Prodromal labour was the name of the game this week. Four babies were born, who each gave their mums long prodromal labours (and some long active labours, too.) None of the births were "easy" this week. But they were all amazing and beautiful and triumphant.
What's prodromal labour? It's Slow Birth at its ironic finest. It's that part of birth that isn't really labour yet (patience, patience). It's the body trying to deal with something without making it too challenging for the mum. But, the body doesn't realize that the mum has a brain (a very intelligent and 21st century brain) that continually tries to figure out what's happening...why is this taking so long?...why am I not having a 2 hour labour?...when will it pick up?...why?...how?...when? All those questions are exhausting. Prodromal labour demands that we honour the needs and rhythms of the body, and shut down the thinking brain. Prodromal labour forces the reptile brain to kick in. My job is to remind the mum that she must trust her body and baby...they both have their reasons for taking their time.
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During our initial phone call, many first-time mums nervously laugh, then ask me if I can just order them a fast birth "and one epidural in the parking lot, please." It sounds like a drive-through order.
"Why?" I ask myself. Really fast births don't allow the body to churn out all those wonderful pain-relieving endorphins (boy, do you want them!) Fast births don't allow any time for the brain to keep up with what the body is doing. Actually, my least satisfied client had a 45-minute labour and birth. She said, "I waited 40 years to give birth, and THAT'S IT??? It was so fast, I missed it!"
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Maybe I'm just a little slow...but I've finally decided that I have to act on my decision (2004) to start focus-writing on Slow Birth (think slow dancing, slow cooking, slow kisses, slow lane, take it slow, baby...) Don't you just take a big breath and sigh when you read those words?
I loved reading "In Praise of Slow" by Carl Honore, and discovering the Slow Food and Slow Travel movements as they emerged. We had always raised our children according to the "slow" philosophy. We talked, we listened to music, we read books together, and my husband and I kept our lives in pace with our children's development - we kept things slow, and the family flourished. When the slow movement began, it was nice to see that other people were discovering this way of living.
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On my first day of Stats 316, my prof said that there was a 99% probability of finding two people who shared the same birthday in our class of 57 people. This is known as the "Birthday Paradox". Well, I think I was hit with the doula equivalent today.
I walked to my visit this morning. As I got closer to the couple's house, I thought, "This is really close to where Julie and Trevor lived then they had their baby in 2001." I walked another block, checked the address...and, it was EXACTLY where J&T lived. The same green house on the corner. I know the bathroom where she laboured...the stairs she walked down as she headed to the hospital. Wow! I know this home has good birthing energy.
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Well...it was a busy day. LL's water broke late Monday night (first baby), but there were no contractions immediately. She said that she'd try to sleep and call me in the morning. Only a few hours later, the phone rang. I answered, thinking that the contractions must have started quickly...but it was LF in labour with her third baby. I knew she was going to be quick, so I crossed my fingers and headed off to meet them at the hospital.
This is always a dance for a doula...two clients at once. I knew I had backup at the ready, but I felt pretty sure that I'd be able to make it to both. I just had a feeling... I decided not to panic.
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After she had her baby the other day, this new mum said, "You know, once you're in it, labour isn't scary! You just do it!"
I have so many clients who have carried the fear of childbirth with them for years and years. Some even postpone the event for as long as possible, just because their friends (or families) have told such horror stories over the years.
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Man, I do love working with clients for a second (or third or fourth) time!
I get to really connect with the mums, dig deeper into what makes them (and their labours) "tick", and watch the emergence and transformation of a mother.
I love the postpartum visit, where I always manage to have a tea-party (or, in this case be presented with a wooden mixer and a plate of wooden toast, wooden egg, and a special spoon) laid on by a little sparkling one in a tutu, play a song or two, and hold a crying baby.
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Myth #3297:
"You shouldn't have a home birth because it's too messy!"
One client's mother, a surgeon, was concerned about her daughter's decision to have a home birth because, "I walk around the OR with my boots covered in blood, dear. It would be SUCH a mess!" I asked her if we walk around our houses during our periods with our boots covered in blood. "Well, no," she answered. "That's silly. We wear pads or tampons." After her daughter's home birth, the surgeon Grandma was amazed..."I guess it's the docs that cause the mess!"
Well...labour at home (even when planning a hospital birth) is clean because we are used to keeping clean when we bleed on a monthly basis. Labour is no different. And, for some reason, women seem to lose WAY less blood at home births - a matter of fully functioning hormones, perhaps?
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If you’re having a hospital birth, perhaps one of the most challenging parts of labour is the transition from your home to the hospital. Many couples worry about the car ride to the hospital, but it’s amazing to see how most women manage the ride with surprising grace. If the car ride is timed so that it coincides with the trance induced by high levels of endorphins (well past the mid-point of labour), then the whole journey can be manageable.
To illustrate - I vividly remember one client’s ride to BC Women’s from UBC. It was around 4am. She threw a coat over her naked body, somehow managed to run to her car down a long apartment hallway (between contractions), then crawl onto the back seat of her minivan, exposing her bottom to an old man in a trilby hat, who was coincidently walking his little Scotty dog past us at that moment (you should have seen his face!) Bouncing along in the car, this normally private woman laughed and laughed. “That was FUN!” Yes, the trip was uncomfortable, with her husband trying to negotiate hundreds of potholes, but the absurd nature of the trip far outweighed the pain it may have caused.
