A Breastfeeding Story- Overcoming Thrush

I am so excited to share another breastfeeding story, this time from is Amanda  the writer of Blinded by the Light (http://blindedbythelightt.blogspot.com).  I have talked to experienced nursing mothers who have almost quit breastfeeding due to painful dealings with thrush.  It is no joking matter and can make the most dedicated mother  have doubts.  I LOVE these stories of breastfeeding triumph!

Enjoy!

 

I consider myself a pro when it comes to breastfeeding. I’ve white-knuckled through the painful first weeks (twice), experienced the pitfalls of supply and demand, attended local Le Leche League meetings, and eventually been able to provide advice to other nursing mothers.

Fate figured it was time to kick me in my side with a steel-toed boot.

The name of that boot was: thrush

If you’re not sure what thrush is, well, it is fungal infection of the breast that causes severe pain. It’s undoubtedly the largest obstacle in breastfeeding. If you breastfeed (or have in the past) and never had to deal with it, consider yourself blessed by heavenly angels and all things that are holy.

Avoiding antibiotics may help reduce your chances of dealing with thrush (take it from someone who has dealt with it, it’s worth avoiding antibiotics merely for this fact alone). Although in my case, antibiotics was not a culprit.

Thrush is Evil – My Story and How I Prevailed

I had breastfed my first daughter successfully for 20+ months and I was blessed with another daughter 6 months later. Everything was normal for 8 months…and then I started to feel some pain deep in my breast while pumping at work.

I thought nothing of it and just dealt with it.

Keep in mind, 4 month prior I had wrote a post entirely dedicated to using pain as a communicator…we should listen when there is pain since it is one way our bodies tell us something is out of sync (usually a late indicator). You can read more about that here: Natural Childbirth: Pain With Great Purpose.

Isn’t it great how life will keep attempting to teach you a lesson over and over until you finally “get it”? And even if you think you “got it” the first ten times, life wants to make sure you remember.
Life is awesome.

After about a week or so of that type of deep-sharp pain, came the excruciating soreness and cracking nipples.
Yippie for nipples that are cracked.

Then came the issue of my supply dwindling down to nearly nothing. I had to pump all day and all night - no kidding. And you know what milk looks like when you have to pump with excruciatingly painful, sore, cracked nipples? Oh, let me show you –

What the hell am I supposed to do with that?!

 

I thought if I just waited long enough the agony and misery would heal on its own. I was wrong.

Waiting until it got to the point of utter anguish and torture, I reached out to someone I met through a local le leche league meeting about a year earlier.

I wanted something I could incorporate that was as natural as possible. This is what I did:

Changed Pumping Routine:

I was already using coconut oil after every pumping session although this wasn’t making any dent in my symptoms. Although now, I started a better routine for cleaning up while pumping at work. The current routine was just horrendous – I would pump and then that’s it. I never wiped up or anything. I started using a non-antibacterial soap on my boobs after I pumped and also washed the equipment very well afterwards. (Note: washing boobs at work over a small sink, three to four times a day, is not easy.)

This is what all nursing rooms should look like.

Gentian Violet:

My friend mentioned something called gentian violet. After doing some brief research on it, I tracked some of it down at a local pharmacy (after calling about 10 different places). I also used this on my daughter mouth in case she had thrush (although she only exhibited signs for about 3-4 days and that was a few weeks earlier).

The stuff is messy and really odd looking – your baby's entire mouth is completely purple.
After bath-time I placed some in Charlotte’s mouth and then nursed so we both got the benefits. I only did this for about 3 days because you’re not supposed to use it for a long duration.

Bra Burning:

Ok, I didn’t burn bras but I diligently washed all of my bras in super hot-hot scorching water. This did result in me having to say RIP to one bra.

Took The Offensive:

I took probiotics every morning and of course kept taking vitamin D3 (5,000 IUs daily).

Enlisted Heavy Hitter:

I eventually ended up getting a clotrimazole cream which is just a regular antifungal cream you get at the drug store…not very natural, but I was forced to play dirty.

After about 4 days, things were getting much better and the pain was subsiding a bit (although I’m not sure if they could have gotten any worse...). After about a week and a half, I was joyful that I was determined and stubborn enough to stick it through – my supply was coming back and things were becoming normal again.

I still occasionally have supply issues, but I think every mother should expect to go through that (if you never have this issue then, again, feel very blessed).

In my experience with thrush, I had to adjust numerous things to tackle the symptoms and the core of what was wrong – of course, I could have always quit breastfeeding. Even though that was the quickest and easiest solution, that was never an option for my daughter or myself.

Now when I think of the horrific pain and the unpleasant experience, I think how it has the potential to help another mothers. A large part of me is grateful for the time I spent overcoming such a terrible obstacle – I’m glad I stuck it out AND WON!

Those that conquer, endure.

A Breastfeeding Story- Overcoming A Lip Tie and Severe Cracking

I am really excited to share something a little different than the usual.  A mom sent me her breastfeeding story and it is WONDERFUL.  It isn't an easy story but it teaches a lot of wonderful lessons about finding the right help with breastfeeding and persevering even when it is difficult.  I love that this mom was triumphant (I believe) with ALL of her babies.  In the end she is able to nurse successfully after diagnosing and treating a lip tie and a tongue tie.  Having the right knowledge makes all the difference.

Enjoy!

Before my oldest daughter was born in October 2008, I was sure of two things:

1. I wanted an all-natural birth.
2. I was going to breastfeed.

But at the time I didn’t realize how much I didn’t know ABOUT those two things. My daughter’s birth didn’t go as I had envisioned it, and breastfeeding wasn’t at all as I had imagined either. Within days of her birth, both my nipples had developed extremely painful ulcerated sores. I was in agony, dreading every feeding, putting it off for as long as I could, crying and tensing when she latched on. My daughter was a slow nurser, and I thought that I was supposed to keep her on until she unattached herself (this may work for some babies, but I there is NO way my daughter was actively eating for those lengths of time). At first I thought the pain and the sores were normal, my sister had told me that it would hurt in the beginning. Then my midwife came for a home visit when my daughter was a couple of weeks old and told me that though it looked like my daughter was latching on well, my nipples shouldn’t look like that. She asked if I wanted to meet with a lactation consultant and I said sure.

So at two and a half weeks post-partum, I went to see a lactation consultant. When she saw my nipples, she said, “I wish you women would come to me sooner, before your nipples get into this shape. That one looks like it could use a stitch.” Then she went on to watch me nurse my daughter, not saying much about my daughter’s latch, but criticizing me for using a pillow (“it’s a crutch!”) and for using the football hold (“what are you going to do when she gets too big for you to nurse her like that?”), which was the only way I could deal with my daughter’s flailing arms and floppy body. She made me try nursing without a pillow, in the cross-cradle hold, once again not really focusing on the latch. She gave me a prescription for Dr. Jack Newman’s All-Purpose Nipple Ointment (APNO), with a dire warning not to use it for more than five days because the steroid would thin out the skin, a prescription for domperidone (a medication whose side effects include milk production), and she gave me a medical grade double pump, also to use for five days. 

So I pumped and bottle fed my daughter for five days, and in that time my nipples only barely started to heal. I put my daughter back to the breast, only to have my nipples immediately become just as painful as before… And now my baby was only interested in nursing the foremilk. She would unlatch and scream when the milk flow slowed down.

I was a first time mom. I was in constant agony (with a bout of mastitis on top of everything else). I didn’t know what I was doing. My hormones and my emotions were going wild. No one TOLD me what a proper latch was, and I didn’t know enough to go find out for myself. No one told me that I had options other than bottle feeding while I was pumping. So I gave up. I decided that I wasn’t going to try to breastfeed anymore, I was just going to pump. 

For a month I was able to borrow the medical grade pump and I got my milk supply fairly well-established, only needing to supplement about 1 – 2 ounces of formula a day. After the month was up, I started pumping with a hand pump because we couldn’t afford to rent or buy a better one. It took a lot more time, but I was able to get nearly as much milk with it. I pumped until my daughter was 7 months old, my supply slowly dwindling. I obsessively recorded every ounce that I pumped and that she ate. She was a horrible bottle feeder until she was about 3 or 4 months old; it sometimes took over an hour and a half to get the milk down. By the time I stopped pumping, my nipples were a dark purple all the time from the stress the pump put on them. I suffered from post-partum anxiety and felt that I had failed somehow as a mother, although a lot of people told me that it was amazing that I had pumped for that long. Oddly enough, when I stopped pumping, I started feeling better in a lot of ways.

Before my son was born in April 2010, I had already decided that either breastfeeding had to work or I was just going to formula feed. There was no way I would have enough time to pump with a newborn and an eighteen month old. I was better prepared in every way this time, both for the birth and what followed. I didn’t struggle emotionally at all. My sister had read a book called Dr. Jack Newman's Guide to Breastfeeding by Jack Newman and Teresa Pitman, and she lent it to me. I devoured the book, learning the importance of a proper latch and how to do it. 

