Thursday 25 August 2011

Tips for a Successful VBAC

I think that really, most of what I will suggest here are more like tips for planning any birth.  In my case, it took the second time to put more thought into it.  But really, if most women put more thought into what they wanted to achieve through their birth experiences right off the bat, I'm sure most of them would end up getting the result they were hoping for.  Anyways, I did learn a lot through my second pregnancy and VBAC experience, and am more than happy to share some of the things that I thought were important during the planning process.

First and foremost, make the decision to have a VBAC.  Most women I have talked to in a VBAC situation didn't start their journey thinking they wanted to have one.  It was more of a "well, let's see how things play out" or "I'll decide closer to my due date" sort of a situation.  In my personal opinion you are setting yourself up for failure leaving it to chance.  If you know a vaginal birth is something you want, for yourself and for your baby, make the commitment right away.  If you are unsure initially, do all the preliminary research to help you make this decision.  Don't let it go on and wait to decide later. 

Read and research about VBAC.  Even if you are not pregnant yet but think that you want a VBAC for your next birth, start now.  I started reading about VBACs when my first son was only weeks old and continued my research throughout that first year even before we knew we wanted to have another baby.  Seek out other women who have had VBACs to share their stories with you.  Hearing from others first hand is very inspiring.  I was fortunate that my mother in law had experienced a VBAC, 25yrs previous, and in less than ideal circumstances when it was not the norm.  Sharing her story with me gave me a lot of hope for my own VBAC.

Find a care provider who supports VBAC.  And I don't mean a doctor who tells you "sure, you can give it a shot".  To me that is also setting you up for failure.  Your doctor or midwife should be supportive right off the bat, and there should never be any doubt that it is achieveable.  A good care provider will give you all the proper information up front, and answer any concerns you have honestly and without judgement.  If he/she has any reservations, I can almost guarantee they will cast a negative cloud over your efforts.  If for any reason you feel like your doctor is not supportive, don't hesitate to get a second opinion or even change care providers.

Hire a doula.  Especially if this will be your first labour and you don't know what to expect, but even if it's not every birthing couple will benefit from the added support and knowledge a doula will bring.  We didn't decide to hire ours until I was in my 6th month of pregnancy, but I had always felt we would benefit from having one.  And I was right.  A doula is not there to replace the support from your partner.  Many partners (mine included) may feel threatened that you would like to have a third party involved at such an important time.  But the support from a doula is invaluable.  She is not there just for the mother, but for the whole family.  She can provide lots of information throughout your pregnancy, not just at the end when it's time for baby to come. 

Prepare your mind.  This is one of those things that every pregnant woman should consider anyway, but I felt that in my VBAC situation especially, with the added pressure of success, I really needed to focus on my preparations.  I felt a lot of anxiety throughout the later months of my pregnancy, anxiety about the position of the baby (my first son being breech), about whether my body could handle labour, about whether I could handle labour, about going into labour on my own, and of course about the pressure of being successful and how I would cope if I wasn't.  Talking with friends, my husband, my doula, my midwives, and other members of my support team helped with this.  It helped me to air my frustrations and worries, and to be reassured that I could do it.  I also found that practicing my Hypnobirthing breathing techniques helped me relax and release any fears that I had.

Prepare your body.  Again, a good tip for any woman planning her labour but even more so in a VBAC situation, at least for me, because of the desire to be successful.  Perhaps in the case of the woman who attempted labour and ended up with an emergency c/s, she may feel that her body somehow failed her.  Spending extra time preparing your body for labour may give you confidence and peace of mind that you can do it.  I found in my case especially, since my first son was breech, I was always wondering if there were ways I could have encouraged him to be in the right position.  So for my second pregnancy I was very attentive to my posture, making sure not to put my pelvis in any positions where it might be out of alignment.  I attended regular chiropractic and osteopath appointments.  The knowledge I gained from my chiropath and osteopath was invaluable.  I consulted with my naturopath to find out how I could be as healthy as possible through my pregnancy.  I stayed active and did moderate exercise.  In the weeks approaching the time my baby was due, I used several different homeopathic and herbal remedies to help prepare my body (on advice of my naturopath.  I would urge any woman interested in this route to seek advice of a qualified professional).

