Friday, January 30, 2015

Welcome After 20 years of educating pregnant couples in San Luis Obispo County and supporting over 100 women in labor I decided I wanted to connect with women in a new way to share the wisdom I had gleaned; my new baby, a doula blog, was born. It is dedicated to all the women who have come before; a gift from them to you. Please use it to help create the birth you want. Read, enjoy, empower yourself! 

I Believe

Loving Guidance Mama Mentoring

Pregnancy, birth and early parenting are a very special season in the cycle of your life. I believe every woman deserves to be treasured during this transformational process. True care and nurturing for the entire family throughout their journey empowers them and creates deeper bonds. An educational foundation rooted in the natural abilities of women to birth their babies instills confidence and is a critical component of empowerment. My classes prepare the heart, mind and body for the journey ahead. Through the birth of my son I came to understand the critical role a doula plays in helping couples achieve a harmonious and uplifting birth experience. A doula is a vital member of your team no matter where you birth or who you choose as a care provider. As an experienced guide providing one-on-one continuous care throughout your birth I allow everyone to relax and be fully present in their roles. As a communication facilitator I help insure your voice is heard and respected, as well as, translating medical information and options; providing you the opportunity to make your own choices. I have been helping birthing women here on the beautiful Central Coast of San Luis Obispo county since 1992 and am passionate about protecting and preparing women during this most vulnerable time. Please use the words I have written in this blog to learn more about my beliefs surrounding birth.

Certified Intuitive Birth Doula
Certified Intuitive Postpartum Doula
La Leche League Leader
CranioSacral Student

Wednesday, January 28, 2015

A Spectrum of Pregnancy, Birth & Parenting Services to Meet Your Needs

After working with San Luis Obispo families for over 20 years I am more strongly committed than ever to helping families find what feels right to them for pregnancy, birth and parenting. I have a broad perspective and a depth of knowledge which is grounded in the work I have done with families making a wide variety of choices. As a doula I have been blessed to be part of over 100 births. Working beside doctors and midwives I have witnessed inspiring births both in and out of the hospital. As a birth educator I have impacted the births of several hundred babies and through my work with the Birth & Baby Resource Network, La Leche League, and the International Cesarean Awareness Network I have touched the lives of countless families in our community and beyond.

I offer a variety of support/education options to match your unique needs. Our journey together may start at any point along the spectrum. Please feel free to mix and match and make the exact support and education package that meets your needs. All classes are offered both as group or private experiences with flexible schedules.

Before You are Pregnant

Private consultations over tea: learn about options & resources in our community or review and process a past birth and discuss possible effects on future births. We can meet in the privacy of your home or at a coffee shop.                              

Early in Your Pregnancy

Classes: learn how to nurture your body, your baby and your relationships in my Healthy Beginnings/Healthy Choices classes.

Preparing for Your Birth

Classes: My small group classes held, in the privacy of a home, foster a sense of belonging as we eat, laugh, learn and share together this amazing adventure. My Heart, Mind & Body series empowers and inspires you to create the birth you want.

For each class group I create a private on-line community for extended sharing of ideas, inspiration, connection and support which continues until your baby is sleeping blissfully in your arms.
Labor Land Practice: My Birth Connection Date Nights are serene spaces where all learning is experiential through relaxation, guided imagery and touch. The focus is encouraging oxytocin, the “love hormone”, to flow between you, your partner and your baby, and to teach you how to move through labor land together. These “practice” sessions are ideal for experienced birthers, homebirthers, or as an expansion of more intellectual birth classes.

Private Classes in Your Home: Every family has different needs; bed resting moms, changing schedules, or simply a desire for privacy. I try to be as flexible as possible to let you create your unique education package. Let my Class Outline be your guide. I am happy to create a series just for you!

