Postpartum Bleeding: Holistic Prevention Strategies

It is normal to have light bleeding in labor as your cervix dilates and breaks its tiny blood vessels. And as baby emerges from the birth canal there can some local tearing that can cause bleeding. Expect to experience the most bleeding at delivery and postpartum. Most of this bleeding is from where the placenta was located in your uterus. 

At normal vaginal birth and immediate postpartum, it is common to lose up to a half liter of blood. After cesarean birth, one liter of blood loss is the average. After birth, your uterus needs to contract around the major blood vessels that supplied the placenta to close them off and prevent excessive bleeding. 

The first few days, bleeding can be like a heavy period. Then, it tapers to a moderate period, after which it becomes lighter and changes color over several weeks from shades of red, then pink to brown. The body is healing the former placental site, shedding the internal scab there, and extra tissue and blood that was lining your uterus during pregnancy. 

Postpartum hemorrhage usually occurs immediately, or up to the first 24 hours post birth, and remains a major cause of maternal death in the US and around the world. It must be taken seriously. Currently, there is substantial evidence in support of what is termed ‘active management of the third stage of labor,’ to reduce the risk of severe excess postpartum bleeding. It includes the use of:

•  The synthetic hormone oxytocin (referred to as Pitocin in the US) via intravenous or intramuscular injection

• Early cord clamping with waiting 1-3 minutes until baby gets at least most of the cord blood

• Controlled traction on the cord along with counter pressure on the uterus to effect placenta delivery within the first 5-30 minutes after birth

• Uterine massage to make sure it is firmly contracted

• Assessments every 15 minutes for the first two hours. 

The above process, or a similar version, is done routinely in most hospitals, and can certainly be done in out of hospital birth settings. However, the studies that determined these procedures, were based on hospital births in mostly resource poor but also well developed countries. Like all studies, they have their limitations and flaws, some were even considered to be of poor quality according to the esteemed Cochrane Review. Also these interventions are not without side effects and concerns. The American College of Nurse-Midwives support the use of active management of third stage of labor in low resource settings, according to their position statement, although they do admit its benefits are not as clear in the low risk healthy population, and encourage the provider to have a risk benefit discussion with each pregnant family so they can make an informed decision about it. 

Most homebirth and birth center moms and providers are passionate about physiologic birthing, minimal interventions and holistic modalities, do not routinely want an injection of medication, and are more interested in natural alternatives. They trust the incredible wisdom of the normal birthing process, which has worked for thousands of years or we would not have survived as a species. They share a common belief that if it is not broken, don’t fix it, wary of medication and interventions unless absolutely necessary and benefits outweigh risks. They tend to like the alternative, ‘expectant management’ approach, which also entails close observation by the provider, but tends to take longer, allowing for the normal physiologic process to take its course, and for interventions only if needed in select cases. 

After birth, mom and baby are of course carefully assessed, but encouraged to bond skin to skin. There is no rush. Cord clamping is delayed until pulsation has ceased, or after placenta is birthed. Mom and baby are assisted to breastfeed which helps release mama’s own natural oxytocin.

The provider waits and watches for signs that the placenta is naturally separating and then assists mom into an optimal position usually using gravity, and encourages her to use her own bearing down efforts to birth her placenta. The provider may sometimes guide the birthing placenta with gentle traction on the cord, while supporting the uterus, then massages the uterus to make sure it is firm, assesses the bleeding until stable, and assesses and repairs tearing as needed. 

Certainly, if there are certain concerns or risk factors, you may truly benefit from medical prevention and active management.

If there is an actual hemorrhage, make sure your provider is skilled, experienced, and fully equipped to deal with it with at least the commonly used effective medications, IV fluids, suturing material for lacerations needing repair, and hands on care that are usually sufficient to control it successfully. 

However, you can build up a strong blood supply and reduce excess bleeding and its risks with the following suggestions for natural support both in your pregnancy and postpartum.

Prenatal Support

Make sure you get checked and treated for anemia common in pregnancy, that your iron stores (ferritin) are sufficient. 

Eat 3 large servings of wild greens or dark green leafy vegetables every day. They can be made into a salad, lightly sautéed or steamed. Good options are parsley, dandelion, alfalfa, kale, collard greens, comfrey and turnip greens.  For additional support, you can try the following:

NETTLE AND RASPBERRY TEA

Starting in the third trimester, drink 1 cup of this nourishing herbal infusion several times per day. 