Consider fetal positioningSpinning Babies is an amazing website and resource when it comes to learning about fetal positioning and how it affects labour.  In the case of a previous breech baby (like mine) you might be more worried about a second breech.  Or in the case of the mother who was told she had to have a c/s because her pelvis was too small (something that is actually not truly likely), position may be even more important.  There are things you can do to help baby get into the right position for birth, which in turn may be the difference between a quick labour or a more drawn out one. 

Avoid induction.  Actually, every woman should avoid induction VBAC or not, but that could be another topic altogether.  Depending on where in the world you are, induction may not even be an option, as many medical methods of induction increase the chance for uterine rupture (not just in VBAC situations, but in all births).  The best thing for you and your baby is to go into labour spontaneously.  Many inductions will go on to end in c/s, even for the woman who is not trying for a VBAC.  I remember feeling very nervous about baby going post dates (it also helps to remember that full term is 42wks, so there is no need to hurry the baby out before that point or even after in most cases), but I found that since I had prepared myself both mentally and physically, and practiced fetal positioning, we were all set and my son made his appearance on his own, and in good time.  He was ready, we were ready.

Trust your body.  Probably one of the most important points.  Remember, a woman's body is designed to give birth, it is a natural event.  It helps to remember this when you are stressed or worried about labour and birth.  If left to unfold as nature intended, the birthing process will almost always go smoothly.  Trust in yourself, and your baby, that you will know what to do.

Wednesday 24 August 2011

Interesting Article on VBAC

I love finding stuff like this as it fully sums up how I feel about VBACs and reinforces everything I learned when I was planning my own VBAC.

VBAC Sabotage - Is Your Doctor Really VBAC Friendly?

Wednesday 17 August 2011

Fears


The thought of childbirth never ever scared me.  I can't remember one moment where I thought I was scared of what it might be like or feel like, or that I wouldn't be able to do it.  When I read the Hypnobirthing book and read all about pain being the result of fear, it made so much sense to me.  And it really was true, since I was not afraid, I really did not experience pain, even during labour with my second son.  It was very uncomfortable by the end, but not painful.  I am always in awe of myself over how I mastered the fears that most women have about childbirth.

I have new fears now though.  I am not scared of pain, but I am scared of failure.  Traditionally I am one of those people who has lots of ideas but never follows through.  Most great ideas fizzle and die before they become anything.  Not to say that I've never done anything great in my life, obviously I have, but I do wish I had more motivation, that I didn't let fear get the better of me.

What am I afraid of?  Afraid of not succeeding?  Afraid of hard work?  I'm not too sure.

The same holds true with my doula ambition.  Because I am not in a position to start training formally, I am worried the dream will fizzle and die.  I'm worried I won't follow through.  That I'm all talk and no action.  When I think about doing it, I think YES I CAN.  But then I think about what comes next.  What happens after I finish my training?  Education has never been a problem for me, it's the go-get-'em attitude that comes after that part is over.  The part where I start my own gig, start working.  I usually fade into the woodwork, lacking the drive and motivation it takes to go out there and be successful.  So then I wonder, am I just chasing an empty dream here?

But then, when I am reading my books, and articles, and blogs, I feel it.  I feel like I want to continue, that it feels right to be a part of this, and to share it with other women.  Surely those feelings can't be wrong, and I need to just focus my energy on them and keep moving forward. 

I'm afraid I do lack terribly in self-confidence.  I get discouraged easily.  I have my humble little blogs, but then I go out there and see what other women are doing, what they are putting together, and I feel so.....small.  There is so much more information out there that I have yet to learn.  I don't know where to put it.  I feel like I lack the creativity to make it, at anything really. 

These are fears I am trying to master.  I am trying not to let them get the better of me, like they have always done.  With everything I have ever been good at or interested in, my husband would say "Why don't you do it/teach it?", and I would shrink back, lacking in confidence to go out there and get it done.  I do want this to be different.  I do have visions of starting something.  I still don't know when, but I feel it can be done.

I coach myself everyday on how to be a better person and overcome my short comings.  I feel like I have grown more as a person in this past year that I ever have before in my life.  If I want to do it, I can, I just need to keep growing and keep moving forward.  And stop procrastinating.  And stop worrying.  And start doing.