Doula Service: I am happy to join your birth team no matter where you are planning to birth; home, birth center or hospital. We start building a trust relationship with prenatal visits in your home. Through listening I learn what you need and want to feel confident about your coming birth. I facilitate thinking and dialogue between partners to help clarify and prioritize what is important to them and help craft a birth plan which reflects these values while being well received by your care provider and staff.

I am available via phone, email or Facebook to answer questions and lend support throughout the pregnancy.

                    Once labor begins. . .

 I will stay continuously by your side
 where ever you are laboring until. . .
your baby has arrived. . .

and is blissfully breastfeeding for the first time!

I will visit your home a few days after your birth to ensure breastfeeding is going well, check on your postpartum recovery, and help you process your experience with tears, talking and laughter. I will answer questions, clarify and enlighten you on issues you may not have understood. I want you to have a thorough grasp of what happened, why, and how necessary it was, to empower you for future births.
After Your Birth

Private consultations over tea: When women suffer after a difficult birth experience it is very helpful to share your story to a listening heart who is knowledgeable enough to review your birth, answer your questions, and help you move forward in your process. I can connect you to resources for your recovery and discuss things you will need to think about for future births.

Private Postpartum Visits: I believe new mamas need to rest and adjust to motherhood in the comfort of their home. I am happy to travel to you. The first days and weeks of parenthood many new families need some additional guidance. A little hands-on help from an experienced mother/doula can give a new mama just the boost of confidence she needs.

Welcome to the parenting community!

Classes: My Becoming a Family monthly support and learning group is the only new parents’ class for couples. Meeting on a Sunday afternoon allows dads to participate and become more confident in their role, as you learn and share together. Designed to cover areas of concern from birth to 18 months.

Support Group: I lead a La Leche League Mothers’ Meeting once a month in the South County which is free and open to all mothers for breastfeeding advice and support.


Loving Guidance Workshops: These periodic workshops cover my Five Steps to Creating a Healthy, Happy, Whole Family empowering parents to move through the normal ups and downs of parenthood, take control of their own learning, and make their own decisions on how they wish to parent.

Support Group: I created “Whole”istic Mamas and Papas to provide community for families choosing to parent from an alternative point of view; attachment parenting, co-sleeping, extended nursing, baby wearing, individual vaccination choices, homeschooling, etc. It is a safe space; both in our face-to-face play day meet ups and private on-line group for asking questions, gathering information, sharing and learning from each other.

Parenting is much more fun when we share and play with others!

Let's connect! I am happy to answer questions and get you started on just the right path for you.            Call: 473-3746

Wednesday, January 14, 2015

Looking Deeper into a Negative Birth Story

This blog piece is in direct response to the recent piece in the Huffington Post, “My True Feelings Regarding My Home Birth Experience” by Ashley Martin. Please take the time to read her birth story before you read my response.

This is a sad story. As a doula I have listened to many sad birth stories over the years. Sad stories from home births. Sad stories from hospital births. Unfortunately negative births happen all too often although the vast majority of births in the U.S. have positive outcomes; healthy moms and healthy babies. When I hear a disturbing story I have learned to pause and think. To put it in context with all the birth stories I have heard and all the births I have witnessed. I have learned to dig deeper while at the same time to not judge either the mother, place or care providers. It is important to remember that this is HER story. Her perception of home birth based on her two experiences of home birth. I wish her title had been, "What MY Home Birth Was Like". This birth lives large in her mind and heart; although she had previously birthed at home and I can only assume it went well because she chose to birth this baby at home as well. The trauma of this second home birth has indelibly imprinted its personal message in her psyche. If we were to hear her midwife's or doula’s perception it might be vastly different.

When birth turns high risk it instantly becomes traumatic for mom and dad no matter where it takes place. No matter how blissful the labor. No matter how much they trust those around them or themselves or a higher power. Naturally parents are extremely grateful to the person or people who they perceive as "saving" their baby. I put saving in quotes because I paused and put this birth into context. I used this mom's words about the actual timeline to direct my thinking. I thought about the births I have attended in hospitals that suddenly took a turn into trauma. I thought about what I know about neonatal resuscitation and procedures and time lines.