1. Combine a handful each of the dried herbs Nettles and Red raspberry leaf with 1 quart boiling water.

2. Steep for at least 4 hours.

3. Strain to a glass mason canning jar.

4. You can add fresh mint leaves, lemon juice, or honey to taste.

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GREEN DRINKS

Drink 1 ounce fresh, frozen, or powdered  wheatgrass juice 1-2 times daily to enrich and build your blood.

Or, try 1 scoop daily of powdered greens in your smoothie, 1-3 Tbsp bottled chlorophyll, or tablets or powders of spirulina and chlorella.

Postpartum

You need to rest in bed, on the couch or an outdoor lounge chair as much as possible for the first 2 weeks to recover.  Make sure you arrange for help in the home during this special time. Limiting activity and increasing rest help the area of open uterine blood vessels where the placenta detached to heal. 

Check the top of your uterus regularly for firmness, and massage it if it feels soft, until it hardens. Postpartum bleeding can be minimized when mothers are taught regular postpartum self massage of the uterus so that it stays firm and contracted around the blood vessels that supplied the placenta. 

Start breastfeeding right away, and every 1 ½ - 3 hours thereafter, especially taking advantage of the times when your baby is awake and alert and eager to suck.  Nursing frequently causes the body to secrete its own natural hormone oxytocin to keep the uterus firm and decrease bleeding.

Urinate frequently to keep the bladder empty so the uterus can contract easier.

You can also take homeopathic caulophyllum 30 or 200 C immediately after delivery, then 3-4 pellets arnica 30C under your tongue every 2-3 hours. Or, try herbal shepherd's purse, 1 dropperful of the tincture three times daily for the first 3-5 days after birth. If you need additional herbal support for heavier or persistent bleeding, you can try a dropperful of Angelica tincture a few times daily. 

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for postpartum bleeding prevention or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

As always, if you need more personal guidance, schedule a consultation with me. 

If bleeding becomes heavier than a heavy period, and you are soaking through two maxi pads an hour for 2 hours, empty your bladder, make sure the top of your uterus is firm and massage it if soft until it becomes hard. If no relief, take 1 tsp shepherd’s purse herbal tincture under your tongue. You can repeat the dose a few times, but if the bleeding becomes heavier, contact your practitioner. 

Do read my Natural Birth Secrets book, to prepare yourself for a healthy, joyful and calm pregnancy and childbirth - NOW OUT IN SECOND EDITION!

For further inspiration, empowerment, and optimal health in pregnancy, birthing and postpartum, please make sure to take my online Love Your Birth course, so you can ROCK your journey wherever and however you plan to give birth.

Photo by Megan Hancock Photography

Singing and Dancing My Way to Natural Birth With Pre-Eclampsia

My heartfelt thanks for reading my story. I'm so blessed and honored that you will post my birth story on your blog and social media.  I hope and pray that this would inspire more women to try birthing naturally and perhaps encourage them also to sing and dance their way through labor! 

I was diagnosed with Pre-Eclampsia with severe features due to the extremely high amount of protein in my urine. My blood pressure remained normal, below 120/80, all throughout my labor, delivery & recovery. This is my 5th pregnancy. My first pregnancy was with twins.  The 1st twin, Annalise, was born naturally (no anesthesia, IV, oxygen, pain meds) in our church's birthing clinic.  The 2nd twin, Therese, was born via CS in a hospital. I was transferred because Therese went transverse when Annalise came out and it was Therese's hand that first came out.  My midwife put her hand back twice before transferring us to the hospital.  

In most hospitals, 24 hour monitoring is only done in the High Risk unit, so when my fluid was low, I had to be monitored for a full 24 hours before I transferred to a regular room.  I went back to the High Risk unit again for the Magnesium sulfate, to counter possible seizure or convulsions, according to my OB.  They also don't allow the natural birthing suite for high-risk cases like mine, because I already underwent Caesarean in a previous pregnancy, even though I've already had 3 VBACs.

Valentine’s Day, Thursday, Feb. 14, 2019, I was looking forward to a lovely dinner that night with my husband of 13 years, Ritche, to celebrate our 15th year of being together, when we received news that my husband’s 98-year old maternal grandmother “Lola Auring,” whom he was very close to, had just passed away peacefully in her sleep.  He regretted not being able to visit her sooner when she was still alive but looked forward to flying out from our home in Metro Manila (Philippines) to their province to be with her for the last time.  