So the truth is I haven't posted here in a good week because I had run out of things to say.  And that is all part of my fear, that I start strong and then fizzle out.  And then I realized that this blog isn't meant to be about pregnancy or birth or parenting exclusively, it is meant to be my outlet on my journey towards this goal, and I should absolutely post my fears here.

It is halfway through August and I am halfway through my first book, right on schedule.  My next goal is to get my ICAN Simcoe County membership up and running, and see what I can do through that organization.  I figure if I set small goals for myself, I will feel good if I accomplish them one at a time.

I conquered fear in childbirth, and I can conquer fear in this as well.

Tuesday 9 August 2011

Cesarean Awareness and VBAC Support


A few months back I met a lovely mother at the YMCA where I take the boys for active tots.  Her son was the same age as my older boy, and she was about 37wks pregnant with her second son.  After speaking with her I learned that her first son was born by c-section after a long and gruelling labour, but that she was going to try for a VBAC this time around.  I was happy to hear this of course, and I think she was pleasantly relieved to hear that I had a successful VBAC.  Finding a woman to talk to who has had a VBAC seems to be a difficult task for many other women.

I bumped into her yesterday and her gorgeous new baby, not even a month old.  Of course I was curious how it went, and had even been thinking of her over the last few months.  I was disappointed but not at all surprised to hear that she ended up having a repeat c-section.

Obviously only having spoken to this lady a few times, I wasn't about to go pressing for intimate details about her birth, but I gathered the gist of it was she went into labour on her own (yay!) 10 days overdue, but soon into it decided to have the c-section (boo!) to avoid the same situation she had last time which was a long labour ending in surgery.  I wondered to myself, was she informed?  Was she supported?  Not only by her careprovider, but by those around her.

Why is it so hard to find successful VBAC stories?  This is not the first instance where I have encountered someone who mentioned they were thinking of trying for a VBAC but opted for a c-section instead.  Granted this lady actually went into labour first at least, in most cases the mother just goes ahead and books the surgery ahead of time.

It is not my place to judge individual situations.  But a small part of me cringes every time I hear someone in a possible VBAC situation say they aren't going to go for it, or even if they were but they changed their mind at the last minute.  I don't want this to be taken the wrong way by anyone as I do know many fantastic ladies who ended up in these types of situations, and I'm not going to go unfriending people or making enemies over their choices.  Not to mention the fact that what's done is done, I won't lose sleep over someone else's decision.  But naturally I do wonder, why?  Why did they choose another c-section when a VBAC would have been better for them and their baby?

VBAC aside for a moment, I will never understand why a woman would book a c-section (ok wait, we had booked our first one so I guess I do understand from a certain point, but now that I am the wiser I would not do it).  Like with breastfeeding, I will respect that women have the choice, but in most cases I won't understand why they would choose surgery over at least trying for a natural birth.  The only thing I can come up with is, they were not properly informed.  I know that if I had been, and done my homework, I would not have booked an elective c-section for my first son's birth.

When I was pregnant with our first son, my husband had a client who swore up and down that booking a cesarean was the only way to do childbirth.  Her reasoning?  It was more convenient for her.  She almost had him sold on the idea.

In a VBAC situation, I realize that a lot of women are scared.  Particularly if they laboured the first time and ended up with a c-section, they are afraid of the same situation happening again.  I had the fortune to not have this fear, never having gone into labour my first time around.  I can appreciate that fear is a very strong emotion and driving force when making decisions, especially one where the health of your baby is concerned. 

Of course then there are all other things I hear - the doctor said there isn't a chance at successful VBAC, it's too dangerous with the risk of uterine rupture, first labour was failure to progress and the mom's pelvis was too small so no point in trying again because the same will happen.  I cannot stress how there is so much information out there about these topics that is not being shared, and what women aren't being told is that medical intervention is often what led to their cesarean in the first place. 

I feel that it is a woman's job to be informed when making these decisions, and unfortunately most of them are not being given the proper information and support.  In the case of the lady I spoke to yesterday, I suspect she was under OB care and the doctor said to her "sure you can try if you like" but didn't give her the support or the resources she needed to be successful.  With a proper support team in place, the chances of having a successful VBAC are great.