It is very difficult for parents when they feel let down by ANYONE at their birth. It is even more devastating when it happens in the middle of a high risk situation. When one group of care providers points fingers and lays blame at another during the process, rather than working as a seamless safety net for mom and baby, then things really begin to unravel emotionally for parents. Through this mother’s words I can hear the echoes of the hospital staff blaming the care she was provided, although they were not their to witness it, before she entered their doors. I have walked the halls of our San Luis Obispo hospitals. I have heard these words of blame and yet I only hear words of support for all involved echoing down the hospital halls when one of their births suddenly turns into a dangerous mess. Even when a baby dies. Our culture is always looking for “the other”, the one who is different. The one we can safely blame because they are not like us.

When we add the fact that our culture insists on a perfect baby every time in every birth place AND a perfect experience, AND someone must be to blame when that doesn't happen it often surprises me that anyone is willing to help birthing women at all. When things go bad the people providing care have put their lives, their livelihoods and their families in the line of fire. This has happened in our community. It has happened to both midwives and doctors. Good people providing good care as best they could.

Now we need to look more deeply into this mother’s birth. Here are the facts she presented. She had a very rare presentation. We are not told when during the birth process this was discovered or what steps or actions were done based on this information. It may have been missed until the baby was close to crowning, especially if her pushing phase was rapid or she hired a midwife who believed in a hands out of vagina birth. It is easy to immediately jump to the conclusion that if it was missed it must mean that her midwife was not qualified or was somehow negligent. But consider that I have been at 2 different breech situations where, despite numerous vaginal checks by doctors, midwives and nurses, no one realized that the babies were breech during labor until mom was fully dilated. If they had come rapidly after reaching 10 centimeters we would have had accidental vaginal breech births. Breeches happen much more often than brow presentations so presumably all of these providers had had the opportunity to feel what a breech feels like; whereas very few providers have ever felt a brow presentation.

Her second difficulty was the shoulder dystocia. Now I know from my son's birth that shoulder dystocia is scary even in the hospital. Everyone in the room goes on high alert. I have seen this dealt with quickly, smoothly and successfully both at home and in the hospital. Actually as scary as it was for her it appears since her baby is fine that it was dealt with successfully at her birth too. She mentions receiving fundal pressure to help get her baby out. I too received fundal pressure. Is fundal pressure risky for mom? You betcha. I learned this long after my birth. Have I seen doctors and midwives deal with shoulder dystocia successfully with no further complications for mom and baby? Plenty! Can shoulder dystocia go horribly wrong? Yes. I know of 2 cases in our county where it went horribly wrong. One at a home birth with a qualified midwife and one in a hospital with an extremely qualified and well respected doctor. She says her baby was stuck for 9 minutes. I assume she means head out body trapped inside behind the shoulder trapped behind her pubic bone. What steps can one take at this point in a birth anywhere. You can move mom into different positions. You can reach inside and try to free the trapped shoulder or turn baby into a new position. You can push back on the shoulder to break the clavicle. Were these tried? We don't know. What we do know is you can not get a cesarean in under 9 minutes in a labor bed.

Then she says 911 was called at 1 minute after birth. That is a very quick response from a midwife and right in line with MOST hospitals. Currently our local hospitals have baby respiratory specialists standing by at all births. Don't let this fool you. This has only been the case in our community in the last few years. Before that, like many hospitals around the country, labor nurses would have been taking care of this baby until a specialist could be called in. Normally at a birth, home or hospital, babies are given help if breathing is difficult or heart rate is low. As the baby is worked on it is constantly assessed every 30 seconds to see if it is responding to the intervention. If not, a swift decision is made to continue and/or go the next step. This midwife knew in 1 minute that this baby needed more help than they could offer at home and the call was made. She did the RIGHT thing and called an ambulance to transport. The ambulance arrived, assessed and transferred baby into the ambulance by 6 minutes! Not sure how that is possible but bravo! I have seen respiratory specialist teams struggle much, much longer at the hospital bedside before transferring into the Neonatal Intensive Care Unit.

