The Baby is Breastfeeding - Not the Mother

Hot off the press! In the March 2008 issue of Birth, check out the article "The Baby is Breastfeeding - Not the Mother" by Dr. Lennart Righard. The ending sums it up:

"In natural birth the woman is moving around in upright positions trying to find the most comfortable position and turning to herself to find her own inner strength. Such a woman is not so easy to control! She follows her own impulses and intuitions and her own body’s signals. She relies on nature. The same is valid for breastfeeding. The mother does not know how much her baby is eating, she has to rely on nature. This is the secret of success in the triad of reproduction (coitus, giving birth, and feeding from the breast): rely on nature, relax and let go, and you will be amply rewarded."

Then, take some time to view the WHO/UNICEF Breast Crawl video. Perhaps we all need reminding that instincts work! 

That's it! Time's up!

There is a very real anxiety that surrounds birth...and time.  "How long was your labour?" "When will I have this baby?" "How long did that part take?" "If your water breaks, and you haven't had the baby in 24 hours, well..."

And then, someone puts a big round clock right smack in your line of sight in the hospital room.

When I initially ask clients what they wish for, the most common answer is, "A fast birth."

However, after we've been working together for a number of months, most clients realize that each labour takes as long as it needs - no more, no less. Each woman's task in labour is to accept its flow, allowing it to unfold as it should. Time and space start to recede, endorphins increase, tension starts to release, and then labour works well.

To put an arbitrary time limit on any normal pregnancy or labour harms its natural rhythm. Birth is a psychosexual process. And, just like lovemaking ("Are you two done yet??"), it withers when it is pressured by time.

Ultimately, once you understand the nature of birth and its relationship with time, you settle into a pace that fits you and your baby on this particular day. It may be fast. It may be slow.

So cover your eyes and plug your ears, and you won't be rushed or ruled by the clock.

Madonna

This Madonna collage will always remind me of the couple (both artists) who gave it to me as a gift after their daughter's birth. It's a treasure. It will always remind me of all the births I have attended - the layering of experience, the significance of cherished objects, the importance of history, the value of memories, the power of nature.

I see an old family portrait, a pomegranate, the impermanent dandelions, the water lily, the doll I had as a child, that special bike, that beautiful floor fragment, a cupola with light streaming through to the ground. We each see those things in the collage that hold meaning for us.

Labour is like this. Fragments, layers, images - all confusing, deeply challenging, yet breathtakingly beautiful. Our births are not "the pain." Our births are not physical. Ultimately, they are not of the body, they are of the mind. They are personal, they are dependent upon perception, they are ours. We birth as we live.

Birth is not "paint by numbers." Each birth is like a collage - totally different for each woman, each birth.

I've been at 5 births in the past three weeks, with each teaching us new lessons to draw upon. I will look at the collage and name a part for each woman.

- With love and thanks to Tanis and David
www.silentalbum.com

Äpfel schütteln

"Komm, wir wollen Apfel schütteln,
Äpfel schütteln;
alle Kinder helfen rütteln.
Ria, ria, ria, rums."

This German children's song would be perfect to sing while shaking a woman's hips with your hands in labour. One of the many indigenous practices used for centuries to loosen the pelvic muscles and ease a baby's journey through the pelvis, "shaking the apples" works really well with first time mums in early labour, as well as multips as they approach birth.

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Walking the Labyrinth

"You are a gift to me beloved
trust my body
trust my baby
breathe..."

Last night, friends and family painted the labyrinth in the living room of a woman in early labour, hoping that she would have a chance to walk the labyrinth as the labour progressed. But her labour skyrocketed and her baby was born sweetly before the paint had time to fully dry!

But I think she had been metaphorically "walking the labyrinth" for a long time and was fully ready. There were no blocks. She trusted her body, trusted her baby, and held firm and fast to her husband, whose hands held the baby's head as it slid out into the flickering light of a candle.

With a labyrinth there is only one choice to be made. The choice is to enter or not. With the smooth and quick birth of this beautiful boy, the choice was made. What a joyful entry to the world.

Crossing the Portal, the Old School Way

I stood still in Pottery Barn the other week, in front of a phone that looked just like the lovely heavy black phone that we had when I was little. You know, the one with the rotary dial that, when you needed to dial 9-1-1, took such a long time for that 9 to rotate. No wonder they didn't stick with the British emergency code of 9-9-9. The emergency would have been over before the dialing was done.