But, first things first… I had to go to St. Luke’s Medical Center in Bonifacio Global City, for my routine 36th week checkup & ultrasound.  My OB did a Biophysical Score of our baby and told me that my fluid was low.  In my mind, I thought, “Okay, I’ll just have to drink up at home then.” But, my OB had another plan... I needed to be admitted to the High Risk Pregnancy Unit and hydrate via IV. I called Ritche and he agreed for me to be confined, thinking we’ll just stay overnight until my fluid goes up in 24 hours.  

So, aside from the IV drip, I tripled my water intake to 3 liters in the morning, 3 liters in the afternoon and 2 liters at night, which equated peeing almost every hour! AND I had to be hooked to several machines so my heart rate, blood pressure, baby’s heart rate and my contractions will be monitored for 24 hours. It was super uncomfortable but I thought, “No problem! As long as baby’s fluid will go up right away.”  We then asked our churchmates and close family & friends to pray with us.  I also prayed that I would be discharged as soon as possible so that Ritche could still travel the next day to be with Lola Auring.

24 hours later, Friday afternoon, my fluid just increased a tiny bit so my OB double checked the protein-creatinine ratio in my urine. While waiting for the results, we got a regular room and waited another 24 hours.  My husband already cancelled his trip and let my mother-in-law, Mama Tess, go ahead to their home in the province.  My UPC ratio was still extremely high, which made me a candidate for severe pre-eclampsia. We couldn’t believe it.  Even my OB couldn’t believe it, either. I’ve always been careful with my diet, preferring veggies & fruits. I always made sure I had regular exercise.  My blood pressure has always been normal.  How could I have pre-eclampsia?   

We’ve been praying for Baby Abe to come out at least on his 38th week so, imagine our surprise when she advised us on Saturday afternoon that we’ll both be safer if he came out as soon as I reach my 37th week, which was the following day, Sunday!  Questions ran through my mind.  We knew 38 weeks is the ideal.  How do I induce labor?  We’ve always just waited for me to labor naturally.  With Agatha, our 5th child, we had to keep her in as long as possible.  With Abe, it seems, we now had to bring him out as soon as possible! We hadn’t even packed our hospital bag! We were just supposed to buy baby boy stuff this week!

I had my Birth Plan printed out for the doctors and nurses and went back to the High Risk unit so that I can be given magnesium sulfate to counter possible seizure/convulsions.  I was also given 4000 mg of Evening Primrose Oil every 4 hours to soften my cervix. It just seemed so foreign and unnatural to me that we had to naturally induce labor.  How do we do that?  

My husband comforted me and reminded me that we have a great and awesome God and that so many people are praying for us.  He had been diligently communicating with and updating our close friends.  My dearest friend Kartika from Singapore visited me twice. My best friend and sister, Lala and her husband, Solomon, came all the way from Carmona, Cavite, to encourage me with their love and presence.  Our dear godparents, Fr. Dino and Sis. Anj, braved the 3-hour traffic to show their support and pray with us. When they mentioned the words “total trust” and “perfect peace” in their prayers, I was inspired by the Holy Spirit to write down the alliterations the Lord revealed to me as they were born in my heart so I can meditate on them:

“Total Trust in Thee”  “Perfect Peace in the Prince of Peace”  “Sweet Surrender to My Savior”  “Calm and Courageous in Christ”  “Blissfully Blessed and Brave to Birth our Baby Boy”  “Relaxed, Rested and Ready”

Most importantly, my mother, Mama Lou, my father-in-law, Papa Adelo, and our 5 beautiful and wonderful children, gave me so much encouragement that I knew that we can bring Baby Abe out in God’s perfect timing.  The Holy Spirit will lead me and guide our baby out.

Monday, after the magnesium sulfate treatment, I had another ultrasound.  Baby’s fluid had significantly increased from 7.89 to 13!  Praise God!  We could really feel the prayers of everyone.  We were ready to induce natural labor.  My OB mentioned that Baby Abe could even be born on Thursday, which was her birthday!  But I thought to myself that I didn’t want to labor that long.  Our churchmates, Dcn. Jojo and Sis. Evelyn, brought homebaked muffins along with much laughter and prayed over us before leaving.