When my son was born, breastfeeding wasn’t immediately easy, but right from the beginning it went better. When it seemed that my nipples were going to start developing sores again when my son was around 5 days old, I went into a walk-in clinic and strong-armed a dubious doctor who had never heard of it into giving me the prescription for Dr. Jack Newman’s APNO (yes, it is the same guy who wrote the book I read), and used it for a couple of weeks and the sores never developed. By about three weeks post-partum, everything was great. My son was a champion nurser; he was so efficient that he would have milk running out of his nose as he sucked. By two months, nursing sessions were lasting a total of maybe 10 minutes total, and by 4 months, they were about 7 minutes. I worried that he wasn’t getting enough, but his weight gain was great and he never cried for hunger. It was a balm to a wound I still carried from my experience with my daughter. I wasn’t broken, I COULD breastfeed. (And I used the football hold with my son too, until he got too big for it, and then I switched to a personally modified cross-cradle hold with absolutely no difficulties. And I used a pillow for most of the time that I breastfed him too).

Armed with the knowledge that I could breastfeed, I was blindsided when I had problems when my third son was born in January 2013. Breastfeeding was awful again… The ends of my nipples developed scabs and they just stung and burned long after every nursing session was over, and I had extremely painful vasospasms (and don’t even talk to me about showers). At five days post-partum, I thought I would review the breastfeeding information on Dr. Jack Newman’s website (nbci.ca), and discovered that I had remembered wrong about how latch they baby properly. 

So I fixed the latch and within a day the ends of my nipples healed. I thought I was in the clear and that it would only get better from there until I noticed that my nipples were developing cracks along the base. I was mad. What was going on? I nursed through the pain, and while my nipples were ridiculously sensitive, the pain wasn’t as bad as it was with my daughter, I think mostly because of the placement of the sores (I did have a better latch with my son, so they developed at the base rather than the ends of my nipples). I was using APNO, checking his latch every time, and still the cracks got wider and wider and more ulcerated and more painful. I treated my nipples and my son’s mouth with gentian violet, thinking it might be thrush, though there were no indicators of it.

I was in despair, though I wasn’t in the pits like I had been with my daughter. I KNEW I could nurse, so that was a big help for my state of mind, but I was being driven crazy, trying to figure out WHY this was happening. I researched breastfeeding issues and solutions feverishly on the internet. I tried all kinds of things (breast shells, hydrogels) but nothing was helping. Everything I read said to keep my breasts free, but I had to wear two sleeping bras at all times because the least bit of rubbing was just unbearable and caused them to become more raw. And I couldn’t expose them to air because the vasospasms were so awful. In my research, I kept coming across forums where moms talked about lip ties, but I had no idea what they were talking about, I’d only ever heard of tongue ties. 

When my son was five weeks old, I was looking in his mouth yet again to see if I could determine if he had a tongue tie, when I noticed that the frenulum on his upper lip looked a little funny. It came all the way down his gums and wrapped around onto his palate. I was like, “Huh, does mine look like that?” I felt it with my tongue and it seemed to stop above my teeth a fair distance. I looked in my older son’s mouth… His stopped above his teeth too. I was starting to get a little excited. I looked in my daughter’s mouth… Hers came right down her gums too. I looked in my husband’s mouth… His stopped above his teeth. I hurried to the computer and googled images of lip ties. My younger son and my daughter both had severe upper lip ties, and probably tongue ties as well, since they almost always go hand in hand. I started to cry; my nursing issues with my daughter hadn’t been completely my fault. I felt relieved and exonerated and sad for how it had all happened. When she had been born, they checked for a tongue tie, but she had a posterior one, which isn’t as obvious as the regular tongue tie, and no one had checked for a lip tie at all.

I emailed Dr. Jack Newman and he told me that they clipped tongue and lip ties at his clinic in Toronto. That night I called my doctor at home and excitedly told him what I had discovered. He was a little confused at first and he probably thought I was a bit crazy, but he told me to come into the clinic on Monday and he would take a look. 

On Monday I took my baby to the clinic in the middle of a massive snowstorm. My doctor had researched tongue and lip ties over the weekend, and readily gave me a referral to Dr. Newman’s clinic. I got an appointment there for about a week and a half later and we travelled 1200 kilometres to see him. At the clinic, I saw a lactation consultant before I saw the doctor and the experience was night and day from my first one. I walked into the clinic, ready to be on the defensive about my breastfeeding pillow and the football hold. 

I was immediately relieved to see that the room they saw me in had all kinds of pillows in it, and they told me to use whatever hold I was comfortable with (although they wanted me to try the side-lying position. I can’t figure that one out, and don’t think I would like using it anyway). The LC told me that she could tell he had a lip tie just by looking at his face; the area between his nose and upper lip was bluish, and his upper lip kind of stuck out a bit. They clipped his lip and tongue ties. It took about ten seconds and I had to sit down, haha! Poor baby cried for a while, although I stuck him right on the breast and that eventually calmed him down. I could tell that his nursing was different right away, his sucks were stronger and longer. I left with Mepilex (a wound dressing), and another prescription for APNO. We had a rough evening, but he was just fine after that and never even noticed when I rubbed the wound sites to make them heal properly and keep the ties from reattaching.

I returned home, expecting that now my nipples would start healing and that everything would be great, but no such luck. The damage to my nipples was so severe, the cracks sucked open so wide, that there was just no chance that they could heal with the constant pulling and rubbing on them. I emailed Dr. Newman in desperation when my son was 9 weeks old, asking about hand expression and pumping. He emailed me back saying that this was often the time that nipples started to heal on their own, as the baby’s mouth got bigger. So I waited another week, with the pain getting more severe on my right side all the time. 

Finally, at 10 weeks, I visited my doctor, with the idea of getting a prescription for domperidone and hand expressing for a few days until my nipples healed. He took a look and said that my nipples would take at least 2 weeks to heal, even if I left them severely alone and didn’t touch them at all. I couldn’t handle the thought of possibly losing my milk supply for good, so I hand-expressed from my right side and bottle fed, and then nursed from the left. I was so extremely fortunate that my son was fine with both. I had sworn that I would never pump again, but after 4 days of hand expression, my milk supply dwindled alarmingly, so I caved and began pumping from the right. All in all, it took 3.5 weeks for each nipple to heal completely and I was pumping for just over a month in total. After 2.5 weeks of pumping from the right, my left side became too painful to nurse from, so for a week I pumped exclusively from both sides. All during the time I was pumping, I used the Mepilex wound dressing and the APNO (and my skin never thinned…).

There were times when I felt like this ordeal would be never-ending, that my nipples would be forever painful and never healing… There were times when I was tempted to kinda sorta think about maybe giving up, but mostly I was just stubbornly determined that I WOULD feed my son breastmilk because I knew I could. I thank God for the experience I had with my older son. I was even prepared to pump for months if I needed to. But my ordeal did end when my son was four months old, my nipples did heal, and I am so so so grateful and relieved that breastfeeding is working again. 

In the end, I think there were a lot of factors for why my nipples cracked this time. The lip tie and tongue tie were definitely contributing factors, but my own skin had something to do with it too. I am really prone to stretch marks (as in, my skin isn’t very elastic), and in the winter my skin is really dry. This year winter went on forever and was very cold and very dry and I’m sure that had something to do with it as well. Mentally I never felt like I was in danger of depression or anxiety this time (though I did have several good cries about it all), but now that I’ve been nursing without pain I realize just how wonderful it is to not have that underlying dread all the time, counting down the minutes to when I’m forced to feed my baby, sighing with relief at the end of the day because I have a good 6 or 8 hour break from nursing. I hadn’t really realized how much of my time and energy went into worrying and stressing about my breasts until I was free of it. Now I just hope he doesn’t develop into a biter, haha!

I don’t really know if there is a moral to this story, there just isn’t a lot of information out there about long-term trauma to nipples, other than what I came across in forums, so I wanted to share my experiences... I want to tell women to get help when you need it, from someone who is actually helpful. I live in a remote area, and most of my help came from the internet, particularly Jack Newman’s website, which I would recommend to anyone. And don’t give up, it is usually worth it to do the hard work and stick it through to the other side (although not at the cost of your peace of mind). 

Also, if you are having these kinds of issues, you’re not alone. Sometimes we can feel guilty or unworthy or something like that when everyone else is talking about how breastfeeding is beautiful and wonderful and amazing and how close they feel to their babies when they’re feeding them and they just love it and blah blah blah, and you just feel like ripping your breasts off because they’re not working right. In reading the forums, a lot of moms with these kinds of long term, non-healing sores seemed to find resolution at around 16 weeks. I thought I would never be able to make it for that long, but in the end it did take four months and I did make it, one day at a time (I am glad I didn’t know how long it was going to take in the beginning, though!).

A Nurse and Her Home Birth- A Birth Story

I got a great e-mail from this mom along with her birth story and I am so excited to share it with you.  There is something special about every birth.  What I love about this story is it shows how wonderful and transformative birth can be even if it isn't roses and soft lighting.  Natural birth- it changes women and it helps them recognize their power.  

Enjoy!