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October 2, 1940

Hear my mother's voice

Maurice was born
during the Battle of Britain
mum
gave birth to him in a basement
nurses helping
having walked to work
after going to the pictures

now
bombs
falling on the engineering works around the hospital

the babies were put in boxes
pushed into the cabinets in the wall
of the morgue

the new mothers sat together
in their nighties on the floor
incendiary bombs falling

dad took us
to the bottom of the road
‘that’s where your mother is’
as we watched the flames
all red
rise in the dark sky
across Manchester

the next day
we walked
to see the new baby
walked the road
five miles past the burning
past the rubble
past the children running in pyjamas
alone

say welcome to the new baby
in the hospital
standing
white
all by itself
in the city

This is just one of the many family stories of birth that I have collected over the years. My own mum told this story about her brother's birth during one of the heaviest bombing raids on Manchester during the Battle of Britain. As a child, I loved hearing this story because it told me that the people in our family are strong, resilient.

I used to love hearing that my grandfather kept his family together. He wouldn't let the children be evacuated. "If we go, we all go together." I like to think that our family is stronger as a result - that my own children are stronger because of this.

But it also told me that we are profoundly impacted by the stories of our births - that we believe certain personality traits are borne out of our experience of that day. Is Maurice constantly nervous because he was born in a bombing raid? Or is he nervous because it has been an expectation of the story that has been told over and over again? What are your family stories of birth? What stories will you be telling your daughters and sons? Are they stories of resilience and empowerment? Are they stories of loss or victimization?

I hope that we carefully frame the stories that we tell, so the listeners will find strength in our words. We need to especially watch the particular words that we use when we talk to our daughters about birth, remembering that these epic stories will weave themselves into her thoughts as she is giving birth. I know that I saw visions of the bombs falling around the hospital as I gave birth to my own children. It didn't make me fearful, it made me strong. "Gran did it...I can do it... Gran did it...I can do it..."

We Rode the Ling Ling Storm

Five babies came as Tropical Storm Ling Ling washed across the Pacific.

Three at home - Anna, Ruby and Sami...

Two at hospital - Jack and Thompson...

Was it the low pressure system that made these babies - due from September 27 to October 28th - come in one week? Did they surrender to the draw of the new moon? Was it both? Or did these babies just tumble to earth in this month's enthusiastic group arrival?

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...she jumped up and grabbed onto the edge of the note.

Singing in labour is sacred. In the middle of a contraction, without warning, the note rises out of the woman. She sings to the baby, to herself, to all women. Her song can connect her to both the earth and the sky.

This past week, without planning, each woman has found her voice in labour, grabbed onto the edge of a note, and used it to take her through to the end of the contraction.

On Monday...we might not have heard her sing aloud in labour, but my first client this week drew power from the Dixie Chicks and others, by candlelight...

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Why do babies come in groups?

Do they get inspired by other babies that have made it through recently, and decide to come early just to join in the fun? It's a funny image, but it kept coming to me recently as seven babies came in a steady stream. The due dates ranged from August 28th to October 14th...but they all decided to come in a 10 day period. So funny :)

When I have time, I'll write more about the amazing lessons that we all learned from these babies...

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Kaleidoscope

"For we live with those retrievals from childhood that coalesce and echo throughout our lives, the way shattered pieces of glass in a kaleidoscope reappear in new forms and are songlike in their refrains and rhymes, making up a single monologue. We live permanently in the recurrence of our own stories, whatever story we tell." - from Divisadero by Michael Ondaatje

Shattering reflective pieces of a kaleidoscope tumble in my mind's eye. These are a million moments of experience, random sounds from births - a cry, a laugh, tumbling beside facts, data, then mingling with sparkling words from literature, history, and art. Our experience of life is beautiful and complex and always changing.

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An Argument for Non-Linear Thinking

I just love how our brains work. Well, I actually only know how my brain, a woman's brain, works. And it's totally non-linear. My daughter's brain works like mine, and people laugh when they hear us talking, shifting from one subject to another without any apparent link. Ah, but we independently followed the link from five minutes earlier in our conversation.

