"To sleep/Perchance to dream"

I love the drive from a client’s house to the hospital. I’m following my clients, watching the labouring woman’s hand reach up to the roof of the car during each contraction. For me, it’s an in-between time of quiet watchfulness, similar to that “out of time” feeling I remember while feeding a baby in the middle of the night.

Last night, we had a long drive from Surrey to Burnaby General. So, I turned on the radio to CBC Ideas and heard an amazing piece by Jeff Warren called "While You Were Out" about the changes in sleep patterns over the last three hundred years.

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Helping mothers open the door to life

Journalism students at Langara College produced eight weekly issues of The Voice newspaper. As a final test of endurance the pressure was ramped up and in the ninth week they produced four daily newspapers. Adam Johnson's submission made the top story in "The Best of the Dailies!"

“A 65-year-old midwife held my foot and she didn't move. Then she would look up and she'd smile. And I thought, obviously things are okay.”

“I just said, I need to do this.”

The deep kindness in her eyes grows determined as Jacquie Munro, 45, describes the day she found her calling. She was inspired by her second birth to share this positive experience with others. That was 18 years ago.

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On Memories

"So much of our early gladness vanishes utterly from our memory: we can never recall the joy with which we laid our heads on our mother's bosom or rode on our father's back in childhood; doubtless that joy is wrought up into our nature, as the sunlight of long-past mornings is wrought up in the soft mellowness of the apricot; but it is gone for ever from our imagination, and we can only believe in the joy of childhood."
George Eliot, Adam Bede

Conscientious parenting begins before our children are born. Writing a pregnancy and birth journal can help to create wonderful memories for our babies. My own children loved it when I read my journals aloud at bedtime.

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“You say you want a revolution/Well, you know/We all want to change the world"

“Crisp and non-preachy” is how John Lennon’s Revolution was described on the radio today. After almost 40 years the form of the message is still unmatched. What would John Lennon have said about the social and political climate in 2005?

I think I’m pretty clear on what he might have said about George Bush and Iraq. But what would he have thought about the “Britney Spears School” of birth? Would he have commented on the “Too Posh to Push” scene? Would he have questioned why women seem to be so scared of their bodies?

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“There’s snow! That means it’s winter, so the baby must be coming!”

...to paraphrase an excited older sibling (age 4) this morning...

Her logic worked so well. Mummy and daddy have said for 9 months that the baby will come in the winter. It snows in the winter. Today it is snowing. Therefore, the baby must be coming today.

And the baby came. We drove through snowy streets to the hospital. What joy to find that my client, on arrival, had already surpassed her last labour’s final dilation! What a triumph for her to labour without intervention or medications (other than nitrous oxide gas - which doesn’t count, right?) and birth a glorious 9lb 1oz baby girl after only an hour of pushing.

This VBAC (vaginal birth after cesarean) was the talk of the hospital today. Congratulations!

Mail sampler (to encourage new mums)

Dear Jacquie,

Sam is 10 months old now, and doing really, really well. She is a very mellow, happy baby (and she sleeps through the night which makes life SO MUCH EASIER).

My birth experience has stayed close to me through everything - to be expected, I suppose, but it has become a memory that I draw on when I'm having one of those tough days (i.e. not enough sleep, Sam teething, Sam not eating her peas, all of the above in combo with PMS - I *so* didn't miss my menstrual cycle...). My memories are overwhelmingly positive, and much of that has to do with your calm presence throughout. You set the tone, you guided me to that place where I knew that my body would - and could - do what needed to be done. That strength and confidence has made all the difference, particularly during the early months when everyone around me seemed to think they knew what Sam needed better than I did; whenever I've had doubts, I've gone back to that basic trust in my body, and it has so far given me the best advice.

My trust in my intuition, and in my body's ability to take care of itself and my babe, is at the very core of my mothering. I think that your guidance through the birth helped me find that - and for that I thank you. I hope you're available when we do this again! I'm really looking forward to it. How weird is that? I must be ovulating... ;-)

I hope all is well with you and yours!