We finally finished my IV (Yay!) and I drank my red raspberry leaf tea, walked about our windowless room, slow danced, bounced on a birthing ball. Contractions were very mild at 3-5 minutes apart, but they weren’t “painful.”  Mama Chato, our midwife who helped me naturally birth our other children, taught us that we must reframe contractions as “good pain” because it helps bring the baby down.  The more you welcome each “good pain” and embrace the sensation, the more relaxed you will be and fear will leave you.  So, everytime I felt a contraction coming, I relaxed my facial muscles, my jaw, my shoulders and let the tightening sensation do its work on my belly. The uterus is a very powerful muscle and I looked forward to the pressure, imagining that every contraction brought Baby Abe closer to being in my arms.

The resident doctor did my first internal examination and said I’m only 2cm dilated.  Well, at least it’s not totally closed, right?  However, at 530pm, I had an unexplainable occurrence of “chills” where I suddenly felt like I was freezing.  I couldn’t stop my teeth from chattering and my body from shaking violently. My mom wrapped me in thick blankets, wore socks on me, rubbed my legs. I called my husband to hurry, as he was getting some documents for our hospital stay. I placed my cold hands in my armpits and prayed that the nurse won’t peek in and report that I’m having some kind of seizure.  The chills passed after 20 minutes.  My husband warmed me with his embrace.  However, I couldn’t sleep a wink that night.  My husband decided we transfer again to a normal room with windows so I could be more comfortable.  I searched online “how to dilate cervix fast” and visualized my cervix opening and prayed constantly to the Lord to give me thoughts of peace and not anxiety.  The baby knows when to be born.

Tuesday, I had a prenatal massage to relax and press those labor-inducing points, drank more red raspberry leaf tea, bounced on the ball and did more than walking, I did some dancing, too!  Contractions were still mild at 3-5 minutes apart. I had another bout of “chills” at 530pm so my mother wrapped me again and I rebuked every thought of convulsion or seizure.  I kept telling myself that this will pass and Baby Abe is safe in my womb. The chills stopped at 6pm. By 8pm, I was so tired from the lack of sleep that I was able to sleep very well, even with the regular rhythm of my belly tightening.  We continued to entrust everything into the Father’s hands. 

The next day, Wednesday, February 20, I was determined to up my natural induction techniques.  My OB was pleased with the progress of my labor but reminded me not to wait until my water broke.  She reminded me to let her residents know when I’m already 4cm dilated, because I gave birth so quickly to our last child, she almost didn’t make it.  

My Mama Lou and I danced belly, hip hop, Zumba to the jiggiest songs I could find (Think “Trolls” soundtrack, “Walking on Sunshine” “Moves Like Jagger” “Waka Waka” you get the picture) and I sang my heart out to our Hillsong & Bethel favorites (Oceans, What a Beautiful Name, O Praise the Name, Open Heaven/River Wild, It Is Well, No Longer Slaves, etc.) when I rested. The doctors and nurses were amazed I could still sing and dance through my contractions.  Haha!  It actually took my mind away from the pressure.  By 530pm, I thought my water was leaking so I called a resident to examine me.  No water, just the EvePrim Oil melting but I was 3-4cm dilated.  Yay! She then asked me to go down to continue laboring in the High Risk unit.   Labor progressed very quickly and I did feel more and more pressure every minute!  

Shout out to the doctors and nurses of St. Luke’s BGC for honoring my Birth Plan as much as possible and I agreed that I will only be hooked to the monitor for 20-30 mins every 2 hours.. No pitocin, no IV, no oxygen and no pain meds.  By 8pm, I was 5cm dilated.  Hooray! That pushed me to do even more dancing, bouncing, marching, swaying & singing during contractions, with my husband playing every song I requested.  The pressure was already immense at this time, and I had a tugging feeling I was very close to transition, although it’s only been a couple of hours.  I was thankful that my husband was just right there to tell me I’m doing great, and my mother was also with us, cheering me on.  Whenever I felt the tremendous pressure, I would say, “Baby’s going down, down, down!  Yes, yes, yes! Go, go, go!” and I knew that they both agreed with me and believed with me.  

I was already speaking in tongues, asking the Holy Spirit to be my Comforter, my Teacher, my Guide.  I envisioned Mama Mary giving birth to our Lord and Savior Jesus Christ.  I remembered all our children who are happily awaiting their baby brother at home. They’re counting on me to give birth to Baby Abe soon.  I wanted to birth this beautiful being in my womb without fear, only love and joy and peace... Feelings of indescribable bliss welled up in my heart for this boy whom Ritche and I had so conceived in love.  I was determined to confidently bring him out in that same love that conceived him. 