Birth is also feminine, non-linear. It works like a woman's brain. There are multiple tasks being accomplished at any one time - descent, rotation, softening, opening. Almost ESP-like communication can take place between a woman and a wise caregiver - this is the "monkey-brain" or "reptile-brain" at work. Thoughts, memories, past experiences, and current understanding are accommodated, merged, drawn upon.

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L'Arbre et Le Fruit

Here's a little excerpt from an article by Dr. Michel Odent, noted French obstetrician.

"According to traditional wisdom in rural France, a baby in the womb should be compared to fruit on the tree. Not all the fruit on the same tree is ripe at the same time. A fruit that has been picked before it is ripe will never be fit to eat and will quickly go bad. It is the same with a baby. In other words, we must accept that some babies need a much longer time than others before they are ready to be born. If you have some apple trees in your garden, you will listen to your common sense and choose an individualized and selective approach: you will not pick all the apples on the same day."

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On "Beyond Evidence: The Complexity of Maternity Care"

I must say that I've had a long-standing passion for Murray Enkin. I was first "introduced" to him in 1987, when he was an obstetrics professor at McMaster University, and was writing "A Guide to Effective Care in Pregnancy and Childbirth". His book became my "bible". The underlying thesis of the book is that evidence from well-controlled trials should encourage the adoption of useful measures and the abandonment of those that are useless or harmful. The full text of the 2000 Edition is available online, courtesy of the authors!

Dr. Enkin's insightful comments in the "Guide" made me respect his judgment. His pragmatic review of the research helped to guide me in my role as a doula. I would photocopy pages of the book to give to clients, to help them negotiate the best care during pregnancy. Over the years, I have always checked in on his current research, and tried to follow his teachings.

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To epidural or not to epidural...

That is the question...

I had two back to back calls the other day, regarding epidurals. The first was a last-minute possible client who called to say she wasn't going to need my services after all...because she'd just had her baby that morning (in very short order). She was quite surprised how quick and simple birth was - surprising since, as a family doctor, she'd been attending births for some time, and had anticipated...well, something more hellish than she encountered. She said she now understands that the decision to have an epidural isn't one that can be made before birth...it's all about responding to the needs of the day.

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Statistics for the Utterly Confused

I usually wait for a full year to pass before doing my client stats, but a lot of doctors, nurses, doulas, childbirth educators, and clients have recently been expressing concern about the high epidural rate (reports are as high as 80%) at local hospitals. A recent article in The Vancouver Sun also reported that the cesarean rate in B.C. had climbed to almost a third of all births, far in excess of what the World Health Organization deems acceptable.

So, here's a glimpse into my own client outcomes from January 1/07 to June 7/07. Now, remember, these are not a special group (i.e. highly motivated multips under age 30 with a history of fast births). These are 30 women with an average age of 36, most (73%) having their first baby, who hired me to help them and their partners. The majority entered the process without hard and fast expectations about the birth experience. They all hoped to "do their best on the day", some wanting an epidural at the door (and not needing it), and some wanting to avoid a cesarean (and needing it). They are all capable and amazing women.

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Lessons from a Happy Flying Baby (Advanced Level)

Did I tell you that I think that labour lasts as long as you need to learn all the lessons required for this particular child? There’s perhaps a little extra time added to work through some particularly tricky past life experiences. The baby’s personality has a lot to do with this...

One of the family doctors I know, said that all three of her boys had labours to fit their personalities. One came flying so fast that his cord broke. And that’s how he goes through life - flying headlong into things (both physically and emotionally). Another son takes his time, considers all his options, then considers them some more. As a result, his labour took a long, long time.

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Birthing from Above

From the desk of Jacquie's daughter

Growing up surrounded by my mum's work in childbirth, I had a slightly different introduction to the subject of reproduction than most children. Instead of reading "Where Did I Come From?" I looked through a plethora of illustrated Sheila Kitzinger and midwifery texts. I thought it was fascinating that the egg that was fertilized to make me was in my mum's ovaries when she was born, and was thus formed inside my grandmother! Wild. When she taught prenatal classes, I would come along and play with the infant-sized dolls in her teaching materials, using the plastic pelvis as a cradle. Then, as she began to do more labour support, I would act as her secretary and run into the kitchen to intercept calls before anyone else, often to hear a flustered dad drop the phone, with his wife moaning in the background -- "Mum, it's for you."

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