What happened during the first minute? Was the baby dried and stimulated? This is the first step taken with any baby in trouble. Yes I can see by the photos this was done immediately. I see the assistant about to put the baby stethoscope on and listen to the heart rate. The mother tells us the assistant was warned to listen carefully and be sure of her assessment. Was this baby suctioned? Did they use only a bulb syringe or the DeLee which the hospital would have used? This mom doesn't say. Was the baby given oxygen? Yes. I know this from the photos. I can also see the baby has the slightest bit of pinking up beginning to show which indicates that his system is trying to circulate blood and that blood is oxygenated. They are also in the process of cutting the cord. This might be done if they are about to start CPR and therefore need to move the baby to a firm surface. Did the baby require CPR? Did the baby respond to CPR? The mother doesn’t tell us. Perhaps because she was in too much shock to take it in. She also doesn't tell us how long she pushed or what the baby's heart rate was during labor; especially pushing. Without all of this important information I have no way to assess the quality of the care provided by her midwife or if anything would have been different about her birth if it had taken place in a hospital. This may be an excellent midwife taking exactly the same steps they would have taken at the hospital in the same order and with the same rapidity.

We also don’t know what “life-saving” steps were taken by the traditional medical staff. Did the EMT need to do infant CPR when they arrived? How did the baby respond? What was the baby's condition when it arrived at the hospital? Did they need to intubate this baby so it could breathe? Perhaps, but there is no sign of that in the photos. The baby appears to have a line of fluids going in indicating medication of some type. Could this simply be the antibiotics so often given to home birth transport babies because of the perceived bias of a “dirty” home environment? Perhaps. Perhaps not.

She also feels that she almost died during this process. Women can die during birth. It happens due to hemorrhage. When a woman hemorrhages there is blood. There is LOTS of blood everywhere. This mom mentions no blood. Remember her description of the bathroom floor? She talks about baby poop being everywhere but not blood. Could she have bled too much? Perhaps. I have been with moms who have bled too much. Most of them were in the hospital. They received the same medication and physical manipulation a mom would receive at a home birth. As a birth assistant at a home birth I have held the medication drawn up in a syringe ready to go as the midwife monitored the bleeding and made a careful assessment about how much blood the mom was losing. Did this mom need medication and receive it? Did she need it and not receive it? We don't know. There is so much about this birth that we don't know. Making ANY decisions about the quality of care she received or the safety or risk of home birth is impossible based on the facts she has given us, no matter how compelling her story is. No matter how much it tugs at our hearts or shocks us.

This woman's perception of her son's birth IS important to me. It makes my heart ache but it doesn't cause me to believe more or less in place of birth. It DOES get me thinking more about what a woman needs to feel positively about her experience. The importance of having quality communication before, during and after a birth is very important. When a birth becomes traumatic or suddenly high risk this is a critical component that often gets lost. This is where I know this mother was let down. No woman should feel she was not listened to during her birth or have to "fight" to get her records. No woman should ever feel the need to make the statement, "I was misled, lied too, and manipulated. Informed consent? Hah. I wish. I left my birth feeling broken, beaten down, cheated." Unfortunately I have seen this too often with too many care providers in too many places. It is their fear response. They go on the defensive because they fear for themselves and their families.

To help a mother heal from trauma it is critical to keep blame, of the mother or any of the people who helped her, out of the conversation. Listening to her truth. Helping her sort through and understand the facts. Helping her go beyond her fear and shock and pain. This is important. Unfortunately rather than seeing this birth as unfolding just as it should; a hard labor followed by swift action to turn around a potentially bad situation by her midwife, the EMTs, the doctors and nurses, with a healthy mom and baby in the end, she is stuck in the negative feelings of guilt, blame and shame.