On the first day of December, I woke up on an emotional low.  It was now no longer my “due month” and I was showing no signs of going into labor.  I burst into tears shortly after waking that morning, no longer one hundred percent positive I really could trust in my body’s internal wisdom.  But I managed to pull myself together and enjoy the day.  I did pick up an herbal concoction of black and blue cohosh with pennyroyal at Cheryl’s Herbs at my midwife’s suggestion; we agreed that I would start that evening with very conservative dosing (not to induce labor, just to “encourage” it).  And it was a good thing too – that was my last day as a (non-laboring) pregnant woman.  My husband Simon and I went to dinner, drove around to look at Christmas lights, and settled in with a Red Box movie at home.  While we were watching the movie (Snow White and the Huntsman – wow Charlize Theron is creepy as the Queen), I noticed that I started feeling crampy. 

I didn’t think a whole lot of it, not wanting to “jinx it,” but I did find that it was more comfortable to bounce on the birth ball than to sit on the couch towards the end of the movie.  I took one tiny baby dose of the “labor blend” during the movie, although based on how my labor progressed thereafter, I’d say my body was all primed and ready to go on its own!  (Anyone want to buy the herbs off me? At 10PM I used the bathroom and noticed I was passing some of my mucus plug and having loose stools.  We went to bed that night just like any other night.  Although on some intuitive level I knew labor was fairly imminent, the doula/nurse inside me took over and wrote it off as the “teasing” that happens to most women before “the real thing.” I didn’t even mention it to Simon.

I woke up at 4AM to pee.  When I used the bathroom, I was shocked and delighted to see that I was having bloody show!  I went back to bed right away, knowing that sleep before labor (and parenting!) is crucial, but I was so giddy and anxious I did not sleep.

At 5AM I started having contractions.  They were mild but regular.  The furthest spaced they ever were was eight minutes apart, but only a few were like that; they were pretty much 5-6 minutes apart from the beginning.  Furthermore, they were pretty much lengthy from the beginning as well.  I had a few that lasted 30-45 seconds in that first hour or two of labor, but they quickly established a pattern of lasting 60-75 seconds.  Again, I tried to sleep through these early contractions, but it was uncomfortable to stay in bed, and my mind was reeling.  Labor!  I think I’m really in labor!  So I got out of bed and started pacing around our condo.  I went to the bathroom frequently and had more show and mucus plug every time. 

I had been texting with my primary midwife, Mary, since the initial bloody show at 4AM, so she was up to date on the situation (I hadn’t expected her to text back so early in the morning; I figured she’d get the message when she awoke at a more decent hour – and I also didn’t think there was any need to wake her at this point – it was early in the game and this was my first baby after all!  But she had been up since 3AM as it turned out – she was on her way to someone else’s birth in Springfield!  And this is why I hired more than one (remotely located) midwife!).

After half an hour or so of pacing around, smiling to myself with each contraction, the next big event happened on the hour: my water broke at 6AM.  It was a gush, but not a huge one (I didn’t leak on the floor .  Bloody show at 4, contractions at 5, rupture of membranes at 6.  Wow this baby could be coming quickly after all!  I went to the bedroom to wake up Simon and tell him the good news.  After his initial groggy surprise, he sprung into action.  I told him I had been texting with Mary, but that I thought we should call Jessica, one of our local midwives, since it seemed like active labor was coming on fast.  He agreed, and prepared to go to the grocery store as we had planned (we wanted to have “labor food” at home for us and for our birth team). 

I called up Jessica and let her know what was going on; I told her we were alright by ourselves for the time being, but that I wanted her to be ready to come over in a few hours, or faster if things picked up rapidly.  Mary and I continued texting, and once I’d informed her of my regular contraction pattern and that I was fairly confident my water had broken, she made plans to have another Springfield midwife take over for her at her birth center so that she could drive to St. Louis ASAP.  While Simon was at the grocery store, I made oatmeal for breakfast (“midwife’s pitocin”) and blasted my “upbeat” labor playlist while I danced around the kitchen in my nightgown.  When Simon got home he thought I seemed to be having a little too much fun for a woman in labor!

We texted a few dear friends around 9AM to request they pray for a smooth labor and delivery for mama and baby.  Simon called my mom and his mom to let them know that I was in labor and that we’d keep them updated.  Jessica came over at my request around 10AM.  (By the way, all of the times I quote during the telling of this birth story should be understood to be my best guess.  Any of these times could be significantly off, and the closer we get to the time of the birth, all the more so!). Upon arriving, she assessed my vital signs and Doppled baby’s heart tones, which sounded perfect (120’s-140’s beats per minute my entire labor with great variability and not a single deceleration ever as far as I’m aware!). 

My contractions at this point had picked up to about every 3-4 minutes and were reliably at least a minute long.  They were increasing in intensity, but still felt very manageable.  I felt them pretty much only in my lower back – a pattern that continued my entire labor.  (I’d say I only had 5 contractions my whole labor in which I felt anything in my belly!).  Simon did counter pressure with every contraction, which at this point took the discomfort away (nearly) completely. 

I was still having some bloody show, plus mucus leakage, PLUS amniotic fluid leakage, so I was wearing what was essentially a diaper at this point.  (I’m still baffled at just how much STUFF leaked/gushed out of me!).  Despite the symphony of bodily fluids pouring out of me, I wanted to get out of the condo and enjoy the beautiful weather.  (Although it was December 2nd, it was 70 degrees and sunny outside!).  So after being assessed and getting the green light from Jessica, I threw on my maternity jeans for what would be the last time, and Simon and I set out on our walk in the park around 11AM.

The walk was delightful.  There were people all over the place, so my labor pattern did slow down a tad (labor tends to be “shy,” and is sometimes slowed or stalled by the presence of strangers and/or crowds, a phenomenon which proved to be true in my case).  But thankfully it had already been moving at a pretty decent clip, so the slowing wasn’t a big deal (actually it was nice!).  We strolled through Tillis Park and had a really wonderful time – I will always remember this walk we took together in labor.  The last walk we took as a family of 2.  We decided during our walk that if we had a son, his middle name would be James, to honor both Simon’s brother and my father.  (We had previously decided on a first name for a boy, but had not settled on a middle yet).  Well, we walked through the whole park, and then decided to hit the streets of Brentwood too. 

We ran into one of my best friend’s fathers on our walk and stopped briefly to chat with him, although we didn’t tell him I was in labor…”When’s that baby coming?”  “Oh, you know, any day now…!” We continued merrily along, me stopping to lean on random trees, cars, street signs, etc when I would have a contraction.  I was still gushing fluid randomly, and my diaper held up well…until it didn’t.  By the time we got back home, an hour later, there was fluid leaking not only through the diaper, but through my pants, down my legs, and pooling around my feet!  Certainly not my finest moment, but it makes for a funny story, right?

We got back home around noon.  In our absence, Jessica had been busy setting up various supplies that would/might be needed during my labor and birth.  We filled up the tub, as I was starting to feel like I would enjoy the relief from the warm water.  Mary was on her way, coming as quickly as she could. 

I moved around our condo a lot, meaning that I changed my immediate location as well as my position frequently.  I couldn’t NOT move!  Moving helped.  Staying still?  Umm, no thank you.  I sat on the birth ball.  I got on my hands and knees.  I walked from room to room.  I leaned on the counter, on the coffee table, on Simon.  I got in and out of the tub (whilst in the tub, I switched frequently from hands and knees, to sitting and leaning back on the side of the tub, to side-lying and letting my legs float in the water).

Regardless of my location and position, I wanted Simon to apply counter pressure on my sacrum with each and every contraction.  Of the many, many comfort techniques and coping mechanisms I utilized while in labor, counter pressure remained throughout my absolute must-have!  At some point, I felt a contraction coming on, and I said to Simon, “Go, go!  Do it!”  “Do what?” he asked, exhausted.  I answered, “The same damn thing you’ve done with every other contraction!”  Needless to say, I was feeling feisty – and working hard – at this juncture.

During those afternoon hours, I believe around 1:30, I told Simon I wanted the rest of our birth team to make their way over.  My sweet friend Allison, who is also my midwifery preceptor with whom I have attended many other women’s births this year, arrived first I think, with her 10-week-old daughter in tow.  Mary arrived around the same time; maybe it was 2:30 by now?  Mary, Jessica, and

Allison collaborated beautifully to provide me with exceptional care over the course of my labor and eventual birth.  (As it turned out, I was in labor for quite a while, so it was good that I was spoiled with 3 midwives, as it allowed them to take turns resting, while still offering me continual support and care.)  My dear friend Corinne, pregnant herself, arrived around 5, in the role of doula and photographer. 

All of these wonderful women cared for me so well during my labor.  Allison held my hands and whispered words of encouragement and affirmation.  Jessica always verbalized that baby sounded strong and healthy when she Doppled heart tones: “Baby doesn’t mind those contractions one bit!” (She also talked me off the ledge when I wanted to go to the hospital later!).  Mary gifted me with her presence, simply sitting nearby, often in silence, but very much WITH me throughout labor.  Corinne?  Well, she stripped off half her clothes and jumped in the birth pool with me!  She did a great deal of hands-on labor support, which allowed Simon some much-needed rest.

It was late afternoon or evening when I discovered that I LOVED the shower.  I liked the birth pool very much; I was in and out of it all day, but I loved the shower.  If we had had an unlimited hot water supply, I would have been in there my entire labor.  And at this point in my labor, it was actually FUN to be in the shower!  Simon came in there with me, and it was like a little vacation from labor.  I was still in labor, obviously, but rather than the focus being on the physical intensity, it was instead about our love story, and the wonder that we had created a new life and were now bringing that life into the world.  It felt like our honeymoon.  I loved it.

