Reality Check

     I am just now getting around to posting this even though I wrote it in 2013. I was hesitant to post it all those years ago and now as I read it I can't understand why...it is one of the most real things I have ever written.




     When you seasoned mothers out there read this post you will say, "Ah, yes, my dear, we told you so." But you didn't tell me. You didn't tell me how to detach, only how to attach, you never mentioned how to wean, just that I should breast feed. You never told me how to get my daughter OUT of my bed, only that I should sleep with her. You never told me I would get mad at her, only that I would think that she was the most precious human being to ever walk the earth. You never told me I would bang my head against the wall from the frustrations that come from sleep deprivation or that I would give up every career ambition I have ever wanted previously. You never told me that cleaning toilets and sorting the recycling would become my greatest achievement in a day. You never told me I would look upon my partner with scorn as he snoozes away while I lie awake, permanently trained to sleep lightly, my ear searching for a whimper or a cry...even though there was silence at the time. I have a beef with you mothers and here it is... Now, I know it isn't exactly your fault, but it isn't as though you didn't have an opportunity. All those hours we spent during prenatal visits, long labors and chats over tea. The Women's Studies classes, the conferences and the yoga training workshops. Why didn't you say something. Some of you hinted at it. "The deepest spiritual journey you will ever go on", was what one of you said. But here I am, year 3. A motherhood survivor.
         The midwife who thought she had it all together, the midwife who knew everything about pregnancy and birth. The midwife who knew all about attachment parenting and how important it is. And breast feeding without question, hesitation or predetermined length. The midwife whose maternal instincts were overflowing and at 35 had set an ultimatum for her partner..."Have a baby with me or else!" It may seem quite obvious to most of you, however, for this midwife "it" was not. I am referring to the grand realities of motherhood. The desperately stark difference between pregnancy and motherhood, who thought of that? Shouldn't pregnancy be better preparation for motherhood. For me, it wasn't. I basically just got knocked up and proceeded to eat everything I could get my hands on for 10 months and then out popped a baby. My motherhood instincts were in overdrive initially. I could not be stopped. I had so much energy and was so proud of myself and my daughter that nothing could shake me. No baby blues here. But then around 18 months the sleep deprivation caught up with me and I started to crumble. At almost 2 years post birth I was still breast feeding but started my period again. It was irregular and so was I. I began to have the worst PMS, mini-bouts of depression that blindsided me and were somewhat unpredictable, as was my cycle. This happened to coincide with having a two year old. Emotional, intelligent and expressive my daughter began to strut her stuff. She was learning to be human. She tested the waters of emotional volatility and couldn't control herself when things didn't go her way. Soon these outbursts became more about me than her. I struggled to ride out the tantrums, stay calm, protect her, but allow her to express herself. It was so hard. Breast feeding became this insane road block to freedom for me. Intellectually, I wanted to continue, but emotionally I felt like I was suffocating. I struggle to find the words to describe it now. Trigger. It felt like breast feeding was triggering negative emotions that I did not know how to deal with or expect. I think the time around 2 years and 9 months was the most difficult and yet the most liberating. I weaned her in April just before she turned 3 and at this time she also gave up her paci. We moved into a new chapter, preschool and freedom, for both of us.
     Why am I telling you this? Why do you need to know that I struggle. Why do you need to know that a home birth midwife who thought she was a born mother pulled over her car and walked away from her daughter in her car seat so she could scream into the blank sky, trying to vent some frustration. Why do you need to know that attachment parenting is bullshit if no one ever supports you in a healthy detachment from your child?  Why do you need to know that coffee will become more important than water? Because no one ever told me and now I am here to right that wrong.

Recent Article I Wrote...ENJOY!

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Rebecca Pugh, Registered Midwife, CPM, Doula

Apr 07, 2011 | 29 views | 0 | 0 | |

Rebecca Pugh began her journey into midwifery as a prenatal yoga instructor, when she was asked to attend a birth to help the mother relax. Soon after she became a doula, a non-medical labor support person who accompanies the birthing mother to provide emotional and physical support. Pugh was so inspired by her first experience as a doula attending a home birth that she applied to midwifery school the very next day.

Pugh graduated from the Midwives College of Utah in 2004 and is now a licensed midwife in both Colorado and Utah. She is also a certified Emergency Medical Technician, and is certified in Neonatal Resuscitation, prenatal yoga and childbirth education. In 2007 Pugh volunteered at the Bumi Sehat Maternity Clinic in Ubud, Bali, Indonesia, where she worked alongside local midwives and educated visiting ones.