I think I just have such a hard time wrapping my head around two things:  One is why there are so many cesareans in the first place, and two is why more women aren't offered support for attempting VBACs when it is a known fact that vaginal births are healthier and safer for mothers and babies in almost every instance.  I will not dispute that in rare cases a cesarean birth is necessary, but in the vast majority of situations it could have been avoided with proper knowledge and support.

There is a great organization called the International Cesarean Awareness Network (ICAN) which offers information and support for women planning VBAC, as well as providing awareness about unnecessary surgical births.  I am currently in contact with the Simcoe County branch and am going to become a member and volunteer, so I can help educate and support others about these important and often overlooked topics.

I wonder how many cesareans could be avoided, or how many women would go on to have successful VBACs, if only the right information were being shared.

It is easy for me to sit here and preach about VBAC after having had a successful one.  But I can honestly say that it did not come without research or effort.  If you want it, then learn and do all that you can to make it happen.  If you are indifferent and decide to see what happens, or want to just go ahead book a c-section, make sure you are making an informed choice.  You might find your attitude changes when you realize not only how much better a vaginal birth is for you and your baby, but that you have a great chance of success and are at no greater risk for complications than in any other birth situation.

Back to the topic of my own planned cesarean.  Of course at the time, being far less educated than I am now, I was made to believe that it was the safest thing for my baby.  I now know that it would have been better to at least have let us go into labour naturally before making the decision to have surgery.  I do feel a little guilty for having taken that decision out of my son's hands, and again feel fortunate that we had a positive experience because it could have been worse.  He might not have been ready to be born and as a result had suffered complications.

I feel like I have so much knowledge to give other women planning their births, not just in VBAC situations but even for first time pregnancies.  There is so much information that gets overlooked which could mean the difference between an unnecessary surgical birth, and the natural birth that is healthier for the mother and child.  This was a hard post to write, simply because there is so much information to share, and because I feel so strongly about these topics.  It was hard to organize my thoughts, hopefully I have made some shred of sense in all my jabber.

I found this article really interesting on the topic of risks associated with VBACs:  VBAC: making a mountain out of a molehill (be sure to watch the video at the end, it is so heartwarming and empowering, and I cried all the way through it)

The bottom line, the choice is personal, but make sure it is an informed choice.  The natural start of labour and a vaginal birth is how nature intended babies to be born, and it is a healthy and safe choice even in a VBAC situation.

Monday 8 August 2011

The Womanly Art of Breastfeeding

This month's book is La Leche League's The Womanly Art of Breastfeeding.  I have read this book before, after my first son was born.  A lovely neighbour of ours stopped by one day and dropped off her copy for me to borrow.  I ended up buying my own copy because it was such a valuable resource (and I love having my own copy of books so I can go back and re-read them).

Breastfeeding is an art, and as far as artforms go there is probably no more womanly one at that.  I knew without a doubt that I would breastfeed my children, even before I knew all the benefits of breastfeeding for both baby and mommy.  It just made sense to me.  Why would a woman buy food for her baby when she could make the best stuff for free?  It seemed like a no brainer.

What I didn't know, was that breastfeeding isn't always easy right off the bat for a new mother and baby pair.  I didn't read much about it before I became a mom.  I always just assumed it was natural, that it just happened.  That baby would know what he was doing even if mommy didn't.  I remember sitting in my child education class at North York General, 1 week before my son was born, and the teacher asking for a show of hands who was planning on breastfeeding.  Most mothers put up their hands.  Then she just kind of waved at us and said "Don't worry, it's easy.  You'll all be fine".  At that was that.

After my c-section, when my son was finally in my arms, I remember looking at him and thinking, "What do I do now?  Do I feed him?  How do I do that?"  I looked to my midwife for answers, and unfortunately she didn't have any for me (bless her she was sweet, but I could tell she was inexperienced and lacking in confidence).

