Normal Birth?...part 1....

What is normal birth? I often ask this question. Often times a normal birth may include many things that are not "normal" but that happen. Here is an example...

She was a sweet first time Mama, her man was supportive and loving, her Mother was present and wonderful. She labored beautifully, was in the pool and started to push all on her own, instinctively and with strength. Soon the babe was crowning, and crowning, and crowning and crowning..my senses prickled up a bit...and crowning, then with one push the head emerged and quickly retreated back into the perineum. With speed, we moved her out of the pool to her hands and knees on the floor, babes head was still tightly squished up against the perineum...with some help and effort, one minute after first emerging, he was out! He was not fully with us, his cord was pulsing strongly but he was purple and not breathing. We stroked him and spoke to him, his Dad loved on him, eventually we had to use the ambu bag and give him some breaths. Immediately, he turned pink and began to cry...of course, the BEST sound in the world. We moved the new family to the bed, baby boy skin to skin on Mama with Dad curled up next to them and a radiant Grandma at the bedside. One of my favorite times of a birth...the afterglow. The nurse and I were busy trying to strike that balance between invisible and present. I was ever so gently holding the umbilical cord, feeling the pulse of life, when something felt off...there was a "loosening" feeling and a gush of bright red blood. However, for some reason I knew it was not the normal cord lengthening and placental separation gush. I immediately felt up the cord, into her vagina and felt a partial cord evulsion!! I grasped the cord and crimped it off, while asking the nurse to hand me a clamp. I clamped the cord and took a deep breath for myself. A few minutes later, her placenta emerged all intact, thick and healthy. Again the new family was the picture of beauty, baby was crawling on Mama finding his prize of the breast. Then a little while later, Mama started to bleed and pass clots and bleed and pass clots....with some vigorous massage, herbs and finally medications, the bleeding eased up. Finally, all were well and healthy, basking in that afterglow.

This birth was "normal", so what does normal mean? As a midwife, I must always guard the birth process; help to create and hold a space that is calm, centered and uninhibited. The vast majority of the time I am not needed...but in those times when I am, I REALLY am.

This birth made me think of two things: 1) unassisted birth and 2) birth trauma. I will follow up with my initial thoughts and my follow up with this lovely family, but what are your thoughts? How do you feel about unassisted birth? How does birth trauma happen and what can we do to lessen it?

And Tantrum Makes Three....

It was a good to have a baby...I had two lovely first time Mama's working on their little ones. The sun was shining, the flowers were out and the sky was sapphire blue. Day time births are less common and so seem somehow different and rare to me.....

Andrea's water had broken the day before, early in the morning. It was well over 24 hours later and her labor was flirting around the edges....not quite ready to take off, and Andrea was on the verge of losing her steam. She came in with her Mom, Susan, who was such a great support. Andrea's husband is in the military and is deployed overseas, which of course was difficult for her. We did an NST (non stress test) and her babe looked good. We decided to try and help her labor along. We sat down and had a good talk about how she was feeling, about letting go of wanting/missing her husband and letting her labor happen and I gave her an herbal tincture. Then I sent Andrea and her Mom out to get some lunch and to go for a nice walk.

Meanwhile, another Mama, Ellen was ready to come in with her husband. She was laboring beautifully, really letting her body go with the flow and opening up to it. Her husband was great and just followed her lead. It is so wonderful to see couples at this time, working well together and being present to see the love they share.

Andrea came back from her outing and had good news....she was able to call her husband and he was going to be able to be on the phone, on speaker, to be "with" her during the birth! It was great...somewhere from a ship, somewhere in the world...he was at least able to be present with us. Her labor was picking up a little bit, but still not too strong. We decided to try the breast pump and after a "round" of that.....she kicked into serious gear. After an hour of serious, consistent contractions I checked her cervix for the very first time since her water breaking and she was 4cm....great news! She got in the pool and we all settled in for the work. She talked to her husband a lot and despite the distance the love was so palpable in the room. Literally, 30 minutes later, Andrea said she had to push! A quick cervical check...she was C/+1 and after 24 minutes of beautiful, instinctual pushing a beautiful baby girl was welcomed to the world.

Not long after that birth, Ellen was ready to welcome her sweet babe. Ellen was complete...but not ready to push...instead she paced and paced, unable to relax. She did not like the sensations and seemed to try and run away from them. She was fidgety and had a lot of trouble getting into the work of pushing. I have seen other ladies do this and eventually they stop "running" away and get into it. Just over an hour later, Ellen was getting frustrated....her energy was spilling over and she was busy trying to contain it. I felt that she needed to have a "melt down", let the energy go and move forward....and then it happened. Ellen threw a temper tantrum; seriously stomping around the room, crossing her arms, pouting her lips and kicking things!...in true three year old style!! She was saying things like wanting to the hospital, this "sucks", whose dumb idea was this, etc. I was actually happy and trying not to laugh, this needed to happen...and after she calmed down, Ellen sat on the birth stool and gracefully with strength pushed out her gorgeous baby girl.