Since attending her first birth in 2002, Pugh has attended hundreds of births. Her most treasured accomplishment was the home birth of her daughter, Paige this past June. Her business, Mountain Birth, is located in Rico, Colo.

Q: What can a pregnant woman do to promote a low-risk birth?

A: First, let me say that staying low risk allows you to have the labor and delivery that YOU want, not the birth the hospital wants. Despite what many doctors may say, pregnancy and birth are inherently safe and natural processes that happen every day, without complication.

Staying low risk means being an active participant in your care. Bring questions and concerns to your prenatal appointments – writing them down always helps. If you feel you don’t have enough time for your own needs during an appointment then you may be seeing the wrong provider, or you may just need to ask for a longer appointment. Most providers will accommodate you if you ask.

Be aware of your baby’s position. Studies show that women who are aware of their baby’s position have less instances of breech or posterior positioning because they can then be pro-active about changing the position. Breech positioning is now the reason for cesarean section in most hospital-based care, and a posterior position can make for a long and difficult birth. During the third trimester, ask your care provider what they feel and where, practice at home with your partner by trying to guess what parts of the baby you feel and then confirm at your next appointment. Your provider should palpate your belly at EVERY visit during the third trimester.

Avoid the “whites”... white sugar, white flour and white rice. These are empty calories that leave your body needing more. If you crave sugar, your body really needs protein. Try protein first and a small, sweet snack later. Focus on nutrient dense foods like fish, chicken and vegetables and healthy fats like organic dairy, nuts and avocados. Exercise three-to-five times per week and try to get at least three liters of water per day. Pregnancy is NOT the excuse you were looking for to eat whatever junk food you would like; choose whole foods not processed ones. The QUALITY of your weight gain is much more important than the QUANTITY. If you follow these tips you are more likely to avoid problematic diseases of pregnancy such as gestational diabetes and high blood pressure.

Q: Can you address a few common concerns that you hear from women during their pregnancy.

A: Most women are concerned about anything they take into their bodies during pregnancy, from foods, herbs and supplements to medicine and alcohol. A small amount of alcohol is safe in pregnancy, so I believe that it is safe to have a beer or a glass of wine one-to-two times per week – but just one and always with a meal.

I do not think that it is imperative that women eat only organic foods during pregnancy but I ask my clients to prioritize meats and dairy when they buy organic to avoid unnecessarily added hormones and chemicals.

Almost every medication or vitamin and supplement says, “Check with your care provider when pregnant or breast feeding,” despite the fact that many things are safe. But you should always check with your care provider about anything you want to take and bring a list of your medications, vitamins and supplements to your first appointment. Kellymom.com has a very user-friendly list of common prescription and over-the-counter medications and their safety ratings for pregnancy and breast feeding.

Morning Sickness is a common problem. The worst thing you can do is NOT eat. I tell mothers not to be too concerned about the quality of food they eat in the first trimester if they suffer from nausea and food aversions, just as long as they ARE eating. Many women perpetuate the nausea by not eating because they are nauseous and food isn’t appealing, but an empty stomach is a trigger for more nausea. Increasing simple carbohydrates, adding B complex vitamins, especially B6, and eating small, frequent snacks is helpful. Many women have a difficult time digesting proteins and vegetables during the first trimester, so keep it simple – yogurt, bagels, toast, cereal and fruit are good choices. Follow your instincts; most nausea resolves itself spontaneously around week 13, if not, there are options your care provider can suggest.

Anemia, or low iron, occurs due to changes in a pregnant woman’s blood volume. This results in fatigue and in severe cases makes the birthing mother more susceptible to hemorrhage during delivery and post partum. Increasing iron rich foods such as red meat, black strap molasses, dark leafy greens like spinach, dried fruits like prunes, and cooking in an iron skillet are all great ways to combat this problem. If that isn’t enough I recommend a product called Floradix, a food based iron supplement that contains B vitamins and Vitamin C, which helps your body metabolize iron.

The naturally occurring sources of iron in Floradix do not have a constipating effect, unlike the ferrous sulfate in prescription prenatal vitamins. Unfortunately, the vitamins that most hospital-based practices prescribe have ferrous sulfate in them. Many doctors even prescribe a stool softener when they give you the vitamins. This is crazy to me when there are excellent prenatal vitamins,with more easily metabolized forms of iron available over the counter.

Q: The fear of pain during delivery is significant concern for many women. What are your suggestions for pain management, whether or not natural childbirth is planned?