All throughout the day, I had not desired to have my cervix “checked” to assess dilation.  I didn’t want to know because I know that that “magic number” can really cause emotional setbacks in labor…it’s great if you’re told 7, 8, 9, or 10, but if you hear 1, 2, 3, or 4, it really sucks!  So I feel it’s often best not to know

However, after laboring all day (and pretty much active labor all day), I eventually started to get pretty curious.  Especially when I started vomiting after the sun went down.  It sounds strange, but I was glad to be throwing up, and I know my birth team took it as an indication of my labor progress (women often vomit during transition, the last part of labor before pushing).  So I threw up once…and then again…and again.  My contractions remained strong and close together, and I think pretty much everyone thought the baby was coming soon.  When the sun had gone down, I moaned, “Please tell me this baby is coming before the sun comes up again!”  Mary smiled and said, “Oh yes!  I think December 2nd will be the birthday for sure” (telling me baby would be born before midnight). 

I know she would have never said this if she didn’t feel quite confident, but as it turned out, my baby fooled us all!  So there I was, vomiting, contracting, vomiting, contracting…after a while Mary asked me if I was feeling any pressure in my bottom.  I said no, none at all.  I have no idea if I finally asked to be checked, or if my birth team requested to check me, but it matters not…around 8pm, I had a cervical exam, and it’s a very good thing the results were kept from me at the time…I was only dilated 3cm.

I know what you’re thinking.  3cm?! Hadn’t she been laboring for like 15 hours?!  Yes, dear reader, you are correct.  That was the situation.  Thankfully, Mary is both very wise and a complete sweetheart, and instead of crushing my morale with “You’re only 3cm!”, she said instead, “Wow, you’re baby is very low in your pelvis, about +2 station!  You’re doing such a good job of brining this baby out into the world!” (and didn’t mention my dilation at all). 

Granted, I’ve been around “the birth world” long enough to know that if you’re not being told how dilated you are, it’s because it’s a number you don’t want to hear.  Still, I assumed the “bad number” was like a 5 or 6 (not a 3!), so I do think it’s good they didn’t tell me (they did pull Simon aside and tell him).  My birth team quickly set to work having me do various things to quicken my progress and ripen/dilate my cervix (apparently the tissue was quite tight, in addition to being largely un-dilated). 

First, I consented to and was given a vaginal dose of evening primrose oil, or EPO as it is sometimes called.  EPO is a fairly gentle cervical ripening agent; you can buy it at health food stores and take it orally and vaginally in the final weeks of pregnancy to encourage the cervix to soften and open.  I had been taking it myself for a week leading up to labor.  However, as a maintenance dose, I was inserting 4 capsules nightly.  My labor dose was much different: Mary drew up the contents of 10-15 capsules in syringe and administered it right on my cervix (for those of you who are imagining a needle because I said syringe, there was no needle…it was like a squirt gun, not a shot

Next, my birth team told me that I really needed to get some rest.  I’m sure it was clear to everyone that I was very tired, and since I had a ways to go, it was crucial that I not become completely exhausted.  I drank a small amount of red wine, and also an herbal tea of sorts (I know it had chamomile in it), both of which were intended to help me relax and hopefully catch a few zzz’s between contractions. 

Although it sounded absolutely horrid to me, I laid down on my bed as I was asked to and attempted to “rest” between my contractions.  I know from assisting other women in labor that any rest is good rest, even if it is between contractions.  While that may be true, I must say, when you’re the laboring woman yourself, and you manage to fall asleep (sweet relief!), only to be awoken every 3 minutes by a monster contraction, it feels like a cruel joke to call that rest!  Even so, it probably helped me get through.  I put up with this sleep-contract-sleep pattern for only a short while, before I flipped out and jumped out of bed – the pain of my labor was much more intense while lying down!

I believe it was around midnight that I began my 4th episode of vomiting.  I started to get a little worried about dehydration, knowing my body was more and more spent every time I emptied my stomach contents.  I had been eating and drinking freely during labor, in order to keep up my strength and hydration, but at this point everything that I took in just came right back out.  I requested IV fluids from my birth team.  I stood up in the bathroom and leaned over the counter when I would have a contraction; the overhead light was flipped on to visualize my veins. 

To my birth team’s chagrin, it proved quite difficult to start an IV on me.  Although my veins were easy enough to find and stick (there was flashback every unsuccessful attempt actually), they kept rolling or disappearing when the fluids were started.  Jessica tried twice, and then Corinne (who is a nurse) tried once too.  They kept apologizing that they were having to re-stick me, although I honestly didn’t care a bit. 

The discomfort of the needle stick was nothing compared to the intensity of my back labor; I actually found the entire IV ordeal a welcome distraction!  After Corinne’s unsuccessful attempt, Jessica said that it didn’t seem to be “in the stars” for me to have an IV at home.  I said something along the lines of “No!  I have to have it!  Keep trying!  Put it in my foot if you have to!  And I need someone to pray for my cervix right now!  Out loud!”  At my insisting, Corinne promptly started to pray aloud for my cervix to dilate and open and let my baby out – it really did make me feel better. 

Simultaneously, also at my insisting, Jessica attempted a 4th IV start.  Praise the Lord; that one worked!   I soon had a 1,000cc bag of fluids running into my left forearm, replenishing my electrolytes and reviving my energy level.
Now that I had ceased resting, and I had my very-much-desired IV in place, my birth team put me to work!  Mary had checked my cervix again and found it to be 4 ½ centimeters dilated (she didn’t tell me that one either, ha!).  The cervical exam also revealed baby’s head to be asynclitic, meaning it was cocked in a funny way, making baby’s descent more difficult. 

Due to the asynclitism, Mary wanted me to assume some inverted positions that would encourage baby to slip back out of my pelvis (“un-engage,” if you will), and allow him to “fall back in” in what would hopefully be a more favorable position.  Picture this: I’m kneeling at the top of my stairs, and I have my hands on the floor about 3 steps down.  So essentially upside down, yes.  (This is formally called the forward-leaning inversion, coined by Gail Tully, a midwife who is known for her techniques in “spinning (malpositioned) babies”).  So I did my inversion on the stairs for several contractions, with Simon and Corinne supporting me in that awkward position. 

After I had labored like that for a little while (I’m sure it felt longer than it actually was), I also “did the stairs” for a while: I took them two at a time and walked sideways (facing the banister).  Up.  Down.  Up.  Down.
I went back to leaning on everything.  I went back to the pool.  I went back to the shower.  My time in the shower, now in the wee hours of Monday morning, was no longer the sensual, beautiful experience with my husband it had been hours before.  It still hurt. 

Labor was hard no matter what I did.  Even so, the shower continued to provide me the best relief of everything I tried.  (The 3rd time I hopped in there, I neglected to consider my IV, now in a saline lock, and I managed to infiltrate it before I had realized and asked for it to be wrapped up to keep the water out.  I had a pretty good bruise on my forearm for a week or so after the birth, where my vein infiltrated).  I would stay in there until the hot water ran out (always a sad moment!), and then I would resume utilizing counter pressure with each contraction.  The tub and shower let me know I loved heat as a coping mechanism, so I also came to rely on a rice sock for relief, heated in the microwave and then placed directly over my sacrum, with firm counter pressure applied on top.

Pretty much everything from 1AM(?) to 6AM is a blur.  This makes sense to me, because this is when I was doing the hardest work: very active labor and transition.  I was finally getting into my “primal brain” (meaning I was letting my hindbrain, my animal-like instincts take over, and my neo-cortex was no longer “getting in my way”).  Some people refer to this as “Labor Land.”  I like that description because of the reference to being in another place…that’s exactly how it was.  I was not there, in my body…and yet that’s the ONLY place I was.  I can’t explain it.  It was ethereal, other-worldly.  I only remember bits and pieces of my trip to Labor Land…

When I was checked and found to be 6cm and Mary was excited that my cervix finally felt “like butter.” “The rest of your cervix is just going to melt away now!”
When I really started to crash emotionally and doubted my ability to birth naturally: I started fantasizing about getting an epidural.  It sounded so absolutely tantalizing…I just wanted the pain to stop!  “I keep thinking about the E word! (Epidural).  Just take me to the hospital!”  I remember Jessica’s gentle but honest reply: “Well, we can do that, Halley, but even if we left right now, it’d still be about 2 hours before you’d get the epidural, since you’d have to be admitted and have labs drawn and all that.”  %$*&!#@, she’s right, I thought to myself.  Maybe I can have this baby OUT in 2 hours.  

I managed to put “the E word” out of my mind (mostly) and sort of get over it.  How?  I don’t know.  Women do amazing things.  (I think it was mostly because the epidural was not easily accessible.  If I’d been at the hospital already, I really think I would have “caved.” To all the moms who have done natural birth at the hospital, anesthesiologist down the hall – MAD RESPECT).