My first attempts at putting my baby to the breast were unsuccessful.  I just could not get him to latch on.  For my entire hospital stay I couldn't feed him.  I was surprised at how foreign it was to me, and to him.  Neither of us knew what we were doing and we were both frustrated as a result.  I was also frustrated at the lack of support at the time.  Midwives, nurses, doctors, no one there seemed to be able to help (or want to help for that matter).  It was the weekend, and there were no lactation consultants around.  I hand expressed my colostrum and gave it to him from a tiny cup or syringe, and just kept trying.  After two days we thought we had a breakthrough when a more senior midwive came to visit and was able to get my nipple in his mouth, and he seemed to latch on briefly, only to lose it again.  But it didn't stick.  We figured we would have more success once we were in the comfort of our own home.

That first week was horrible.  My milk came in, and my son was still not latching.  I was in so much pain, and I just didn't know what I was doing wrong.  The engorgment made it worse because he just couldn't get on since my breasts were too full.  When the midwife visited us she suggested pumping a bit first to soften them up, and we thought that was the trick we needed and would be fine.  But every night I would lie in bed in frustration, trying over and over again to latch him and then expressing and feeding him by cup or syringe when I was too exhausted to try anymore.

I cried and cried.  It was the most horrible time.  I was in pain, I was hormonal, and worst of all I felt like I was starving my child.  My nipples were sore and cracked from the poor latch I was getting from him.  Finally on the Thursday after he was born, when he was almost a week old, my husband called a lactation consultant out of desperation.  We just went online and looked one up randomly.  She spoke with me right away, and said she would make it down that evening, but until then to do nothing but sit on the couch, skin to skin with my baby.

That afternoon our other midwife who had been on vacation visited.  Finally, she was able to help us latch him on.  Her advice was much more specific than the previous midwife had given, and we were finally getting a sense of what we had to do to get him latched on.  After she left I was able to latch him on successfully for the rest of the afternoon.  When he was feeding properly, the pain was gone.

I cannot tell you have relieved I felt when I saw he was latched on and feeding properly.  It was one of the most joyous moments for me as a mother. 

The lactation consultant arrived a few hours later.  She was fantastic, and actually she confirmed what our midwife had discovered too, and that was that all this time I was positioning him wrong to get him to latch on.  Even though I was trying different positions, I wasn't getting his head in the right spot so that my nipple went to the back of his mouth.  I was trying to direct his head straight onto my breast, instead of more upwards and then moving him onto the breast.

Of course all of this was in the little bit of literature that I had read prior to birth, but that stuff was useless when I didn't know what I was dealing with.  I needed someone to show me how to do it.

Our second midwife and the LC were both fantastic, and I was so relieved to find out the problem wasn't something that couldn't be fixed.  Rather it was very simple, and I just need some proper support and guidance.

It still blows my mind to this day that neither the first two midwives who saw us in the hospital and at home, nor the nurses who attended us, nor the doctors who checked in on us were able to show us what was such a simple little trick so that we could breastfeed effectively from the start.

I didn't know at the time, but I now know how important breastfeeding support is.  Knowledgable and experienced midwives, lactation consultants, and even doula support can help make sure this crucial aspect gets off to the right start.  I wonder how many mothers gave up breastfeeding early on because they didn't have the right support, saying it was too painful, or that they didn't have enough milk.

We did not have any major breastfeeding problems.  It was just a matter of positioning.  And from the moment that the LC left our house onwards, we never had another breastfeeding issue again.

When I first had the realization that I loved pregnancy, birth, and babies, becoming a lactation consultant had crossed my mind as well as becoming a doula.  But when I looked into it, it seemed a little less attainable.  I would have had to go back to college and taken nursing first I think, and then complete the training in Toronto.  Being a doula seemed more fitting to me.  But I have never forgotten my early experiences breastfeeding, and would love to offer breastfeeding support as well.  I am thinking that I will include training to be a breastfeeding educator and counsellor when I complete my doula training.  I may also look into what is involved in becoming a La Leche League leader in my town.  I don't think there is one here, the nearest one being 1hr away in Barrie the last time I checked.

The woman who lent me the book initially attended regular LLL meetings and had invited me.  I never made it out though I wish I had.  I think that having the support of other breastfeeding moms really is invaluable to a nursing mother, especially a new one.

When my second son was born, I felt so much more confident when it came time to breastfeed him.  He latched on almost immediately.  I could tell our latch wasn't perfect right off the start, but it was easily corrected with some patience.  It felt so good to get it right from the start, the second time around.