A: In the hospital there are two main forms of chemical pain relief: the epidural and IV pain medications. Both administer similar drugs, however the route differs. The epidural sends a combination of an anesthetic agent and a narcotic, such as Lidocaine and Fentanyl respectively, into the dural space surrounding the spinal cord, lessening the transfer of the medicine into the blood stream. This in turn reduces the amount of medicine the baby receives. The epidural provides long-term pain relief by numbing the woman from about waist level down to her toes. The laboring woman is unable to leave bed, requires continuous fetal monitoring, a urinary catheter and IV fluids. Sometimes other medications are necessary to counteract some of the negative side effects of the epidural, including fetal distress, maternal hypotension, allergic reactions and cessation of labor. Most women receiving an epidural also receive Pitocin, which is used to accelerate and intensify labor contractions.

IV medications are narcotics, often Fentanyl, administered directly into the mother’s blood stream through a catheter in a vein. IV medications tend to be short acting and don’t provide the long-term pain relief most first-time mothers need. Because they are administered directly into the bloodstream the baby does receive some of the effects of the medicine and may experience respiratory distress at birth. The mother often feels drowsy and sluggish, but receives a short-lived amount of pain relief that gets her “over a hump,” allowing her to persevere.

Natural pain relief comes in the form of tender loving support from a partner, doula or the hospital staff. A doula is a non-medical labor support person who works for the couple, not the hospital. Her role is to provide unwavering support, both physical and emotional, for you, your partner and your birth preferences. Anyone can act as your doula.

My advice for a mother planning an unmedicated birth in the hospital is to not rely on the hospital staff for support, but come with the support you need. Honestly, you should stay out of the hospital for as long as possible if you want to avoid pain medication and you are a first time mom.

Massage, counter pressure, positioning, visualization, hypnosis and physical support are all valuable tools that will relive pain. Soaking in a hot tub is one of the best forms of pain relief available. There are no negative side effects and it is available in most hospital settings. The warm water increases blood flow, relaxes sore muscles and provides relief from the pressure of contractions.

Q: How can parents promote the bond with their newborn immediately following delivery?

A: Having the baby put on the mother’s chest skin-to-skin immediately after delivery is very important. If that is not possible because of a cesarean delivery or a complication, the father can go with the baby and provide a loving touch, or at the very least the sound of his voice to soothe the baby. Most women have uncomplicated, vaginal deliveries; in this case there is no reason why the baby can’t be with the mother skin-to-skin. Dim lighting is preferable because this encourages the newborn to open her eyes and make eye contact with the parents. Breast feeding within the first hour of life is preferable and studies show those that latch on in that first golden hour are more successful nursers. Newborns are typically awake for the first 1-3 hours following delivery; after that they tend to sleep for several hours. I believe these first few hours are very important to the bonding process. The room should be quiet and the parents should be allowed the space to touch, explore and nurture their new baby. All vital signs can be easily collected while the baby is in the mother’s arms and most newborn procedures can be delayed for at least the first hour, if not more.

Q: What can parents expect from their newborn in the first week?

A: There is no schedule in the first weeks of life, so take the pressure off of yourself by sleeping when the baby sleeps and allowing others to help you. Your baby’s poop will become the center of your universe because the state of his digestive system usually dictates his mood. His poops will transition from dark black meconium to brown and then to bright yellow when your milk comes in. Newborns take their time adjusting to the world outside; they may take some time to “pink up” and sometimes have blue hands and feet, so just keep them bundled.

The stomach of a newborn is very small so they only need to take in the colostrum from your breasts until your milk comes in. This is the “liquid gold” that is produced in very small quantities and is loaded with antibodies and protein. It is a highly concentrated “super food” that helps prevent jaundice by clearing meconium from his bowels and provides growth factors that safeguard the gut from disease. Nurse on demand until your milk supply becomes regulated, and try conforming to your baby’s needs, rather than vice versa. It is impossible to spoil a baby; they want to be held ALL the time.

Q: What can a mother expect of her own body in the first week after delivery?

A: I encourage my clients not to leave their bed for the first 24 hours and not to go any farther than the living room in the first week – rest is so important. Your bleeding will pick up if you are active, so use that as a guide; if your bleeding is heavy you are doing too much. The mama should be the queen who is waited on hand and foot in the first weeks. If you think you don’t need help, you are wrong. There are fabulous online services like mealtrain.com that help your friends and extended family organize meals for your family. And visitors should be limited to close friends and family, those who are truly helpful and those dropping off a meal without fuss.

Your milk will come in around day three or four; your breasts will become large, engorged, hard and uncomfortable. The only cure is nursing your baby. Be careful not to start pumping, or you will fool your body into thinking that you have two babies and you will produce more milk. Just nurse and your supply will regulate within a week or two.