Maureen

“In and out like a fiddler’s elbow”

I laughed when I heard this expression on CBC radio this morning. It’s supposed to mean that you’re really busy. Well - that was me this week. It had started out quietly...

And then...

Three births in two days. But the crazy thing is that I didn’t get more than four hours sleep in 64 hours. People said I looked alert and I felt fine the entire time.

I know that if I’d been at only one birth I would have fallen apart. But attending three births, each with their own special atmosphere, flavour, challenge and fun, seems to be what made the difference.

Challenging and fun it was!

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Intuition, Trust and Red Flags

It’s funny how, over the years, I’ve only been given the births that I can handle. Each birth prepares me for the challenges of the next. What amazing gifts these women give to each other.

When I began my life as a doula, I was still breastfeeding my one-year-old son. I knew that I could only manage six hours away from him. For me - I couldn’t stand the breastmilk backlog! For him - hey, he needed me. For the first year, the births were amazing. I was never needed for more than six hours. I was only faced with long births once my son was able to go longer between feeds. Though I do remember pumping midway through long births for a few years...

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An Education in Care

If you want to get the inside scoop on birthing practices in BC, stand outside a kindergarten classroom just before the end of the school day. You’ll find a group of young mothers, with babes in arms, waiting to pick up their 5 year olds. They’ve been through the system - probably a few times - and are only too happy to share their hard won stories. Ask about their first birth experience, and you may hear stories of disillusionment, loss of dignity, overcrowding, or lack of continuity. They’ll tell you they wish they’d been better informed, and had known enough to find great caregivers.

Then there will probably be one woman in the group who shares her second birth experience, and shyly admits to feeling joy. “What a difference my second birth was!” she’ll say. “It was like night and day!” You might hear her talk about empowerment and laughter. What was the difference from her first birth, you ask? “Oh, I changed caregivers...and I hired a doula.”

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Full in the hand / Heavy with ripeness

For Maddox

To feel a baby's head for the first time
full in the hand
heavy with ripeness
is a sacred act

To feel the vernix slick
the fontanelles molded
the marble-hardness
the heat of it all

The sensation remains in my hands still
more than twelve hours later

Necessity made me reach down
to slow this baby's arrival
to make him come gently

I called for her to touch her baby next
and she did
but she should have been
the first
to feel her baby touch the air

a sacred first

I will guard this feeling

the baby's wisdom remaining
on my fingertips

“Full in the hand/heavy with ripeness” are two lines from a Marge Piercy poem. I have always loved these lines, and thought that they could also refer to a newborn at birth. But I had never fully experienced that connection until I held Maddox’s head in my hands. Until then... I was never moved enough to spill the remaining lines of my own onto the page. 

The Doula Solution

Here's an article from the Winter 2001 issue of
Western Living Magazine about my doula service:

When the contractions begin and even Dad starts screaming for drugs, a little backup is a good thing.

Six hours into labour, Dad's feeling like a third wheel at the bedside. He wants to help, but he's not sure how.

"What does it feel like?" he asks his wife.

"Sour!" she hisses.

Sour? He has no idea what that means.

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Effects of the full moon, waning sun, or NHL strike?

It’s been a wild month at hospitals in Canada. At BC Women’s Hospital alone, there were 1000 expected births, with 500 being the norm. You could attribute the increase to the effects of the moon or the sun, or you could put it down to the NHL strike. Who knows! But on Wednesday of this week, all hospitals west of Saskatoon were on diversion - that means NO BEDS ANYWHERE!

There I was, early Wednesday evening, at a client’s house. She was getting deep into her labour, so I had called her doctor just to give her a “heads-up.” She told me something I didn't want to hear.