Every birth is a gift and teaches me new things. These births were very different but had one thing in common: a true and genuine love between a man and a woman, that was supportive and strong. One was witnessed in person and the other was felt from a distance but both were amazing.

Midwives are a Strange Breed

Through the years, I have met many midwives. Though we are all unique individuals for sure, we do seem to share some commonalities. We are empathetic, intelligent, kind, sincere, independent, clear headed...and maybe a little "twisted" ;)

I recently had a conversation with one Mama that included suggestions on natural personal lubricants for sex and positions to try, how to entertain a three year old when nursing the one month old, the best organic diaper creams and the importance of nutrition.

Also, I have noted many statements that midwives routinely say that are pretty twisted:

"You're having a lot more pain? That is good news."
"You're leaking bloody mucous from your vagina? How wonderful!"
"You just threw up all over the bedroom? Good progress."
"You feel like you just sat on a campfire? Yes, it does feel like that, and great work."

Other things that midwives might "enjoy".....

Sitting in a dark room, behind a naked sweaty woman who is on all fours and realizing that she is pooping on your hand. Being drenched, and I mean drenched, in amniotic fluid as you kneel on the floor in front of a woman on a stool. Using a fish net to fish many things other than fish out of a pool. Driving home after a long night at work, looking in the rear view mirror and realizing that you have meconium on your face.....

So, you see, midwives are definitely a certain breed...and potentially a strange one at that! And I wouldn't have it any other way!!

The lovely Placenta...

I really do love keeping this blog, and have found it enlightening. However, I crave to hear the thoughts of those who bless me with their time to read it...so I have decided to periodically post some questions or topics to discuss. Let's start a place where we can share our experiences and thoughts!

So, I am and have always been fascinated by the placenta. It is such an interesting and important creation. Many cultures have very specific rituals and beliefs centered around the placenta. I would love to start a discussion about placenta's...please, post any thoughts, practices, beliefs that you have seen or heard about this amazing organ....is placenta encapsulation popular where you are?....

Here is a thought to start off the talk....Placentas may be the only "meat" that is vegetarian, as no animal is killed in their production!....

When Interventions Are a Good Thing

I firmly believe that each woman should be treated as an individual and that the concept of blanket interventions for all is ridiculous. Birth is a natural process and if we trust it, it will most often work for itself. Most of the time, my job is to be present and provide support...not to manage...but sometimes that is what I need to do....




Erika was working on her first baby. She had been in labor for hours, when early in the morning she started having a LOT of vomiting. After a few hours of this, she and her husband and mom came to the center....she was so exhausted physically, yet so strong in spirit. They had been working on keeping Erika hydrated, but with the amount of vomiting, this was nearly impossible. I started an IV and gave her some fluids...what a difference and she actually took a little nap, which was perfect. Then, she had more vomiting, followed by some more. At this point, she was still strong in spirit, however, her physical self was starting to struggle. I wrote her a prescription for Zofran, an anti-emetic, and her husband went to go pick it up. We also did some herbs and Rescue Remedy, but that Zofran sure hit the spot. Erika was able to "catch her breath" and go on to have a great natural birth, surrounded by love and support, on the birth stool and welcome her 7lb little girl.




This is an example of when certain "medical" interventions can really make the difference and allow a woman to carry on and move forward. Do I think all ladies need an IV or IV access? No. But, do I think we should have these options when needed? The intervention itself is not the problem, it is the over use of the intervention that creates the problem.

Love and Bubbles

I just have to say, that I love siblings at births! In my experience it is such a great way for the older child/children to feel that they are also part of this process...and there is nothing like the look on their sweet faces when they see the new little brother or sister for the first time....

I was recently with a family having their second child, their first is six years old and so smart and fun...Sam. Sam was amazing at his little sisters' birth. While his Mama was in the pool pushing, he diligently gave her sips of water between contractions, and took this job very seriously. Additionally, he would be sure to blow bubbles when she was having her contractions, it was great to welcome little babe to a room full of love and bubbles! Afterwards, he wanted to keep helping, so we employed him as our helper and he drained the birth pool with us. These births are so wonderful and such a family affair...as it should be. I wish that all women and their families could be blessed with this respect and openness for their births.....

Midwifing the Midwife

This calling is truly a blessing...to be included in and welcomed to such an intimate and special time for families is a gift. Seeing these women transform to mothers in those precious first moments and watching the awe in the faces of thier partners...these are times to be cherished. However, that is not always how it works out, despite all the best preperations and intentions. These are times when this calling can and will break your heart. The highest highs and the absolute lowest lows...these are wrapped up together in this calling...and we as the guardians of birth must be able to guide families through it all. We must also be able to nurture ourselves through these times and hold fast to our faith in the birth process....so, a question...who midwifes the midwife?