After birth, many women are very sore, even if they don’t have a perineal tear. Your body has worked incredibly hard so expect to be sore from head-to-toe. Just rest and be thankful. A cesarean birth requires more time for healing. Make sure you ask your care providers about special considerations for cesarean birth healing.

Many women sweat profusely the first night or two after birth as your body sheds retained fluid, so don’t be surprised if you soak the sheets. This should resolve within 48 hours.

In the months following birth, many women experience extreme hair loss as a shift in hormones can result in hair falling out in clumps. This can be the perfect time for a short do that makes you feel beautiful again.

Around 70 percent of women report some sort of “baby blues” after birth. Even if you had exactly the birth experience you were hoping for and you and your baby are perfectly happy and healthy, it is normal and common to feel slightly depressed. This feeling often comes in waves and is accompanied by moodiness, heightened emotions and a sense of being overwhelmed. This is in large part due to hormonal changes but is exacerbated by sleep deprivation. Don’t be afraid to ask for help if this happens to you. Ask a loved one to hold the baby while you shower, eat and take a nap. Sleep when the baby sleeps and talk to other mothers who understand what you are going through.

If you feel as though you cannot make it through the day without crying, if you wish harm to yourself or your baby, or if you have no desire to care for yourself or your baby and basic duties are being ignored, you may have post partum depression. Family members often notice a problem before the mother does. Talk to your care provider about post partum mood disorders during a prenatal visit, especially if you have a history of depression.

Q: What advice do you have for a new mom who is desperate to get back in to her pre-pregnancy weight?



A: Breast feed! When you are producing milk you are burning calories – making milk requires a lot of energy and helps many women lose weight. But there has to be a balance; over exercising results in dehydration in the form of sweating, which depletes the milk supply. Also, good nutrition and hydration are important to keep up the milk supply up. Remember that it takes 10 months to grow a baby, so it will probably take 10 months to shrink the mama! Don’t be in a hurry; your body will be forever changed by birth. I hear many women say that they may return to their pre-pregnant weight before the first year is over but they lack the tone they had before. Your hips will be wider for a long time, so you may NEVER return to the same size jeans you wore before. Or you may be lighter on the scales but your shirt is tighter because your breasts have grown. Exercise is so important, so pack up your baby and get out! But my best advice is patience and acceptance. You may never fit into those jeans again, but your baby doesn’t care what size you are.

Q: So coming full circle…when will her libido return?

A: Unfortunately, breast feeding has the hormonal side effect for many women of reducing their sex drive. When your baby suckles you produce oxytocin, this is the “love hormone” that makes you feel unconditional love for your baby and deepens the bond between you and your baby. For many, the hormone receptors become saturated, leaving you without a desire for any other types of “love.” Combine this with healing from birth, sleep deprivation and a general sense of being overwhelmed, and you have a recipe for celibacy! If you are co-sleeping with your baby the problem is even worse – your privacy has been dashed.

Many couples take their sex life out of the bedroom at this point and get creative. Also, making love during the day is a better option for an over-tired mom who doesn’t want to be bothered at night when sleep is at a premium. Some parents hire a babysitter who can take the baby on a walk while the parents “play.”

Couples need to be patient with one another and understand that this is only a phase. A baby is demanding of a mother’s time, attention and love, and a partner who wants sex is often seen as another demand. Expressing your love is so important and you may need to find new ways to do so. A tired mother may find more value in having dinner made for her or having her partner hold the baby while she goes for a walk, giving her time to herself. Every woman is different – I can’t say when the libido will return, but it will.

Rebecca Pugh may be reached by calling 970/708-1298. Her website is www.mountainbirth.com.

Read more: Watch Newspapers - ASK AN EXPERT Rebecca Pugh Registered Midwife CPM Doula

Paigiekins!