More stairs…Simon falling asleep on the floor for a few minutes (well deserved!)…Mary telling me how sweet I was being to everyone even in the midst of hard labor (apparently I was pretty nice to everyone the whole time?  I didn’t feel particularly nice, but I’m glad I was!)…Allison nursing her baby on the couch…my stupid sweatband that kept slipping off and letting my hair fall into my sticky face…more trips to the shower – my oasis, as long as the hot water held out…being told I was 9cm with a “lip” of cervix left: “A lip!  I have a lip! I’m a 9!”, I cried out with joy to Simon.  Generally thought of as a bad thing (a stubborn cervical lip, a barrier from being complete and subsequently pushing), I was thrilled to be 9 with a lip!  Because it was ONLY a lip!  I had been going for about 24 hours – I could do a lip!

At 6AM I started pushing.  I still had my lip of cervix, but Mary said I could try some grunty pushes if I wanted, and she said she could manually “reduce” the lip while I pushed if I wanted. Umm, yes please!!!  So Mary gently pushed the remainder of my cervix away while I offered some pushes.  Now, I had genuinely been looking forward to the pushing stage.  First of all, pushing means you’re almost done.  Second of all, I just wanted to feel a DIFFERENT sensation.  (And I’ve actually heard of and talked to women who LIKED pushing!).  But boy, let me tell you, I did NOT like pushing!  It hurt SO bad!  It really surprised me how much it hurt.  Give me back labor any day over pushing! 

Granted, I never experienced that “uncontrollable urge to push” that people talk about.  For me, pushing (all 2 ½ hours of it) was a very conscious choice.  I had to make myself do it.  And for the first leg of it, I resisted because of the pain.  To push with much gusto was to bring pain upon myself – and my instincts said NO!  If you touch a hot stove, you pull away!  It wasn’t like labor; my contractions were largely outside of my control; I couldn’t tell them when to start or stop or how strong to be.  But with pushing, I did start it, and stop it, and decide how strong it was going to be.  I had to voluntarily cause myself pain.  At least that’s how I thought about it until I decided I needed to think about it in a new way.

After a while of half-hearted, resistant pushing, I flipped the switch.  I can’t explain it, but I decided I was not going to let the pain hold me back anymore.  I decided that I could be stronger than the pain and that I would overcome the pain rather than it overcoming me.  (After the birth, Corinne told me it had looked like I wasn’t even in pain at all at this point!).  I told myself that pushing was the only way that I could get this baby out, and the only way I could make labor END, and pain be damned, I WAS GOING TO DO THIS. 

So I started pushing with all the strength I had.  I rested in between contractions, but when one came, I beared down and pushed hard til I ran out of breath.  Then I grabbed a breath and did it again so long as the contraction was still going. “That’s the way!  Those are the pushes that get a baby out!” I heard voices around me say.  Sometimes I let a contraction go by and I just rested, always a welcome break that I claimed as needed, but by and large I kept after it with impressive stamina, I must say.  I’d been in labor for over a day.  I hadn’t slept hardly a wink.  But I wasn’t crawling to the finish line – I was sprinting. 

The strongest part of me, a part I hadn’t seen before, was shining.

I pushed in the tub, in various positions for a long time.  Mary got rid of the lip while I was in the tub; at 7AM I was truly complete.  My pushing progress in the tub was slow, so eventually it was suggested that I move to the couch and try there.  (But not before I reached down and, to my utter amazement, felt the top of my baby’s head on the inside!  So incredible!). 

I pushed on my living room couch, on my back with my legs pulled back, in traditional “hospital style.”  It was especially intense on my back like that (just lying on my back during pregnancy was awful; during labor it was ridiculous), but it was effective in bringing baby further down the birth canal.  After that I pushing in a sort-of-squatting position: Simon sat on the coffee table and I straddled his lap, with my legs dangling and my arms clutching his neck.  That position worked really well to bring baby closer!  Baby’s head was now staying visible between contractions I think.  It was VERY intense in that squatting position, so after a time it was suggested that I take a bathroom break.  So the action moved to my tiny condo bathroom – and that is where it remained.

While I was on the toilet, I had some massive contractions, and that precious baby that was sitting in my birth canal, so close to the outside world, decided that it was time to be born.  And then I was crowning. 

And WOW is that the MOST intense feeling ever!  It burned, oh it burned!  I screamed out, “It’s the ring of fire!”, because that is how crowning has been described by many, and I was struck in the moment by how absolutely accurate that description is!  But crowning was over about as quickly as it had started, and POP!  Out sprung my baby’s head!  My birth team did not miss a beat.  They were right there, equipment speedily moved with them, all ready before the birth of the head.  I was promptly pulled to my feet, over the toilet, so that my baby’s body did not plop in the toilet with the next contraction!  It was most intense, crazy, painful, amazing feeling to push that baby’s head out; it was really unreal!

I remember Simon next to me saying, “Oh my gosh, oh my gosh, oh my gosh!”  I had strongly desired for Simon to catch the baby, and he had been looking forward to doing it, but that’s just not how it worked out.  As my friend Samanda says, “You can prepare for a birth, but you can’t plan one.”  After the birth, Simon told me that he had thought in the moment that the head was the entire baby, and that that huge blob was going to somehow “unfurl” into our baby!

So there I was, standing (talk about sea legs) over my toilet, with a baby’s head hanging out of me.  I was totally in the zone, but I was aware of my birth team discussing and quickly acting upon my baby’s nuchal cord (meaning the umbilical cord was around the baby’s neck).  Someone said that it was pretty tight, and I think there was mention of cutting it “on the perineum” (before the birth of the body), but then the shoulders started slipping out obediently, and Jessica was able to slip the cord over the baby’s head as he made his entrance into the world.

Mary caught my baby as he slipped out at 8:40AM.  It was the wildest feeling ever to feel his body flapping out of me – it really felt like a large fish swimming out of my body.  As soon as the baby was out, I collapsed/was set back onto the toilet with support on either side of me.  Although I couldn’t really see it due to my posture and my belly being in the way, my birth team was untangling my baby – he not only had the cord around his neck, but it was also crossed over his chest and wrapped up between his legs.  And then, as he was lifted up to me, time stood still and the unbelievable was happening – I had a BABY in my arms and it was MY baby!!!  I remember utter shock first, then relief labor was over, then more shock over how HUGE his head was, then total joy and bewilderment that this wet, warm bundle of love was mine.  Simon and I welcomed him with tears and awe.

He (though we didn’t yet know he was a he) started wailing right away after birth.  There had not been a moment during my long labor and extended pushing phase that his heartbeat had suffered in the slightest, and he transitioned to extra-uterine life immediately and loudly!  So him being all tangled up didn’t bother him whatsoever, although we think it was a big factor in delaying his arrival (kid had no slack to work with!).  Mary said something like, “Don’t you want to see what you have?”  I had thought it would be like a reflex to immediately check to see if we had a boy or girl, but it wasn’t really like that for us. 

I think we were just so stunned, after 9 months of pregnancy and 28 hours of labor, to finally have a BABY, that it didn’t even occur to us to move beyond that basic but profound truth.  But of course at Mary’s asking, we did lift up the warm towel covering our baby and take a peak between those tiny legs.  To our delight and wonder (and not at all to my surprise), we saw that we had a baby boy, a son!!!  I asked Corinne to call my mom right away and to have her rush over to meet her grandchild – gender to be discovered upon arrival.

Within minutes of giving birth, I got off the toilet

Now that labor was over, it felt wonderful to lie down!  I’m sure I did have 3rd stage contractions to birth my placenta, but I really don’t remember them.  I feel like I had to choose to push my placenta out too, similar to how it was with pushing out my baby.  I do remember that Jessica was yapplying some fundal pressure to my belly, and that was not fun (though I felt fine, and my postpartum vitals were perfect, I was having a fair amount of bleeding.  Nothing crazy, but enough that they wanted that placenta out sooner rather than later I gathe

red).  Nineteen minutes after birth, at 8:59AM, I birthed my placenta.  The sac was pretty much shredded (maybe because it had been broken for a while?  The way that it broke?  I don’t know), but my placenta was big and healthy looking.  We all marveled at my placenta, with its veins composing “the tree of life.”  Even Simon appreciated it – he was sure he was going to be totally disgusted by the sight of it.  (I don’t think he’ll ever think placentas are as cool as I do, but he did think it was neat to see where his son had been living for 9 months).
I took some cotton root bark (a nasty tasting herbal tincture that contracts the uterus) and also threw back a small piece of my placenta (yes, really) to stop my bleeding.  Worked beautifully.  My birth team assessed my perineum and found that I had sustained a straightforward but rather severe tear (borderline 3rd degree).  All 3 midwives recommended I go to the hospital to have an OBGYN do the repair due to the severity of the damage (I took their advice and was stitched up at St. Anthony’s a few hours later.  My own OB, who is very midwife-friendly, made time in his day to do my repair himself.  The experience was totally drama-free and pretty darn painless, physically and emotionally). 