I have enjoyed wonderful breastfeeding careers with my sons.  I nursed my older son until about 14mos.  I had planned on continuing longer, but I was already pregnant and it just seemed like I had very little milk left.  He was rather indifferent which made the decision to stop easier, as he didn't even seem to miss it.  I think I could have kept going if I wanted to.  Knowing what I know now all I would have had to do was just keep doing it.  But stopping when we did felt right, and we were both happy with the decision.

My second son is over 15mos now and he still nurses 3 times a day.  Sometimes he is less interested, and sometimes it feels like there's not much there.  But we are still both enjoying the quiet time we spend together when he is breastfeeding, and I don't feel any need to stop any time soon. 

I feel strongly that every woman who is able to do so should breastfeed her baby.  It is one of the greatest gifts you can give to him or her.  I respect the choices that some women have to make, which often include formula feeding instead, though I may not always understand them.  If you can do it, why would you do differently?

Breastfeeding support is yet another reason I would love to be a doula.  My suggestion to any woman who is thinking of breastfeeding their child, is to arrange support before baby arrives.  There are so many great resources and so much support out there for breastfeeding mothers if you know where to look.  Midwives, lactation consultants, doulas, and even other nursing mothers can all offer advice and support.

Thursday 4 August 2011

Everyone Has to Start Somewhere

I could sit here and write out every detail surrounding my two pregnancies and births in the order in which they happened.  I could probably fill pages with this kind of stuff and would gladly share my stories with you any day.  But it might bore you to death.  If you were interested in reading a bit more about this kind of stuff, I have touched on it on my other blogs.  You can find it all here:
Life on the Bay - Finn's Pregnancy
Life on the Bay - Finn's Birth (VBAC)
Dear Children, Love Mommy - Tristan and Finley Birth Stories

As I have briefly mentioned, I did not put a lot of thought into my first birth.  I read about labour, the stages of it, and the options for pain management.  I knew early on that I wanted a natural birth, free of medications that might harm me or my baby.  But midwife care vs OB care?  Hospital vs home birth?  Cord clamping and cutting?  Birth plans?  How to breastfeed?  Fetal positioning?  Nutrition and exercise?  There was so much information that got overlooked.  I guess I just figured it would all play out, that I didn't have to do anything to prepare.  Sure, we took our Hypnobirthing classes (with Jennifer Elliot from Life's Journey) and we did learn a lot, but somehow so much of it went over our heads, like we somehow didn't need that knowledge because it would just fall into place.

When I found out I was pregnant, my first move was to see my family doctor.  I was curious about midwife care but didn't know anything about it (and assumed that I would need a referral as with an obstetrician).  I enquired about midwife care through my family doctor and she really did not have any information for me but said she would look into it.  A few weeks later the only thing I heard from her was that she referred me to an OB and my appointment was booked.  I figured that was that.

I was under OB care for the first two trimesters of my pregnancy, and never felt satisfied.  It's not that she was doing anything wrong per se, it was just so....impersonal and cold.  I would go there, the receptionist would hand me my stick to pee on and tell me to bring it back.  She would check it, write down the results, then I would sit and wait.  The waiting room literature consisted of pamphlets about cord blood banking, and long outdated fashion or home magazines, with maybe a parenting one thrown in.  Finally I'd get called in, the receptionist would weigh me, then I would wait in the examination room for the doctor.  She would usually come in, head down reading my file, rush over and feel and measure my belly, listen for the heartbeat quickly, then rush back out again.  Sometimes she'd ask if I had questions, and other times she was gone before I could say a thing.  If I did have a question she gave me this look like I was ridiculous.  It was not a particularly enjoyable experience, not to mention the fact that under OB care your baby is not guaranteed to be delivered by your own doctor, rather it would be whoever was on call, and I was not really comfortable with this.

It wasn't until 29wks pregnant that I wised up and switched to midwife care.  We were moving anyway so I took the opportunity to make sure I was under the care of someone I trusted.  We were fortunate that the practice took us so late in our pregnancy, but they accommodated us no questions asked, and from the minute I stepped into their office I knew this was the care I wanted.  It was open, bright and comfortable, with shelves of books about pregnancy, birth, breastfeeding, parenting, and everything in between.  The atmosphere was warm and inviting.  You peed on your stick and relayed the results to the midwife yourself, not having to hand it into someone else to look at (gross!).  There was a scale in the bathroom if you were interested in how much you weighed, but it was not necessary to use it. 