Well, here it is...long awaited, My birth story! I hope all of my clients enjoy this. OK, now I really get it:)

When I look outside and see a beautiful cloudless blue sky I go back in my mind to the day of Paige’s birth. A week before my due date I attended Mountainfilm in Telluride. I stood in line and mingled with the crowd. People would say, “When are you due?” “Next week”, I replied. “Your not going to have the baby in this movie theater are you?” “Well if I do, I am in good hands, I am a midwife...” And thus went the conversation over the weekend. After being pregnant all winter and a prolonged cold and snowy spring I feel as though I emerged from my wintery cave to reveal my pregnant belly. It was a great sunny and warm weekend to get a little culture and socializing in before I settled into my birth cave. Little did I know the birth cave was already calling me. That Thursday, June 3 I awoke at 6 am and I got up to go pee. When I wiped I found some interesting discharge that looked like congealed chicken fat, hey! That’s my mucus plug. OK, that’s cool. I am going back to bed. When I laid down I was feeling crampy, like menstrual cramps and then I noticed I had 3 or 4 sharp cramps that were about 5 minutes apart. They faded away and I faded back to sleep. When Matt and I woke up around 9 I told him the news...something is brewing, maybe I will go into labor soon. We got up and sprung into action. We got the house ready and headed into Telluride to handle some errands that couldn’t wait. I set up the birth tub and felt really great, like everything was in order. That day I was really crampy, cramps and Braxton Hicks would come and go throughout the day. I went for a walk, showered and did chores. As we headed home from Telluride after dark I was hungry and tired...hmmm, something is happening:) That night when I went to bed around 10 pm I told Matt I thought tonight would be a bad night for sleeping, but I was tired and I went to bed. At 1:10 am I was awoken by sharp cramps, I thought, “Aw this is nothing for a first timer, I should try to sleep”. But I just couldn’t lie down. The cramps were sharp and painful when I was lying down but felt a lot better when I was standing. So I got up and headed for the couch, hoping Matt could sleep and be rested in the morning. I tossed and turned on the couch until 6 am. I had contractions that felt more like sharp, menstrual cramps every 5 minutes since 1:10 am. I was trying not to commit the cardinal sin of most first time moms, they never rest during early labor and then regret it down the line when they are exhausted and find that in retrospect the early contractions were pretty mild. But I just couldn’t rest! I was starving, so I ate a yummy breakfast of hard boiled eggs and an english muffin. I woke Matt at 6 am...”Hey babe, I’m in labor, I need your help”. Whoa, cool...Matt seemed excited, even though he was tired, poor thing, 6 am is not his favorite time of day. As soon as I was up and moving and Matt was awake the contractions didn’t hurt as badly. I called Marlene...I’m in labor! “Take your time and head on over, no rush, but I would love for you to be here:)” Matt and I scurried around filling the tub and dealing with the usual tub obstacles, hose won’t connect correctly, need more hot water, etc. After the tub was filled Matt went back to bed and I tried to as well. I was uncomfortable and rolling around in bed, sleep was not gonna happen. Matt and I were snuggling and got kind of turned on by the whole thing so we made love. I can’t believe I actually wanted to, but I did. I had to stop while I had a contraction but otherwise, it felt good. I told Matt I really just wanted the prostaglandins in his semen to soften my cervix:) Marlene showed up around 11 I think. We had a few visitors that morning/afternoon and surprisingly it didn’t bother me to have them there for a short time. I wasn’t ever bothered by Matt and Marlene chatting, we even watched some funny clips on You Tube that made me laugh. Unfortunately, it hurt to laugh. Almost all pain was localized in my lower abdomen, it was a very sharp and concentrated feeling. I chalked that up to early labor where my lower uterine segment was doing most of the work to dilate. Unfortunately, I got to a point later where that cramp never relieved itself in between contractions and I got really frustrated and drained by this constant “in between contraction” pain. But that comes later. Well, we all putzed around the house for most of the day and then realized it was a beautiful day and that we should get out and enjoy it, plus, I needed to walk! We made our way out to a hammock in the yard that our neighbor had put up. It is such a beautiful setting, nestled in the aspen trees. We walked out and I parked it in the hammock and enjoyed a relaxed, semi-sitting pose while rocking away the contractions. I don’t know how long we were there but things were starting to get a little trippy:) I had promised myself that unless something was noticeably different that I wouldn’t be checked until 5 