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Check out the MedWire News synopsis of a new study that was recently published in the journal Birth (2008: 35: 92-7)
Doula support reduces cesarean and epidural rates
by Lucy Piper 03 June 2008
Examining the perinatal effects of doula support for nulliparous middle-income women accompanied by a male partner during labor and delivery.
MedWire News: The continued presence of a doula during labor significantly reduces cesarean delivery rates and the need for epidural analgesia in middle- and upper-class U.S. women accompanied by their male partner or another family member, researchers report.
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I think there’s a purpose behind the nine long months of pregnancy. This time is vital for introspection, reflection, setting boundaries, and discovery. As I’ve said so many times before, birth is not a “body” act...it’s an act of the soul and the mind and the will.
Yes, I have a checklist of the things that I need to discuss with clients...and worksheets for them to fill out if they’re “paper people”. But, in order to serve my clients well, I need to go further, deeper. So, over the months, we talk on the phone discussing everything from diapers to spirituality. I often ask couples some unusual questions to help them uncover how their life experiences may affect them during the birth and postpartum. Usually, the deeper we go, the greater the understanding, resulting in a much more positive emotional experience for everyone.
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One of my recent clients is a doula from Fort McMurray. She drove all the way to Vancouver to have her baby. I was honoured that she asked me to support her and her partner (and sister) through her labour. With her permission, I'd like to share a part of her email that she sent me after she had driven all the way home with the new baby (only a few days after the birth!)
"I really wanted to email you and say thank you once again for a terrific job and your incredible support. I drove to Vancouver with hopes for an amazing birth, and I couldn't have imagined it being any better, even though it was longer than I anticipated! I wrote down my birth story as you suggested, and literally just finished reading your notes. Like you said, it's so funny what a different perception you have when in labor. I love the quotes you wrote down, and I honestly thought you had arrived at my sister's place at 4am, not 4:45! You make the birth sound like it happened a heck of a lot faster than what I remember it feeling to be. What an incredible experience! Thank you for making it be so.
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I've been talking a lot about "an undisturbed birth" lately.
The language that we use in labour is so potent. I'm uncomfortable with many descriptive terms surrounding birth, such as "I'd like a normal birth"...or "She had a natural birth" ...or "We did a pure birth." It sounds like all others are abnormal or unnatural or impure. Birth just should be.
So, it came to me, recently, when I realized that so many of my clients have what I describe as "she just went into labour and then had the baby" births...they had all been undisturbed in labour. My role is to keep her private space protected and undisturbed, to help her feel free to move undisturbed, to be the guardian of her cave. She remains hidden, unobserved, in a safe space.
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I was debriefing with a second-time client yesterday. She wanted to tell me how important it was that I was by her side at her second birth. “This time, lots of people said I didn’t need a doula - that you’re not a midwife...that the doctors and nurses would be there to help me. But I knew that you’d be there just for me - and I trust you. I knew you were there in my corner - always.”
Her husband thanked me for being there again - for helping to create such a positive experience. He put it all down to what he calls “the Jacquie magic”...the fact that everyone in the hospital treated them differently because they were with me.
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To all pregnant clients...here’s a “head’s up”. Some time after the baby’s born...you will make this phone call. The wording and timing may vary, but the questions will be essentially the same.
“I’ve got this pile of books here. One says to get the baby on a schedule, another says to feed on demand. But what does “demand” mean? What if the baby comes off after 10 minutes. Is that a feed? When do I change the baby? Before, after, or in the middle of a feed? Am I wrong to want to grab my baby away from visitors? You know, they’ve come all this way, and brought presents, but I just want to hide...”
We’ll probably spend up to an hour on this particular phone call. We’ll laugh together...we might cry together...then you’ll hang up the phone floating on air. Why? Because you will have been reminded of your infinite strength, your inner wisdom, and your ability to trust your body and your baby.
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“I don’t think I’m in labour yet. I feel it really low down, all in front. It’s not hurting ALL OVER.” said the doctor on the phone.
“ALL OVER?” I asked, sounding like a parrot.
“Yeah.”
“Um...if all is well, it shouldn’t.” I was just a little bit confounded. Here I was, talking on the phone with a physician who’s been attending births for years. She’s amazing with her patients, so intuitive. Now, in labour for the first time, she was just as confused as everyone else in labour.
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Last night was a perfect example of a final prep visit...with a bonus. When I walked into their living room I noticed some special items on top of a shelf, obviously placed with care. I could see potted hyacinths, coloured eggs, wheat sprouts, and more. The shining couple explained that it was Persian New Year, and that the altar held seven items that each symbolizes some aspect of rebirth and rejuvenation. I was honoured to be a guest in their home on this special day. It seemed fitting that we were talking about welcoming a new life into their home at the new year. Then, the cat jumped up and tried to eat the sprouts (to the cat it looked just like catnip, I guess...) So, ancient ritual and custom met the quirky reality of the animal world. That's kind of like how labour works...
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"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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