I do not know Ashley Martin. I do not know her midwife. I do not know what happened at her birth. I do know how she feels about it. I also know my own birth experience which took place in a hospital and included a posterior labor and a long pushing phase and a scary shoulder dystocia and in the end a happy healthy mom and baby. It took me 20 years and witnessing 100 births to stop blaming myself and/or my midwife. I can now confidently say we both did everything we could and my birth unfolded just as it should and I am grateful to my midwife and proud of my strength. I can finally claim the words "birth warrior" for myself.

I do believe many women are told, or choose to only hear, the roses and fantasy of fairy tale
birth. Let’s get real ladies. Birth isn't all orgasms and euphoria. Birth may have that, but birth is life and life is messy and risky and that is why it is miraculous. It is time we embraced the miraculous.

For another perspective and some of the missing puzzle pieces of this birth please check out the birth photographer's account. Remember we are not sitting in judgement. We are NOT trying to decide whose account is the "truth". For this mom, in despair over her birth, her truth is ALL that matters to her. I would caution anyone who would judge all of home birth through the lens of this one birth.

Thursday, October 16, 2014

Why Chiropractic Care for the Whole Family?

Many years ago I met Leslie Kasanoff, mother and chiropractor, when she was planning the homebirth of her second child. Since that time I have grown to understand she is a fierce wellness advocate on many different fronts. As a chiropractor Dr. Leslie practices low force or non-force techniques which work gently with your nervous system to help restore structure & function. Through analyzing the nervous system, she can detect where your body is willing to allow change & work with these areas to allow the unwinding of other problem areas. Allowing her to use 'brains instead of brawn'. No pops or cracks needed! Good thing cause she isn't any bigger than I am. Here is what she writes about why chiro care is a cornerstone of wellness.

"So what is chiropractic & how might it help you & your family? The basic tenants of chiropractic have little to do with back pain. Chiropractic theory states (and modern medicine has proven) that misalignments in the spine (subluxation) can put stress on delicate spinal nerves & cause them to misfire. Indeed science has shown us that as little as 10mm of mercury pressure- about the pressure caused by weight of a dime- can cause misfiring of nerve impulses in the spine. If you think realistically about this, you realize you could likely have several areas like this in your own spine right now and be totally unaware of it. Further, all the nerves in your entire body ultimately connect to nerves that enter & exit the spinal cord so when you think about it, every function in your body, from your heart beat to your hormone function to your immune system & more depends on the messages of nerves running into & out of your spine. AND you have NO way of knowing if all these messages are getting through unimpeded or not. The chiropractor’s job is to make sure they Are. 
Well, this all sounds like it makes good sense, you may be thinking; but what is the practical aspect of this? What can I expect chiropractic care to have an effect on? While we can’t say with 100% certainty that chiropractic will have an effect on any particular problem, I can say that in my 25 years experience, the care I’ve provided has had a positive effect on problems as varied as ADHD, colic, asthma, allergies, back pain, headaches, fibromyalgia and more. I can also say that pregnant woman under chiropractic care have easier deliveries & recoveries and that difficulty nursing can often be traced to a baby being less able to latch on to one breast due to spinal subluxation in the neck. The bottom line is that every function in your body will happen better when it is unimpeded."

Most of us don't know the history of chiropractic care and why Americans are so conflicted about utilizing this basic form of health care. This unease keeps them from attaining real health. Dr. Leslie gives us a history lesson and gets to the roots of this distrust.