pm. So I wanted to hang in there without knowing until then. Sometime in the afternoon I managed to eat a granola bar and a delicious little spinach salad. I was good about staying hydrated. For the past several hours I was having this constant cramp in between the actual contractions, it was pretty painful and tiring because I wasn’t getting real rest in between...time to try the tub! Ahhhhh! Words can not describe how awesome the tub was. Unfortunately, I got in the tub and was so relieved that I didn’t have another contraction for 45 minutes! Uh, oh! Probably too early to be in the tub. But hell! It felt so good I didn’t care. It was a nice break but we needed some progress. At this point I was poking around in my own yoni to see how dilated I was...I think I am a 4, bummer! Matt and Marlene checked me and agreed, they were really great about turning the tables on me, “Hey! 4 cm is awesome, you are doing great! You are doing it Reb, keep on truckin’” Maybe we will have a baby tonight?! Marlene suggested that we rest. Good idea but that was pretty hard because when I laid down the contractions got sharp and more painful. I squirmed around in bed and seemed to get cookin’ a little more. Matt suggested we make love again...I don’t think so buddy! Too ouchie to even consider lying down. Good idea though, I think that it really helped early in labor. Then I really started squirming, I was up and down and all around at that point. The thought of lying down and resting was so alluring, occasionally I laid down on the paco pad we had set up for the birth but that often only lasted a few contractions. Standing and squatting were my two favorite positions, oh and being in the tub of course! That was my saving grace. From then on out until the birth I was in and out of the tub. At around 6 pm we were all getting hungry so Matt went over to the hotel and picked up burgers for us. I managed to eat a little bit of mine while I was in the tub, but food was becoming less desirable. It didn’t bother me at all for Matt and Mar to eat their burgers as they sat right beside me, and it didn’t bother me if they talked. In fact, I was surprisingly tolerant of smells and sounds over all during labor. At some point the smell of my burger started to bother me and the music that was playing was not what I wanted...I was getting a little edgy. As darkness fell I really started cooking. I found myself having what I called “bladder contractions”. They weren’t real, 100% contractions, but when my bladder was full I would contract, and it was slightly painful until I emptied and then it would subside. I had those in addition to regular contractions, so that was fun:) I spent a lot of time on the toilet peeing. Earlier I had diarrhea when labor first started, that irritated my little anus and caused some hemorhoids that I didn’t even know I had to flair up. I experienced a lot of butt pressure and pain throughout my labor, it sucked! When I wasn’t in the tub I was wandering around the house in a mildly delirious state. I would check in with Matt and Mar and occasionally comment, but for the most part we were all very quiet, it was a very peaceful setting. I remember looking out the window as it got dark thinking, “I don’t want to do this all night.” Fortunately, I didn’t have to...at some point I wanted to be checked again, I kept trying to check myself but I always thought I was 2 more cm dilated than I really was b/c it is so hard to feel the back of your own cervix:) I thought I was 8 cm:) Mar said I was 6...I thought I was 10 cm, Mar said I was 8 cm...and so it went. When I was around 6 cm I was in the tub and started to get a little emotional. I had the craziest contraction that just made me cry uncontrollably, heaving with sobs and having a hard time breathing. I kept saying, “I’m OK, I’m OK”, I held one of Matt’s hands and one of Mar’s and was basically holding on for dear life. At this point I really felt labor was happening to me, over taking me...I was now just along for the ride. I looked into Matt’s eyes and saw tears welling up in them, he hated seeing me in that much pain he later said. At this point I remember being very lucid, I remember a lot of detail from that time. I remember looking around the room at the artifacts of my life, feeling like they were in the distant past. I thought, “some day I will use the computer again.” At one point I think I said, “ I just want my life back!” I paced and circled through my bathroom and bedroom, occasionally collapsing onto the bed, only to scramble to my feet before another contraction came b/c lying down hurt so much worse than standing. At one point I said, “ I am gonna really need you guys”, and they said, “What do you need?” But I meant, I just NEEDED them to be there for me! They understood:) I was starting to feel some rather convulsive, pushy feelings. The contractions were really making me bear down. We checked and I was 8...I wanted to be 10!!! I was sitting on the toilet and I tried to check myself again, I could feel a little bulging bag of water and