The baby’s umbilical cord was cut some time around the birth of the placenta (I think it was a few minutes beforehand) and our sweet boy was handed off to proud Papa Simon.  My mom had arrived during the birth of the placenta and was so completely lit up with joy!  It was such a beautiful sight to watch her ooh and ahh over her new grandSON.  (We asked her to see for herself if the baby was a boy or a girl, so she had the experience of lifting up the towel/blanket for the grand surprise, just as we did).  I wanted to wait until my mom arrived before Simon and I announced the name of our beautiful baby, and now that moment was here: Gabriel James Kim.
Gabriel.  We did not start considering this name until I was 39 weeks pregnant.  After disagreeing on boy names throughout my entire pregnancy (and even before), we finally stumbled upon this strong but gentle, classic but fresh name that we both loved.  Bonus, it came with a super cute built-in nickname: Gabe.  Gabe the Babe.  Gabriel means “God is my strength,” which we both thought was awesome.  Additionally, Gabriel is the angel that informed Mary that she would bear the Christ child.  Seeing as our baby was born during Advent, this name choice felt especially fitting.
James.  The name of my father, as well as Simon’s brother.  We loved that with one middle name we could honor both sides of the family.
Kim.  Our family name.  (And the name that telemarketers constantly mistake as my first name!)
Those first couple hours after the birth were so sweet.  Gabe’s first nursing.  His newborn exam, including his measurements (9lbs, 21 ½ inches long, with a 15in head!).  Watching Simon fall in love with his boy.  Watching my mom fall in love with her grandson.  Hearing both of them on the phone sharing the news with our other family members.  Corinne, with her 22-weeks-pregnant belly, telling me that I was awesome and that she felt so inspired for her own labor and birth.  Eating a huge bowl of yogurt with berries and drinking lots of orange juice, and then a sandwich.  (And not throwing up any of it!).  Figuring out just how I was going to word my birth announcement Facebook status.  Feeling my belly and thinking I felt hollow inside!  Rubbing Gabriel’s head over and over again.
I went to the hospital to get my stitches.  Simon took a loooong nap while I was gone.  (I napped a little, but didn’t really sleep until the next day – I was high on oxytocin!).  The midwives cleaned up and left.  My mom cleaned up the tornado that was our condo.  The birth pool was drained and packed up.  My birth was over.  But motherhood (and postpartum adjustment) was just beginning.  In many ways, I found the postpartum period much harder than labor and birth – so many hormones and so little sleep!  And labor was just one day…postpartum is weeks and weeks!  My body hurt so much; it was almost a month before I could sit down without discomfort (darn tear!).  Initially, breastfeeding was very, very hard, physically (hurt a lot!) and emotionally (I was terrified he wasn’t eating enough).  I found out on Gabe’s 3rd day of life that he had a tongue tie, meaning the membrane attaching his tongue to the floor of his mouth was tethering his tongue TOO much and preventing him from sticking his tongue out and nursing properly.  I was so thrilled to finally have an answer, a reason why nursing had been so excruciating!  (I say “finally” as if it was such a long time to figure it out…it was 3 days…but when nursing hurts, and you have to do it every couple hours on demand around the clock…it felt like a long time!).  Mary clipped the excess membrane the very next day, and as Gabe’s tongue stretched out over the next several feedings, my pain completely went away!  Happy mama, happy baby!  Getting a handle on nursing certainly was essential, but for me the postpartum time remained difficult despite overcoming that particular hurdle.  I was overwhelmed by how constantly my baby needed me.  I had bouts of hormonal breakdowns during which I resented my baby and didn’t want to be a mother.  I felt isolated, geographically and relationally.  My frame of mind could deteriorate faster than Gabe could start crying.  Big transition, this baby thing!  Postpartum…another kind of “labor,” I’d say!  (Btw, I’m so glad I encapsulated my placenta.  It was great to be able to “pop a happy pill” when I was/am having an especially stressful day!).  I just kept telling myself (and still do, though I’m not “technically” in the postpartum period anymore), “I gave birth; I can do this too!”

So there you have it.  My birth story, with every detail I can remember.  Postdates. 28 hours of labor. Vomiting resulting in IV fluids. 9lb baby (with a 15 inch head). 2 ½ hours of pushing. 2nd, almost 3rd degree tear necessitating hospital repair. Nursing challenges due to a tongue-tied baby.

These are not traits anyone would choose to characterize their labor and birth experience.  They are not “fun” things (in fact, some of them really stink). No one wants a long labor, or a “big” baby, or a nasty tear.

But you know what else characterizes my birth story?  A baby who had rock-steady perfect heart tones the entire time and was never in any distress whatsoever. A spontaneous vaginal birth, which unfortunately is not at all a guarantee these days.  (I think I would have almost definitely had a c-section if  had been in the hospital – 15ish hours of active labor and 3cm dilated?  They likely would have deemed me a “failure to progress” and wheeled me to the OR).  A husband who was my rock and labored alongside me through it all. A dear friend who jumped right in as my doula.  A team of skilled and compassionate midwives who guided me on my journey (and had great ideas to make my stubborn cervix do its job!).  An environment to labor and birth in where I felt safe and secure: my home. 

Plus – professional benefits – because I had a difficult labor and birth, I can offer great empathy to other mothers who must battle mightily.   Because I know.  Because I did that.  I overcame great adversity, triumphed over considerable obstacles, and delivered my child in a tremendous showing of power.  I gave birth.  I did that!  I am strong!

My baby was born on December 3, 2012, as was a fierce mother: me.

C-Sections Are Killing Women And We Must Speak Up

About one in three women in America deliver their babies via cesarean section.  The cesarean is a lifesaving and a truly beautiful modern invention when used appropriately.  But the c-section is also dangerous, just how dangerous we are only beginning to understand.  A c-section is particularly dangerous to a woman when she has more and more of them.  This phenomena of women having multiple c-sections is growing as resistance to VBAC (vaginal birth after cesarean) grows stronger.

I read this story today out of Utah.  A mother, pregnant with her sixth baby died from complications due to placenta accretia.  She had birthed every one of her babies via cesarean section.  Complications like that are GREATLY increased with each additional cesarean section.

There is certainly a possibility that she needed every single one of those c-sections.  I am going to assume that she did and that she was well aware of the risks that they posed and that her doctors had been honest and kind to her. 

But I can tell you right now that I have talked to women whose doctors assured them (after a quick diagnosis of CPD after a normal amount of pushing) that they could "Have 10 c-sections!" without a problem.  This is disturbing, particularly when we consider that real women with real families are dying because of our cut happy, impatient, fearful of liability culture of birth.  I sincerely believe that some of these women are dying unnecessarily.  

And I'm not crazy.

This news story points out that hospital c-section rates vary an incredible amount- from single digit percentages to around 70%.   This indicates that c-sections aren't done so often because of NEED but rather because of variations in CARE.

This article points out that the World Health Organization claims that cesarean rates over 15% are too high.

This abstract points out that the risk of cesarean birth is more dangerous than vaginal birth by a factor of 2-11.

But I have been a little scared lately to say anything about the truth regarding the risks of various birthing interventions. 

Why?

There has been a rash of political correctness spreading it's venom about the world as of late and it has taken its toll in the natural birth community.  Sometimes the proponents of this talk about how they "support all choices" or blab about how "judgemental" anybody is who dares have an opinion. 

My goodness, I said on my Facebook page the other day that stirrups in labor were dumb and people actually acted like I was an evil person.  Somebody said it was a "valid choice" if mom wants it.  Sorry folks, but if you think that the stirrup used for pushing during labor and delivery was ever designed for your comfort, safety (not to mention your perineum) then you are either blind or ignorant.  The stirrup was designed for ease of use for the physician.  More clearly, it was designed so that while you were laying flat on your back with your legs UP IN THE AIR (you defy gravity!  YAY!) he could easily cut you from stem to stern and pull your baby out with a metal object. (And even if stirrups and birthing on your freaking back was actually five kinds of awesome, I am entitled to believe it is dumb.  I am allowed an opinion in the USofA.)

Yes the stirrup is a valid choice for a birthing woman.  I just don't happen to think that it is a very good one (MOST OF THE TIME).  Did you notice my disclaimer?  You have to put those in or the vultures descend.

And now the c-section is a valid choice.  People get angry if I say I liked natural birth. This makes me "unsupportive" of "choices". 

I can't take it any more.  I am just going to say it.  C-sections are more dangerous.  They are necessary sometimes.  But 1 out of 3 women?  This is mind boggling.  We can take beautiful pictures of c-section birth.  We can talk about it being empowering.  We can talk about it being necessary.  C-section might be all of these things.  But the pretty pictures and the support of "choices" doesn't change the fact that women are dying because of this procedure.

And because c-section is done TOO OFTEN (I firmly believe that this surgery is performed far more than necessary) we can safely assume that women are literally DYING who didn't need to die.

Was that clear? 

Women are dying from surgeries to deliver their babies who didn't have to die.  Women are dying from c-sections they didn't need.  Women are having a lifetime of health issues from surgeries they didn't need.

You can talk about this all day long like it is a rose colored life choice but it is much more than that.

Cesarean is major surgery.  Cesarean is more dangerous than vaginal birth.  Cesareans save lives when they are used appropriately.  And cesareans (at worst) kill people when they are used inappropriately.

This is something that should be shouted from the rooftops.  This is something that every pregnant woman should know before she goes into labor with her first baby. 

