like you want to push?" I shouted "HES HERE". 

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Before getting up to notify Rebekah, she wanted me to promise I wouldn't push. I knew it was no promise I could keep. Our son's ride arrived relieving my husband back to his former duty of being by my side. I had one more contraction in the tub when I demanded we make a run for it. I was caught in the hallway by another surge before reaching the couch. Rebekah was too far away. She would never make it back in time. It was just the three of us. With Rebekah absent, my husband and Paige rushed to get everything ready for the arrival of our newest baby boy.

I was already pushing as I watched them grab the rest of the necessities. I beared down against Paige who was positioned at my feet. Through all the pain I had felt that morning I was at such peace while pushing. With two more thrusts he was here. I lifted him up to my chest and rubbed my fingers across his face. He had the most perfectly round head and that beautiful burgundy after birth color. My husband cut the cord while I took everything in that I had missed the first time. I finally got the birth I had been longing for. I thanked my body for overcoming my mind and showing me what I was truly capable of.

I questioned myself on if I should write my story when I was reminded, I gave birth at home, after a traumatizing first experience, without any interventions, and that itself is a success. I could and I did and this time I remembered. 

@shelbylclowers’’ 

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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! It is a course that is recommended by doctors, midwives, and other professionals around the globe!

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.

 

How To Build A Successful Midwifery Practice

 

What I Didn't Learn In Midwifery School

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As midwives, we go through years of college and post graduate education and clinical training. We learn a lot about women’s bodies and supporting the natural processes of puberty through menopause, of everything childbearing and breastfeeding. We learn to provide excellent midwifery care - the science and the art of it. We learn prevention and management of complications and emergencies, and to collaborate or refer to a physician, when we are presented with situations beyond our broad scope of practice.

Doulas take a short course to learn how to provide labor and postpartum support, what is needed to mother the mother during this special journey. These things are obviously necessary to a successful midwifery or doula practice. But how to run a thriving midwifery or doula business is not really included in our training. Unless you’re going to be working in a setting where you’re purely an employee with no administrative or marketing role, there are some key elements missing to our education.

For those of us who are called to accompany families through the incredible journey of nurturing and birthing new life into this world, there is no greater honor than when a momma tells us, “I choose you.”

Even after helping moms to give birth to over 1,000 babies, every time I am hired to provide holistic maternity care I am so grateful and so delighted. I know that I will be a part of a powerful experience for that family. Returning power to women, encouraging them to feel their vitality, live in joy and love their birth are some of the hallmarks of my successful midwifery practice, as are my holistic approaches to health and healing.

However, I didn’t earn the opportunity to support the successful births of so many beautiful babies or empower so many inspiring mommas by education alone.

Having a successful midwifery practice of 21 plus years has provided me with many resources and a lot of lessons that I wish I would have known when I first started.

After my education and training, I felt skilled as a doula, childbirth educator, and a midwife. I could help people heal and transform psychic pain with Clarity Breathwork; I could teach yoga for pregnancy, labor and postpartum, and for life. With much experience and ongoing deeper work, I knew I had what it takes to help mommas love their birth experience and I created an online course to share my local practice with the global community. Professionals around the world also take it, to help them help the mommas they serve. Eventually I could write #1 international best selling books on natural holistic birthing and healing emotional pain, trauma and stress so prevalent in the modern world!

On the other hand, I had no clue how to build a successful, thriving practice. I spent a lot of money and time taking many workshops and continuing education. I embarked on my own self-study to master and refine my skills as not only a midwife, but also as an owner of a private practice and its administrator. And I made A LOT of mistakes along the way.

Below are the key things I wish I knew before I embarked on my doula, and my midwifery journey.

10 skills you need to learn (even if you outsource) for a successful midwifery practice

1) Bookkeeping. Billing, collections, taxes, accounts payable. If you don’t have financial systems in place from the start, things can get pretty messy.

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2) Dealing with insurance. If you plan to accept medical insurance, there’s a whole world of claims, codes, and coverage that you need to understand.

3) Online Marketing. Between the ever-changing social media platforms, chat rooms and websites, online marketing can feel overwhelming. It’s important to learn how to stand out on the over-crowded internet.

4) Client paperwork. Making needed practice forms, legal documents, and informative handouts for clients is a must in every practice.

5) Charting. The most efficient chart forms vary from practice to practice. And charting challenging cases can be well...challenging.

6) Professional communications. As you grow your practice, there will be a variety of situations that call for written communications to other health care professionals. These include networking and forming collaborative relationships, thank you notes for excellent supportive care, and summarizing cases for consultations or referrals.

7) External Communications. These are letters written to individuals outside the health care team on behalf of expectant mothers as their obstetric care provider. For example, disability claims, approval for gym membership, dental work, or travel, insurance exemptions, as well as payments and appeals.

8) Team Management. As my practice grew, it became increasingly necessary to have clarity about the roles of other members in my practice. Birth assistants and administrative team members need clear protocols for things like handling emergencies and maintaining certain skill sets.

9) Supply Management. This may seem simple, but not having the right supplies for a care visit or a birth can be a real nuisance. Not to mention embarrassing!

10) Self-care. Setting boundaries in your practice for your own personal health and self-care is key to being the best you can be for everyone in your life - family, clients, and self.

Want to learn how I did all this and more (like how I consistently earn six figures)?

Whether you’re considering a career as a midwife or doula, getting your practice started, or an experienced birth professional looking to take your practice to the next level, my programs will get you where you need to be.

You can have a successful midwifery or doula practice, and I’m here to help.