the “beak” of my cervix in the front. That is what it felt like, a rigid little point of tissue. I squirmed around for quite a while before proposing to Mar that, “Maybe we should break my water?” My awesome midwife threw back my own advice right on to me...”once you break the water, you can’t go back, we don’t want to mess with mother nature, it could affect the baby’s position, it will go when it is ready.” Ah, I felt better...trust Rebecca, trust. So I got back into the tub for some relief, after sitting on the toilet poking around in my yoni trying to snag my bag of waters:) This time, the tub was providing very little relief. I was grunting and convulsing in the tub. I think the contractions started to space out and I caught myself falling asleep in between some of them. When finally, my bag broke and a puff of clear fluid rushed into the tub water...I am almost there! I couldn’t stay in the tub any more, I wanted to get out and get down to business. I am not sure how much time passed. I couldn’t help but push. I was standing and I looked up at the clock, it was 1 am. OK, I thought, I have been at this for 24 hours now, time to have a baby. I knelt down on the pad and started pushing seriously. I t didn’t seem like much was happening at first. I could barely keep myself upright. I took some on my side and some on hands and knees. Marlene had been at the ready, but upon seeing me lying on my side and seemingly having a hard time coordinating my pushes, she took off her gloves, knowing it could be a while. At that point I grabbed onto Matt, I was kneeling, he was holding my hips and I was holding his shoulders. I pushed SO HARD...we heard a loud POP! I felt it & Matt could feel it resonate through my body and even Mar heard it. “I think I broke my tail bone”, but at that point I didn’t care, and honestly, it didn’t hurt. Overall, pushing didn’t really hurt. It was intense in an undefinable way, there was so much pressure, you have no choice but to move the baby down. After that pop, I really started moving the baby, I felt her head descend...and here she comes, I was reaching down touching her head as it emerged...Matt readied his hands and began feeling her head too. I feel as thought I slowly, and deliberately let her head slide out...and I did a great job, I didn’t tear!!! I pushed out her head in about 1 or 2 pushes. There was a pause and I leaned forward onto hands and knees as Matt gently guided her to the ground. That was perfect b/c I needed to sit back and swing my leg over her so that I could pick her up. Matt and Mar handed her to me...I was immediately HIGH! I can’t believe the high you get from birth, it is so great, better than any drug because you have actually accomplished something. I just scooped her up and snuggled her, amazed! Matt got out the camera and took some photos...we were ecstatic. My midwife brain kicked in when it was time to deliver the placenta. I think it took a while to deliver, although I am not sure how long. I remember Mar gave me some Angelica to help it along. I will have to check with her on this but I think I finally delivered it myself after following the cord up to ID its location. I remember we cut the cord before it was delivered b/c she had a relatively short cord and I was having a hard time getting her up high enough on my chest and getting us both comfortable. After the placenta was delivered my bleeding was no problem. We encouraged Chica to come over and meet her new sister. She was pretty uninterested. She was in her bed during the last stages of labor just hanging out while mama was birthing, so casual:) After we snuggled and got comfy on the pad she began nursing right away, I think about 15 minutes after birth. She has no problems with nursing that is for sure. I felt so great I was able to get up and make it into the bathroom after handing her off to Matt so they could get acquainted. That was a really sweet sight to behold. We just weighed her at that point, 7 lbs 10.5 oz. She was pretty fussy so I showered and brushed teeth and got into bed to try to make her cozy and nurse her. Just before bed I had some of Aemonn’s burger from earlier, that was a real treat! I was so hungry. The little critter only slept for 2 hours on my chest, then she needed to change position. The bed was tough b/c my tail bone was becoming increasingly painful! We got up and went in to the green chair and snuggled for another couple of hours...Mar slept through all of our fussing and squirming. At 8 the Lindauers came over b/c they couldn’t stand to stay away b/c they were headed to Mrose that day. I was thrilled for them all to come by. They said a quick hello and met the little critter, then Mar and I took care of some biz...Rhogam and Vit K, etc. While we tried to let Matt sleep. After cleaning up and getting just 4 hours of sleep, Mar slipped away and I went back to bed. Then I really slept and so did the babe, I think we woke around 11. Then it was on with our day! And what a day, I was beaming, and so was Matt. Here she is, our little critter.