I wish we would stop glorifying the "gentle" cesarean.  I wish we would stop acting like all choices are the best choice.  There are lots of choices.  They are probably mostly good some of the time.  But ALL choices aren't the RIGHT choice.  My saying so just means that I am willing to speak the truth. 

When we act like everything is good and nothing is wrong and any birth, anyway, anyhow, is just fine we help perpetuate a system that is killing women. 

I am not OK with that and I never will be. 

Women who care about birth can do better by each other.  We need to start telling the truth- not with hate- but truth nonetheless.  I can love a women who schedules her births and still honestly stand up and say that c-section is more dangerous than vaginal birth.  Because c-section is more dangerous than vaginal birth. 

I am so tired of women dying who didn't have to die. 
I am so tired of being told that all choices are equal and valid. 
I am so very sad that women have bought into this line of bull so that they can feel a little better about themselves.
I am so sad that women have given up rather than fight to change the system.
I am sad that the sometimes necessary c-sections are being used to justify out-of-control c-section rates.

Ladies- we can change this c-section rate.  We could do it OVERNIGHT.

All we would have to do is refuse to birth in hospitals or with doctors who have outrageous c-section rates.  Guess what?  They would change.  They would have to.  They need us to pay their car insurance. 

But change doesn't happen if we are afraid to speak the truth.  C-section rates doesn't get lowered when everybody pretends that c-sections are full of gentleness and pure awesome.  They just don't. 

But honesty.  That changes things.  Honesty even when it is hard or offensive.  That changes things.  That gets people thinking.  That saves lives.

Take back your birth.  Don't let the haters silence you.  Make your voice heard.  Make choices that are hard.  Be honest with yourself and others.  And then be smart enough to love people who choose different.  Respect the opinions of others even when you disagree. 

We can lower the c-section rate.  We can save lives. 

Two Birth Stories- An Awesome Epidural Birth and an Accidental Unassisted Birth

I love these birth stories.  I love that the mom found the beauty and joy in BOTH of her births even though they were so different.  And I love that I know this mom!  I got to meet her when she became a teacher with Birth Boot Camp.  You should take her class if you are in Washington!  

Enjoy!

Photos by Kathrine Demidow (My favorite!)

I love your website, and wanted to submit my birth story in case you'd be interested in posting it.  I have two boys and their births were very different, partially because of blogs like yours.  My first birth was a great experience, and perhaps it was typical.  I can't say I regret it because I don't see the point, but if I had known then what I know now I would have had a very different experience.  I feel lucky that it went the way I did because with my lack of knowledge I could have had a very different experience.

Baby 1 - Sam

I was 25 when I had my first son.  We had trouble getting pregnant, but after 2 years, our 4th attempt at IUI worked, and we were finally pregnant.  We took the standard class that the hospital offered, a few sessions that didn't tell me much that I didn't already know.  I was so excited at becoming a mother, but I was really scared of labor.  All I heard were stories about how much it hurt and how afterwards it was "like hamburger down there."  Not exactly inspiring or encouraging.  My birth plan was basically to try and do it without medication, but I fully acknowledged that I had no idea what my pain threshold is since I've never really had any painful experiences.  The most physical pain I'd ever felt before that was probably getting my tattoos.

My due date was May 2, and the day before I was feeling really nervous.  I was ready to meet my son, but one thing I did know was that I did not want to be induced.  I really wanted labor to come on naturally.  I was feeling unsettled about my doctor appointment the next day because I knew the subject would come up.  That night, my husband gave me the choice of going for a walk outside around our apartment complex or of sex to try and get things going.  I chose the latter because the idea of a walk was just too much!  We're both night owls and ended up going to sleep around 1 am.

At 3:30 am I woke up and as soon as I was awake, I realized that I'd been awakened by my water breaking.  I sat up in bed and made my husband go and get me a towel.  I went into the bathroom and the fluid was clear, and after that I was leaking fluid slowly, and gushing a bit during contractions.  At first, I didn't even realize that what I was feeling were contractions.  It took three or four crampy feelings exactly 20 minutes apart for me to realize what was happening.  I did not have any contractions or Braxton Hicks at all before I actually went into labor.  I was so excited, and even though I was tired, I liked the dark and quiet of the morning.  I called the hospital and they told me that I should come in since my water had broken but that I could shower and have something to eat first, no rush.  I was too excited to shower, but we took our time getting ready.  The drive to the hospital was nice, no cars on the street and everything was very quiet and still in the early morning. 

We walked into labor and delivery around 5 am.  I had filled out the paperwork ahead of time, so we got right into a room.  At that point, my contractions were about 6 minutes apart.  The nurses told me that depending on my progress they would probably want to start pitocin around 9:30 (6 hours into my labor).  I put on a gown and robe and walked the halls, leaning on the railings when I had contractions.  My Mom and sister arrived around 6.

As the contractions got stronger and harder, I started to re-think my ideas about having a natural labor.  Around 7:30, my doctor came in and did my first check and found that I was 6 cm dilated.  It was really convenient that my doctor's practice was located in the hospital, so it was very easy for him to come down and check on me.  After that, my contractions continued getting longer and more difficult, but spaced out more.  I know now that is something that happens to some people, and doesn't necessarily mean progress is slowing, but I did not know that at the time.  Around 10 am, my doctor told me that we could either keep waiting or we could use pitocin and move things along.  This is where my journey completely diverges from my current opinions.  I know now that the pitocin was not necessary, but I wasn't informed or empowered to make that choice at the time.

I did know that pitocin can make contractions come on fast and hard, so I told them I wanted an epidural before they started the pitocin drip.  I got my epidural and they started the drip sometime between 10:30 and 11:30.  Around noon, my friend/photographer arrived as well as my stepdad.  At 12:20 they checked me again and I was still only 6-7 cm dilated.  At that point, the nurses suggested that we kick everyone out and try to rest.  The hospital I was at was very quiet and calm, and I had the overhead lights off with natural light streaming through floor to ceiling windows.  I listened to Sarah McLachlan and went to sleep.   

At 1:15 I was awakened by an oxygen mask being placed over my mouth and nose.  In retrospect I have no idea why that was necessary.  They told me that the baby's heart rate was sporadic, and upon doing an internal exam they said that the reason was because it was time to push - I was 10 cm and ready to go.  We called my family back to the room and around 1:30 I started pushing.  Because of the epidural, I was on my back on the bed.  There were no stirrups, so I was holding my legs as I pushed.  The lights were still out, and I did very little talking.  I was not in pain, but did feel an urge to push and a lot of pressure.  My family was there to encourage me, but I didn't need them to talk to me, just be in the room with me to help bring our baby into the world.

After 1 hour and 40 minutes of pushing, Samuel Denn was born.  He weighed 7 lbs 6 oz, was 20 inches long, and had the fullest head of white blonde hair I'd ever seen.  They placed him immediately on my chest and let him stay while I birthed the placenta.

We stayed in the hospital overnight, and were unsuccessful with breastfeeding.  I found out later that I had a litany of medical issues including insulin resistance, PCOS, high testosterone and hypothyroidism that affected my ability to get pregnant and to produce milk.  I tried many things, but never got more than a few drops out of either breast.  My doctor had never checked my breasts while I was pregnant, or told me that the size and placement or the fact that there was not an increase in size might not be good signs.  I never had any idea that some women could not breastfeed, or had low production, or any of that.  We went home the next day, and I was shocked at how easy my recovery was.  My muscles were sore and tired, but I felt fairly good.  None of the vagina horror stories I'd heard held true in any way, and things went back to normal fairly quickly.  My only complication was a labial adhesion (basically my labia was fused together) which was solved with some local anesthetic and my doctor pulling, then followed with progesterone cream.  I fully believe this was just another sign of my body's pretty dysfunctional and undiagnosed hormone issues.

In the three and a half years between having Sam and getting pregnant with our second, I became a bit of a birth junkie.  I HAD felt empowered by my birth, amazed that I'd done that.  In reading more information and other people's birth stories, though, I came to realize that there were other choices.  I read a lot of birth blogs, and then I watched "The Business of Being Born."  I was hooked.  I was incensed.  I hated that I'd been so afraid of labor and birth when it should have been something to look forward to.  I hate that we don't educate young women as to ALL of the choices available to them when it comes to birth.  I hate how our country seems to view all of this as a medical condition, and I hate that people think they need a doctor when in many cases a midwife is more than enough support.

Baby 2 - Danny

As soon as I found out I was pregnant, I knew that I wanted to do things very differently.  I asked a long time family friend who is a hypnobirthing instructor and doula for a recommendation, and I hired a midwife.  We took hypnobirthing classes.  I watched tons of videos on YouTube and read hundreds of birth stories - all positive, all empowering and amazing.  I couldn't wait for my birth, to really feel the power of doing it myself this time.  I trusted my body.  At 30 weeks I realized I was not comfortable with my midwife.  I am generally very confrontation-phobic, and I have often sat back and just accepted something because it was easier and I didn't want to hurt anyone's feelings.  This time, I didn't.  I realized that I absolutely did not want someone attending my birth who I was not comfortable with.  It would have been setting myself up for discomfort and problems during labor.  Luckily, I found another midwife I'd heard good things about who had room to take me, and as soon as I met her I was 100% happy with my decision.  I connected with her in a way I hadn't with the first woman.  We planned to have the baby at our local birth center, about 20 minutes from our home.  I thought about a home birth, but we were living in a house owned by my father in law and I knew the only place we'd be able to set up a pool would have been in the kitchen, and I really wanted to be able to be in the water, and didn't want to have my baby in the kitchen.  We were also 25 minutes from the hospital, and I felt more comfortable being closer just in case. 