"As a chiropractor who has practiced for almost 25 years, I continue to be surprised (and a little disappointed) that more people don’t recognize the positive role that Chiropractic care can play in their children’s and in their own lives. Today, I hope to help you understand the value a little better.
Thanks to the medical establishment, most people think of chiropractic in terms of a quick fix for lower back or neck pain. While chiropractic may help with these issues, this represents a very limited view of an art & science that has really been around for thousands of years.
Hippocrates is quoted as having said “in case of disease look first to the spine.” Throughout history there have been practitioners who were the ancient equivalent of the modern-day chiropractor.  In fact, the results chiropractors got during the great flu pandemic of 1917 were one of the major factors that lead to the California Chiropractic Initiative of 1922, recognizing that we are separate & distinct from medicine. But like many other ancient forms of healing, chiropractic fell out of favor with the advent of drugs, surgery and the symptomatic approaches established by modern medicine. While most people are at least aware that chiropractic care exists, herbal medicine, homeopathy & many other forms of care have been so vilified by modern medicine that many people equate them with witchcraft, quackery and worse. The real truth is that most of that is propaganda and organized medicine did, among other things, promote leeches and blood letting well past the 1900’s. It was only their steadfast organization, pressure, propaganda & boycotting of anything non-medical that lead to the decreased popularity of these forms of care. Ultimately, chiropractic is the only non-allopathic healing science that survived this assault (until the recent resurgence of others). In fact, in 1985, the AMA and several other organizations were found guilty of collusion and anti-trust for trying to systematically destroy chiropractic as a profession in the United States.
I bring this up because to this day, people have negative views of chiropractic but have no idea where those views came from. I like to say its like the wallpaper of the way we grew up; so intimately connected with the American view on health, we don’t even see it." 

Recently Leslie joined the staff of Community Health Centers in SLO. She is happy to be able to provide care to many patients who have been unable to obtain it in the past because they have had no insurance coverage. If you have CenCal, Medi-Cal or Medicare, you are allowed chiropractic care and do not need a medical referral. Unfortunately, most chiropractors cannot afford to see these patients (or see them & charge them a discounted cash fee) due to the low reimbursement rate. At CHC, they are a majority of the patients they see. 

So if any of this makes sense to you, Dr. Kasanoff would be pleased and honored to see you and your family. Simply call the Bishop St office at 805-269-0793 or the Casa St office at 805-269-1500 & ask for a chiropractic appointment with Dr. Kasanoff. 

Thanks Dr. Leslie for 25 years of helping families find better health!

Saturday, October 11, 2014

Laboring in a Secret Garden

I never know when I leave my home to join a laboring couple where the journey will take me. Sometimes finding just the right place to labor can be challenging. Driving away from Linda's house I knew from her history she wouldn't feel confident laboring in the hospital. It was also clear to me that as a second time mother her labor could change from 0 to 100 pretty darn fast and being in Arroyo Grande was no longer an option. So where to go on a hot summer day? As luck would have it Dad found us a secret garden, ideal for laboring with the breeze in our hair and the sun on our faces. 

Every birth I witness is indelibly etched into my soul. Some are long and hard; others fast and furious. They are all intense but sometimes within the intensity is a peacefulness; a serenity of love and trust that rises above the physical experience.

Thursday, June 19, 2014

My Heroes

I'm sure you have heard it said that every birth is unique, each its own story. But no one talks about how deeply that story is written into women. Each woman's birth story is carried in their bones and sinews. It has put its stamp on their bodies and breasts and the very energy contained within their cells. This is how they know "birth" to be.

I have been very lucky in my life to able to attend women in birth. I am constantly in awe of womanhood, its power and its grace. Every birth IS a story. I have so many stories jammed in my head and packed into my heart. Some are private stories only shared with a sacred circle. Others are meant to be shared with the world. Some demand to be shared. So it was with my preemie twin vaginal birth. Now I want to speak about cesareans. Next post I'll share a recent positive cesarean birth story.