When I would go to my midwife appointments, I never felt rushed.  We would sit and just chat.  She would always ask me if I had any concerns.  She would listen to the heartbeat if I wanted, but didn't make a big deal about it being necessary.  She had so much more information for me than I ever hoped to get out of the OB

Not that I would say having an OB is the wrong choice.  For many women pregnancy holds complications and being under OB care means peace of mind.  And I am certain that so many doctors are warm and inviting, and offer more information to their patients.  But the choice between OB and midwife care was just one more thing that had I been more informed and done more research from the start, I would have done differently right away.

A healthy woman with an uncomplicated pregnancy should consider midwife care.  Birth need not be a medical event, and unfortunately all too often it becomes one when medical interventions are offered with what would otherwise be a normal, healthy pregnancy. 

Now, in my case even with midwife care, medical intervention was still present and was a huge factor in how my son was born.  I do not in any way think it was anyone's 'fault', but I do find it interesting to think about the circumstances and what could have been different.  While I felt very comfortable with my midwives and was happy with their care, something stands out to me now after having gone through pregnancy and birth with another practice.  As I have mentioned, my son was breech, and we wanted to try a technique called a External Cephalic Version or ECV.  I had done a little bit of reading about the procedure and from my understanding it would usually be done without any type of medications, and although uncomfortable it is not generally considered painful.  I had also heard through a friend who was also pregnant with a breech baby, that the midwives at her practice performed the versions themselves.  At my practice they did not do them, and referred me to an OB at the hospital who did.  When I met with her I was told that it would be painful, and therefore they recommended performing it under epidural anesthetic and also scheduling a c-section at the same time so if the ECV failed they would go ahead and deliver via c-section.  Additionally, if it did work they would go ahead and induce me the same day.

Well you can imagine that this was not what I wanted, and did not sound right to me.  But at that point I felt like I was entirely in the hands of the OB, and she more or less told us that it would be too dangerous to allow me to go into labour with a breech baby.  When I asked about having the ECV without the epidural, I got a bit of a "tsk tsk" and "Well, you can....but I would not recommend it".  For me, with my limited knowledge from what I had read, I was almost ready to stand my ground.  But my husband, who had not read a thing, was of course ready to follow everything the OB said.  And I did have to respect his wishes too.  I was not nearly as informed then as I am now, and as new parents we only wanted what was best for our baby (according to what the doctor said).

I think what surprises me the most here is that in this case the midwives did not have more to offer.  I know now from talking to others, from my own research, and from my experience with a different midwife practice that this should not have happened.  I should have been more informed.  Someone should have said to me "it would be better for you and your baby if you wait to go into labour", or "you do not have to do this if it's not what you want".

Also at the time, to attempt a vaginal birth with a breech baby was not entertained.  I might have tried, if someone had said to me "You can do this, we can do this" and had been confident in it.  But I was given a flat out no.  I do know that there were practitioners who may have tried, but I didn't know where to find them at the time. 

After my son was born though recommendations have changed, and I am happy to hear they no longer automatically suggest booking a c-section for a breech baby.  A trial of labour is recommended providing there are no complications.

Of course I do not blame anyone for anything.  If anything I should have been more informed myself.  I was clueless at the time, and my lack of knowledge led to a lack of voice to stand up for what I would have wanted.

I am happy to report that although our ECV failed and they were unable to turn my son around, I did have as wonderful a c-section experience as one can hope.  There is always a bright side, and ours it that everything went smoothly, and both my son and I were healthy and had no complications.  I have learned from this experience, learned to be more knowledgeable when important things are at stake.  And this is one part of what makes me want to be a doula, so that I can inform others and help them to find their voice.

Tuesday 2 August 2011

Welcome!

Welcome to my doula blog!  My name is Martina, and I am a self-professed birth junkie.  I love anything and everything to do with pregnancy, birth, babies, breastfeeding and beyond.  I will talk birth to anyone who will listen.  I am one of those ladies who has to fight the urge not to bombard others with pearls of wisdom surrounding all these topics.  It is a hard task to hold my tongue, but as a woman who often does not enjoy unsolicited advice myself, I also believe in respecting others when it comes to giving advice.  However if it is the case that you would like to talk birth me with me, I am always open!