My due date was on Mother's Day, May 9, just 7 days after my older son turned 4 years old.  It came and went.  I was unhappy and uncomfortable.  I had been having some practice contractions in the evenings, usually for about an hour and 8 or so minutes apart, then they'd stop until the next night.

On May 10, I woke up got Sam ready for preschool.  I went out to Thai food for lunch (my husband plotting to feed me spicy foods) and then shopped for my husband's birthday presents since his birthday was the next day.  Pretty early in the day I started having a few contractions - about one or two every hour.  They were very spaced out and not very intense, but it was something different to be having them throughout the day instead of just in the evening.  I was hoping that this was a good sign.  I met Sam at the bus after school around 4:00 and we played outside until Justin got home around 7:00 after dealing with filing a police report because his car had been broken into at work.  Since he'd had a bad day, I decided he should open his birthday presents early, so he did that and he and Sam had some cake.  

Just before 8 pm, I started having some regular contractions.  They felt a little more intense than my usual nightly contractions, and I started hoping that it was for real this time, but I was cautiously optimistic because I didn't want to get my hopes up only to have it not be the real thing.  At 8:20, I started timing with the contraction timer on my phone.  For the next hour, my contractions were 40-60 seconds long and between 7 and 12 minutes apart.  I felt skeptical that this was really it because they were so far apart, and at the least thought that it would be quite a while before we'd be heading to the birth center.  I was wondering if my water would break like it did with Sam, and I texted my Mom and sister that this "might be it."  There was a lot of doubt in my mind about how I would know when it was "real" and how long to wait before calling people or heading to the birth center.  I knew that the "rule" was 5-1-1 - contractions 5 minutes apart, a minute long, for at least an hour, so that's the guideline I had in mind in regards to calling my midwife.  I later realized I was supposed to call her when they were 10 minutes apart to at least check in according to her written instructions since it was my 2nd baby, but it would not have impacted the situation in any way.  At this point, my husband was getting nervous.  He kept asking me how far apart the contractions were and if they were getting more painful, but I didn't seem worried so he didn't push it.

Around 9:40, a little under 2 hours into it, the contractions got closer.  For about 30 minutes, they stayed around 5-7 minutes apart and a minute long.  I was starting to wonder if I was a little crazy for opting for a natural birth because they were getting pretty painful.  I also realized at that point that I literally had no memory of having ANY pain during my first labor despite the fact that my family told me that I was in pain, and I said I was at the time.  My husband asked me if I was able to talk through the contractions since we knew that was another good indicator in terms of heading to the birthing location.  At that point, I was lying on the couch on my side and was still able to talk through them. I tried listening to my hypnobirthing CD, but quickly realized that it was not going to work.  I couldn't relax.  I got up from the couch and turned if off, emphatically telling my husband "This is NOT going to work!" I think if my labor had been longer and I'd had more mild contractions for longer, it would have been great.  If they'd been spaced out further it would have been nice to relax in between.

My husband was packing a bag for Sam so we could drop him off at a friend's on the way to the birth center and getting a few things for himself together.  I walked around the house, stopping to sway and moan during contractions.  I was still very calm, and my husband was moving at a medium pace.  The contractions were not really regular, and weren't getting closer together and he was thinking about how long my first labor had taken.

Suddenly, around 10:15, the contractions got very hard.  They were coming every 2.5 - 3.5 minutes and I was no longer able to talk or walk through them.  I was vocalizing through each one, moaning and trying to keep my voice low and remember to breathe deeply instead of panting or yelling.  I picked up my phone and found myself on my knees in our family room with my elbows on the couch.  I called my midwife and told her that it was time and we would be there in 20 minutes.  She said she would meet us there.  I was sweating and felt my body working hard at that point.  When we looked back later at the contraction timer, my contractions had gone from being 10-12 minutes apart to 3-5 minutes apart in less than 10 minutes.  

My husband was running around the house a bit crazily now, trying to get everything in the car.  At 10:25, he called my Mom and told her to meet us at the birth center, and was about to carry a sleeping Sam out to his carseat.  That's when my water broke.  It was a completely different experience having my water break while in hard labor, I was caught off guard by the loud pop and flood of fluid.  My husband heard it from across the house and called out to ask if my water had just broken.  I could barely answer him.  As soon as my water broke, my contractions were one on top of the other.  That's when the pressure started.

I barely remember walking to the bathroom, one room away from where I was.  I sat down on the toilet, and I could hear my husband rushing around to get ready.  At this point, I knew that we were not going anywhere.  I could feel my body bearing down with each contraction, I was pushing and there was no stopping it.  I knew there was no way I was getting in a car.  At this point I was yelling during the contractions, and my husband came into the bathroom.  He told me I just had to stand up and walk to the car, and I said "I can't."  He thought I meant I thought I couldn't because the contractions were painful, and was getting frustrated because he didn't understand.

I remember saying that it hurt.  After only 7 contractions that were right on top of one another - probably about 10-15 minutes on the toilet - I reached down and felt my baby's head.  I said, "he's coming, he's coming right now" and my husband asked what he should do.  I told him to put down towels and I got on the floor on all fours with my arms on the side of the bathtub.  Justin asked again what to do, and I said "catch him."  And he did.

After four pushes, the head was out, and after two more, our second baby was born in our home into his father's hands.  Sam slept on the couch through almost the whole thing, only waking briefly when I screamed during the final pushes.  I sat down and turned around, and Justin handed me our baby.  I wrapped a towel partway around him, but honestly was a bit in shock.  My husband swept his mouth out and made sure he was breathing.  He looked up at me and he didn't cry, he just made a few noises, enough that I knew he was fine.  

Daniel John was born at 10:55 pm on May 10, 2010.  He was 8 lb 3 oz and 20 inches long.  I held him in my arms and my husband rushed outside to call our midwife and the people who were headed to the birth center to tell them to come to the house.  He stayed fairly calm until he started making the calls, then started to get shaky and called my Mom twice.  Our midwife arrived at our home about 15 minutes after Danny was born.  She looked at the placenta, which I had already birthed, and clamped his cord so that my husband could cut it.  Holding him for about 30 minutes after he was born, skin-to-skin, without any interruption was amazing.  Once we cut the cord, our midwife helped me up to my bed and my Mom and her husband arrived.  Soon after, my stepdad and my sister also got to our house.  

Our midwife weighed and measured Danny and we wrapped him up in a couple of sleep sacks and a blanket because he had gotten a little cold from when I was holding him without a blanket on him.  She stuck around for an hour or two and made sure we were all okay.  A couple of hours later I got up to go to the bathroom and sit so my husband could clean up the bed and get it ready for us to sleep in. Unfortunately there was a bit of a mess to clean up (one of the reasons I HADN'T planned on a home birth!), so it took a few minutes. We did have chux pads on the bed, but they were insufficient.  I was feeling VERY dizzy and weak, and my Mom started to get concerned. After I sat for a few more minutes and had a couple of bowls of cereal we decided that it was just a combination of getting up from bed too soon, the adrenaline rush wearing off, and not having eaten since lunchtime. With all the commotion, my midwife forgot to remind me to eat something before trying to get up, and it didn't occur to me apparently.

I moved to the floor in the bathroom, and then when the bed was done I got up to walk across the hall back to bed. My husband helped me up, but when he turned around to get something from the bathroom I was in the hall and passed out. It was really weird, I have never passed out or fainted before and I just felt my body become SO heavy and fall to the floor, then I woke up and it just felt like it was morning and I'd woken up. I crawled over the bed and climbed up, and I felt okay. Luckily, I didn't hit anything on the way down!

Danny slept like a champ, which was nice since I didn't fall asleep until after 3:30 am and he slept for a good 5 hour chunk.  We had so many other people around, he just got passed from person to person who loved him.  Despite the mess, I love that I had my baby at home and just like my first birth, he was surrounded by people who love him immediately as he came into his life in the outside world.  It was kind of great not to have to go to the hospital or anywhere and just be at home.  

My recovery was more difficult with Danny than it was with Sam, I think because he came so quickly that my body didn't have time to adjust.  I didn't have any tears or stitches, but I was just really, really sore and spent most of the first week on the couch.  My stomach muscles hurt a lot until my midwife suggested binding my stomach, which I did with an elastic type back brace I happened to have in my house.  After wearing it for 24 hours there was a huge difference, and she told me that in a lot of countries they do that for all women after birth.    

In the end I had two very different birthing experiences.  Both were wonderful in their own ways, but it never stops being fun to tell people about my unplanned, unassisted home birth!  Now I encourage all women I can to educate themselves and decide what they really want - you can have the birth you want, even if sometimes it happens differently than you'd expected.  

Rachael is a natural birth teacher in Washington State.  You can find out more about her on her website- www.readysetbirth.com .