At 1030pm, I asked the resident to check my cervix, which had already dilated to 7cm, with a “bursting” effacement.  I had to be strapped again so I lay down waiting for the nurse when, a minute after, the nurse relays the message from the doctor to tell them right away if my water bag ruptures. She hadn’t left the room yet when my water bag burst!  It felt like a water balloon popped out of me. 

I excitedly told everyone, “Baby’s coming out!”

 They wheeled me out our room into the delivery room right away.  I felt the head of Baby Abe crowning.. I thought I couldn’t hold him in anymore.. but I tried to relax, as the doctors were still preparing, I had to be moved from my bed to the delivery bed and my husband, Ritche, was also getting into scrubs. I requested that I be more upright and not lying down.  Our OB was nowhere to be found but already gave instructions to her three resident OBs present in the room.  I already felt like pushing but was holding Baby Abe in.. I was so excited.. I called my husband.. “Daddy!” and told the nurse, “The cellphone!” Haha!  I didn’t want the nurse to miss taking Daddy Ritche’s picture catching Baby Abe.

Finally, it was only a matter of minutes before I told them I had to push Baby’s head out.  The doctors assured me and said they won’t hinder me from pushing.  His head came out and the doctor was wise enough to remind me not to push anymore because he slid out so easily! It’s a birth phenomenon they call the “Fetal Ejection Reflex.” Pushing would have made the baby fly out.. Haha! It was amazing to see my husband “catching” our son!  As with all our other children (except Therese who underwent emergency CS), he did the ceremonial cord cutting after the cord stopped pulsating.  Baby Abe had already pooped meconium but miraculously, he didn’t ingest any and his Apgar score was 9 out of 10.  Thank God!

I delivered the placenta within 5 minutes. And our OB, Dra. Bambalan, arrived moments after to check on me.  Everything looked good.  My blood pressure stayed normal all throughout. I had a 1 mm tear that didn’t need any stitching. 

They were amazed at how easy the birth was and how fresh I still looked even after giving birth.  We all laughed at how my primary concern was to get the cellphone to the nurse and how Baby Abe didn’t want to have the same birthday as Doc.  Everyone in the room was lighthearted and Dr. De Guzman exclaimed that this was one delivery she will never ever forget!

All in all, we stayed in the delivery room for 18 minutes then I was brought out to the Recovery Room for 4 hours to check on Baby Abe and me.  By the end of the recovery period, my BP was still stable, Baby Abe and I had skin to skin contact and he latched on the breast perfectly, but there was just one problem.  The nurse said that they’d have to put a catheter on me if I didn’t urinate soon. No way!  I gently pressed on my bladder and, sure enough, I was able to pee on my own.

The next 48 hours were critical for me and Baby Abe. I recently saw the diagnosis of my OB upon discharge.  It was Pre-eclampsia with Severe Features.  But, thank God, we never manifested any complications.  No headache, nausea, vomiting, seizure, swelling, convulsion, shortness of breath whatsoever.  My blood pressure never elevated all throughout.  Baby’s oxygen levels were stable.  I didn’t go into shock, stroke, had brain damage or any organ failure. I didn’t need any kind of pain medication.  

Within 48 hours of delivery, we went home to our family, carrying our 6thbundle of joy, our second boy, whom we named "Abraham Nickola."  So thankful to all our family, relatives, friends, and churchmates for keeping us in your thoughts and lifting us up in prayer.  I believe that Ritche’s grandmother, Lola Auring, was also looking down from Heaven and interceding for us, along with all the saints and angels. To God be all the glory, honor and praise!  He is a miracle-working God who faithfully keeps all His promises and grants us the desires of our hearts!

By: Chat Jandayan @chatjandayan

Most of the photos were taken by my husband and my mom.

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.

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!

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.

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.”

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.'
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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.

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.

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.

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.

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.

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.

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

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.

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)

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. 

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.

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.

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.”

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. 

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

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.

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!

“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

RhoGam Shot in Pregnancy

Risks and Benefits of RhoGAM

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.

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.  

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? 

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!

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.

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

“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! 

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 

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

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 here. Have a Great Postpartum Recovery (with a little help from Bellefit)!