For many years I struggled with each cesarean birth my clients had. I took it as a personal failure. If I had just been a better doula this wouldn't have happened. I could have, should have, rescued her. Over time I grew to understand that these stories weren't my stories to write. They belonged to the birthing woman. They were her story. I tried to let go of my arrogance in thinking I held the power and turned it back to the mothers. I am there to help a mother find her own path. Success or failure is in her hands not mine. This attitude helped me, but did it help them?

Recently I have begun to question and be more critical of the whole idea of cesareans as being failures. I have never been with a mother who just gave up. Every one struggled mightily; pushed themselves to the edge of their personal precipice and beyond. How can that be labeled a failure? Who is to blame for this stigma?

The ugly truth is the blame lands squarely at the feet of the natural birth movement. A movement which is near and dear to my heart. A movement which sprang up in direct response to the over medicalization of birth. A movement which wanted to give women back their power; their belief in their bodies.We wanted women to be in awe of their own strength and abilities. A movement I signed on to many years ago. It gave me strength to do my work and replenished me when I was tired, weak, or hopeless. A movement which has branded the heart of every woman with a big fat F who began labor with the intention of birthing vaginally and ended up in the operating room . You failed at the very essence of womanhood. Enough.

I want all the mothers who have courageously fought to win that medal of female honor, only to see it fade from their grasp, to know they are heroes. They are the walking wounded who gave it all in battle for their comrades; their partner and child. Many suffer with post traumatic stress disorder. Some face on-going health issues. All of them have had their bodies invaded by friendly fire and have the scars and internal adhesions to prove it. Why do we treat them as shoddily as the returning Vietnam Vets? If you are for the war, people who believe in the medical model, you are numb to their tremendous sacrifice. If you are an anti-war protester, pro-natural birther like me, you actually have the unbelievable gall to question their loyalty to the cause. Enough!

Isn't it enough that she stayed the course for 9 hours at 8 centimeters without ANY pain medication? What about the fact that the last 4 hours were with pitocin to make her contractions even harder? What if you knew she was in active labor for 26 hours with back pain from a posterior baby? Enough?

Isn't it enough to join the club of "successful" birth if you labored with no medication and then pushed with ALL your strength for 3 hours at home AND THEN had to face your fears of transferring to the lion's den? Your midwife, your doula, your husband, your mother, didn't they all do everything they could? Why isn't that enough?

What about the mothers who train for the war but never get to feel their mettle tested? Herpes outbreaks, breech babies, high blood pressure, intrauterine growth retardation, or their baby's size can have them falling on their sword and relinquishing their bodies to be invaded for the sake of their children before a single shot has been fired. Their birth dreams laid waste upon the surgical table as the fog of war descends upon them.

What about this mom so great fully full of life? First she was told she would have to have a cesarean because her baby was breech. Then she went through an external version to turn her baby, only to have her water break with no labor. She did everything she could to make labor start. She and her husband held off the medical staff for hours and hours and finally, with time running out, submitted to one of her biggest fears; pitocin. After many hours on pitocin her baby's heart rate climbed. Could this be from infection? No mother wants to risk her baby. So she said yes to her deepest fear; a surgical birth and was wheeled off to the operating room. Surely she did enough. Would you have had her say no? She allowed them to cut her body open for the sake of her son. Isn't that enough?

                                             It should be enough.

Welcome home to ALL the mothers who began their births with the bright shiny intention of a natural un-medicated vaginal birth. As you marched off to do battle, you hoped against hope you would come home whole. You raised the banner of natural birth high above you. You held tight to your talismans of homebirth, nurse midwives and doulas believing they could bring you home safe from the war. You counted on your training from Bradley, Hypnobirth, or yoga to sustain you in the trenches. Bravo to those of you who made it through; war weary, battle hardened and whole. But let us not forget the walking wounded that sacrificed it all. Our highest motherhood medal of honor should be reserved for them for their bravery and selflessness. My heroes.

Welcome Home

Ruth M.      Miriam M.       Rebecca P.       Megan B.       Larissa H.