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“Wow! If you had forceps last time, the next one will just FALL OUT!” (or, crazy predictions and expectations about second births)

I’ve attended so many second births recently, and I have 8 previous clients pregnant at the moment. So, I wanted to convey some of the joy and excitement of working with these second-time clients. I also wanted to talk about predictions and expectations surrounding second births.

So, today, for inspiration, I called a very special client whose little one is now about 18 months old. She picked up the phone and we both started grinning from ear to ear. “I’ve been thinking about you all this week!” she laughed. That’s the joy borne out of spending such an intense and sacred time together during her labour in 2004.

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On the necessity of overseas travel

You'll notice, if you've read enough of my blog, that we generally take off to Europe each year. Since I mainly work solo, I am on call 24/7 for most of the year.  Even when I'm not attending births, I'm doing prenatal and postpartum visits, tea visits, and fielding calls/text/emails from clients old and new.  Even if I have a week without births, I am still on call (I promise to be in town for each client's 38-42 week window), so I can't take off on an impromptu getaway. 

So, what's my solution? I book off a 6 week block, most summers, turn my iPhone to Airplane Mode, and hide overseas with my husband (and maybe some family). It's the perfect way to recharge my batteries. Most clients hold on to their questions until I return. Some clients do send me a few non-urgent emails, but they are content to wait a few days for a response. It's all about finding balance. I try to go totally off the grid, but as a solo doula, my work can't really stop 100%.  

So, where do we go?  Scotland, England, France, Italy, Spain are the main go-to's. Most of my family still lives in the north of England (Cheshire, Derbyshire, Manchester).  My husband's family come from the north of Scotland (Berneray and the Isle of Lewis in the Outer Hebrides, as well as Laggan in the Highlands.)  We love hiking, cycling, genealogy, history, windswept moors, searching for hidden castles and standing stones. We don't go to many different places on each trip - we take it slow.

This year, it was Scotland.  Within 48 hours of arriving home, two new babies had already arrived. They were waiting for me to come home!

One bonnie boy made a dramatic entrance. I had a phone call - "Something came out of me!"  She had just gone to the bathroom, her water had broken on the toilet, and one of her baby's legs had slipped out! So, after a fast ambulance ride (I arrived at her home in Ladner at the same time as the paramedics), her baby was safely born at BC Women's hospital. It was a spontaneous vaginal footling breech - with less than 2 hours of labour from start to finish.  She hadn't even known that her baby was breech. What a night!

Then another boy arrived less than 12 hours later - almost 9 pounds of him. Another speedy delivery. I think I can now change from Greenwich Mean Time to Pacific Time.

The August 2005 trip to Scotland was the best yet! My son's band won the Juvenile World Pipe Band Championship title, Best Drum Corps, and Best Bass. Our Alex, as lead drummer, went up before 40,000 people to accept the trophy for best drum corps. What an amazing day!

And the views of Stirling from the iron age fort on top of the Dumyat in the Ochil Hills, the sheep, the castles, the ferns and heather...they will be missed.  Until next time.

Spring 2009 - "Mommy, What did you do in the industrial revolution?"

Mommy, what did you do in the industrial revolution? Meditations on the rising cesarean rate.

Plante, L.A. Mommy, What Did You Do in the Industrial Revolution? Meditations on the Rising Cesarean Rate. The International Journal of Feminist Approaches to Bioethics. Spring 2009;2(1):140-147.

Lauren A. Plante, MD, MPH, FACOG
Department of Obstetrics & Gynecology
Thomas Jefferson University
Philadelphia PA
Email: Lauren@LaurenPlante.net

The cesarean rate in the US has been rising for decades, and in 2006 hit an all-time high of 31% (Hamilton, 2007.) This record is likely to stand for only a brief time, that is, until figures are released for 2007. Can it really be that one-third of women are unable to birth without high-level technological support? And is there an endpoint in sight? “In the next decade or so the industrial revolution in obstetrics could make Cesarean delivery consistently safer than the birth process that evolution gave us.” (Gawande, 2006, 8) Against such an argument, who could hope to stand?

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