VBAC Mothers Rock!

I wanted to make sure that I documented this wonderful client. Here I am with mother, new baby Rebecca (yes, they named the baby Rebecca) and the new big sister Cambree. This was Ramona's fourth baby and 3rd vaginal birth. Amazingly, I got a call from Ramona when she was 37 weeks. She was looking for help. She was being released from care by her Doctor in Utah because she was a VBAC (vaginal birth after cesarean). Even though Ramona had previously delivered 2 babies vaginally since her C-section over 12 years ago. The C-section was performed b/c her first little guy was Breech, and for a first time mother this contraindicates a vaginal birth...even in the home birth setting. At 37 weeks the doctor had his assistant call my client to inform her that she would not be able to deliver in their hospital because of her previous Cesarean. Despite the fact the last vaginal birth (Cambree) had actually occurred at the very hospital that refused to deliver her. What nerve! So, needless to say I was happy to help. We quickly got to know each other and a few weeks later Ramona had a beautiful, gentle birth in her own bedroom, gracefully birthing Rebecca into the world. Congratulations to every VBAC mama out there...you rock!

I am Learning

I am learning what it means to be a pregnant woman. So many clients are saying to me, "I can't wait to talk to you after the birth!" What do they know that I don't? Well, a whole lot actually! I have attended so many births, and there is so much I feel that I understand just from being a woman myself but none of that is the same as actually experiencing it for myself. No man will ever truly understand what a woman goes through, and I now understand more than ever why women need female practitioners to support them through this process. Honestly, because of my work as a midwife a lot of the "magic" is probably absent from my pregnancy. I see pregnancy as overwhelmingly normal and really, I am not a very spiritual person, so I don't look for meaning in most things. I don't rely a great deal on symbolism or hidden meanings...I am a very practical person. I am growing a baby, it is a rather "matter of fact" affair for me. It is something I have always known I would do. I feel in some ways I am fulfilling a destiny, one that I wrote myself. I think the most exciting part of this whole journey is that I get to do it with my long time partner Matt. We have evolved through so many changes and stages that this baby seems like just the fulfillment of all of our struggles and successes. So here we go...

The Midwife is Pregnant!

Phew! Is it possible that I have not posted since last April?! I recently began to write in my journal to record some tid-bits about my pregnancy (yes it is true:) and saw an unfinished entry in my journal from around the same time as my last post...last summer arrived and I abandoned my blog, my journal and somehow have managed to make it to January with a baby in my belly and about a dozen births to show for it all! Well here we go, it is catch up time...I am currently 21 weeks pregnant at 36 years old. This is a long awaited baby for me, I have always been clear that around 35 would be the time to go for it. I love babies and have been excited to experience pregnancy and childbirth for myself, but my love for attending births has kept me on the sidelines. Honestly, the thought of NOT attending births for any significant length of time makes me mortified. I mean, my idea of a vacation was going to Bali for 6 weeks and catching 62 babies. So I have been very aware that becoming a mother myself was going to put a serious damper on my midwifery practice. I have waited long enough and the time is right, I have a wonderful partner and I am ready to put my practice on hold for several months while I adjust to motherhood. I am ready to take a break from births...whoa! Did I just say that?

As for my current birth scene I am currently waiting for a very special client, a woman who has helped me at births in the past and I had the honor of catching her first baby. Her first one was a beautiful "sort-of-water birth" because she was in the water until the head came out, after which I discovered there was a nuchal cord. I thought it was tight at first, so being the relatively green midwife I instructed the birth team to lift her out of the water so that we could manage the cord. It turned out to be much looser than I had first thought and little Violet's body was easily born as mama stood outside of the tub, triumphant and ecstatic. This baby was born into my hands with the help of student midwife Marlene Bergman (now a licensed CPM) because our "teacher" had gone out for pizza (literally) thinking, "Aww, this first time mom will take a while." Nope! We walked and squatted as we paced through the mama's garden-and she progressed quickly. In the picture above you will see Marlene, who is now my midwife, holding little Penelope (a baby she helped me with this summer). Unfortunately, I don't have any pics of Violet and her mama...but I know the birth was video taped. Maybe I can post that some day!

Waiting

     Tonight I am reminded of one of my favorite descriptive phrases about midwifery. "A good midwife knows when to sit on her hands and when to use them." I seem to sit on my hands a lot. Waiting for labor to begin naturally, waiting for a mama to dilate in her own time, allowing a woman to rest as long as she needs to, believing that she really can do it, having faith that the baby will fit through, loving a sleepless night, hoping that the contractions will get stronger, giving a mama permission to cry, supporting her as she screams, bellows and crawls  to bring the baby down. I know when to use my hands as well, when to break the water, when to stretch the perineum, when to ventilate the baby and when to give a pep talk that just may be the difference between a transport and a home birth. I love my work. I feel so blessed to be invited to a birth. I think a lot about who will attend me when I give birth. It is not an easy decision, I do not take it lightly, and I know my clients are bestowing a great honor upon me when they ask me to be their midwife. I do not take it lightly. 

     As a doula in the hospital I recently had 2 clients who had cesareans, one due to a posterior baby and one due to "deep transverse arrest". This is basically when the baby's head is turned looking hard right or left, whereas the head is ideally looking back toward mama's tail bone. I am so proud of both mother's. They both worked so hard and persevered. They were both incredibly disappointed at the loss of a vaginal birth, but the healing will be easier knowing they can look into their baby's eyes with joy and love. A current client just recently was telling me about her vaginal birth with a posterior baby and she said she had to "fight for my birth". The entire staff wanted to give her a section but she persevered, worked harder and gave birth vaginally. It was traumatic. There was an implication in her story that if women would just work harder, push harder, demand louder and more fervently then they could give birth vaginally, when everyone else doubts them. Is this true? Should we have to "fight for our birth"? Or should we just birth at home...where we don't have to fight? Or is it just sometimes the case that it is beyond the power of the woman, and left to some natural forces that we can't explain or fully understand. For now, I will just continue to wait.