This is the reason why I am hoping to start (and complete) my doula training, hopefully within the next year (starting that is, it may take me longer to complete!). 

I am hoping to make this blog sort of like a diary, a place to keep track of my journey towards hopefully accomplishing my dream. 

I would like to take a moment though to mention the ever important disclaimer when it comes to blogs such as this - I am not a medical professional!  And will not be even when I do become a doula.  In fact it is not my goal to give advice here, it is merely a place to document my own personal growth and knowledge on my path to becoming a doula.  Seldom will you hear me writing long pieces involving lots of research and quotes from other sources.  I may include this sort of stuff in my rambling, but it is not my goal to 'be' the research. 

I have included a list of websites and blogs that I have found helpful throughout my childbirth travels, and I hope that you will find them interesting as well.

Now that I've made that point, on to other stuff.  I suppose I will include a little bit about me and why I would love to be a doula.  I am a mother of two boys, born August 2008 and April 2010.  I am one of those women who absolutely loved being pregnant in every way.  It was a joy from start to finish in both cases.  I was fortunate enough to have wonderful pregnancies, free of any discomfort, sickness, or complications.  I had two very different birth experiences which I will probably talk about in separate posts.  And while there are always things I wish had been different, I have made peace with my experiences and view them in a positive light.

I have breastfed both of my babies right from birth with very little issues, and feel fortunate and proud to have done so.  I am a huge advocate for breastfeeding and do believe that breast is best.  My first son was breastfed until about 14mos, and my second son is 15mos and is still breastfeeding without and signs of stopping soon.  I will let him decide when to wean.

And now onto what made me decide I would like to be a doula.  I did not put that much thought into my first pregnancy.  I knew I wanted a natural birth, and I had decided to practice Hypnobirthing techniques to achieve this.  My son had other plans and was breech, at which time I was advised he would need to be born via cesarean section and that I should book it ahead of time.  Which we did.  Again, I will likely elaborate on the details at another time.

After my cesarean (which went as wonderfully as one could hope for in such a situation), there was never any doubt in my mind that for my second pregnancy and birth I would plan for a vaginal birth after cesarean (referred to as VBAC).  As my pregnancy progressed I became increasingly aware of the fact that I needed to plan - to prepare my mind, my body, my baby - for labour.  What I did to plan for my second birth was not exclusive to my VBAC situation, in hindsight I should have planned my first birth the same way.  If I had I may have been more informed and perhaps could have avoided the c-section.  But hindsight is 20/20 they say.  During my second pregnancy, I poured my heart and soul into researching about birth.

Following the birth of my second son it hit me - I loved this.  Not only did I love being pregnant, but I loved giving birth.  I loved breastfeeding (I already knew this of course).  I loved all the planning I did, every detail I put into it to achieve my goal of a natural birth which was so important to me.  I had hired a doula for my second birth (Kelly Maslen from Simply Healthy Family) and I now knew why they were so invaluable.  I wanted to continue on this quest, not only to learn more for myself but to be able to educate and support other mothers who wanted that very special and often elusive natural birth experience.

The early days and even months with a newborn and a toddler left me feeling like my hopes of becoming a doula were light years away.  Sleep deprivation, lack of time and energy, and a tight budget meant that it wasn't in the cards anytime soon.  But I tucked that dream away, hoping to revisit it at another time.

Fast forward 1 year and a few months later and here I am.  My dream seems more attainable now.  My boys are a little older, and while I still hope to have another child I think that soon my time will come to start my training.  It is not exactly in the budget as of yet, but it is a goal I am working towards.  Until I can officially register for training I will be reading as much information as I can.  There are reading requirements for the courses that I want to complete so while I am waiting I can get started on my reading.  I've realized that I already own and have read several of books on the list, so I am going to start with re-reading those and then hit up the libraries in town for other ones. 

Right now my goal is to read one book a month, and that I will have registered to start my training within one year from now.

If you have read this far, thank you for joining me on my journey!  That is all I have time for today, as the boys are up and parental duties are calling.

Cheers!