Yselle L.      Kelly B.          Kristina G.        Suraya S.       Wendy M.

Fara H.      Rochelle W.       Shelly F.          Sarah M.R.         Shannon L.

Katelen F.    Anna R.           Jenna M.          Star A.           Colby L.

Janet M.        Eva N.         Gwendolyn S.     Amy E.         Kambria D.

Stacie S.     Jennifer W.        Bridget B.       Georgie W.       Amy O.

DeAna C.     Amy H.           Jennifer K.         Traci C.        Heather S.

        Kat K.        Michelle L.        Tomi M.            Cindy L.          Linda S.       
   Patti D.         Steph W.        Sarah R.          Kendra W.       Lisa N.
Sabrina S.       Anna T.       Glo       Stephanie A.       Annie R.

Kathryn D.       Sara M.  

Do you have a hero that belongs on my memorial wall?

After 20 years of listening to mothers and witnessing births;
I have more names than I can remember.
Each is an important story.

If you or a loved one or friend belong on my wall please let me know and I will include them.

Thank you to the mothers who allowed me to use their stories and photos.

Next post will be a mother facing down her fears 
with a planned cesarean birth!

Friday, June 6, 2014

What's a Mother to Do?

Normally I take photos at births and write notes throughout the process. I think it is important to chronicle this important family event. I give them to my families and hope that they will treasure them forever. After two back-to-back high risk preemie births I felt these special stories needed to be shared. I had never experienced any births quite like these before. I learned an incredible amount and my hope in posting these stories is to educate future parents. Hopefully it will take some of the fear out of an incredibly fearful situation. 

Yesterday Ada Rose came into this world.
All 1 pound 10 ounces of feisty little girl.
Thank you to Ada's parents for allowing me to share a part of their birth story. 

When babies come unexpectedly in the middle of pregnancy it is quite challenging for everyone involved. Suddenly needing to have a surgery to save your little one's life is scary as hell. Being separated from your new child fills a mother with fear and grief in every fiber of her being. Not being able to put her baby to her breast is an additional sorrow. Keeping it together under these conditions is heroic.

So what's a mother to do? Like every other mother she is going to do the best she can for her baby at that moment on that day. In this situation nothing helps a mother more than getting her colostrum to her baby. And of course the colostrum is VERY helpful to the baby. The colostrum of the mother who just gave birth to a premature baby is designed specifically for them. It has a special balance of nutrients to help their brains and bodies continue to grow outside the womb.

Getting the colostrum out of mom and into a teeny weeny baby who can't suck, swallow and breath yet is quite a trick. So what's a mother to do? Pump! Ada's mama was pumping by the time Ada was 2 hours old. The nurse at Sierra Vista tracked down a hospital grade pump. She brought it to mom's bedside and showed her all about it. I talked to her about tricks to help her let down her breastmilk to a pump.  We had just gotten started when dad got the word he could come be with their daughter in the NICU. I told dad to take photos and send them to mom. 

Poor mom looked devastated after he left the room. Of course she wanted him to go be with Ada. Of course she wanted him to not to leave her yet. After all she just went through major abdominal surgery; a really scary experience. Of course she felt it was totally wrong for him to be the first to touch and see her. Of course she felt horribly guilty for all of these conflicting thoughts. So what's a mother to do? Pump out way more colostrum than anyone expected!

Many mothers of preemies are able to only produce a few drops the first day or so. Vickie, the lactation consultant who came in said, "every flood begins with just a few drops. Don't worry how much you get. Just keep at it and your body will eventually respond." Wise words from a woman who works with breastfeeding moms every day.

While mom was pumping dad sent photos and a video back to the room of precious baby Ada. The photos were hard for mom to see; all the tubes and wires. Seeing her wiggle in protest weighed heavy on a mom's heart. I pointed out her perfection. That her color being so pink was a good sign. It meant she could get the oxygen they were giving her into her lungs, into her blood and circulate it through her body. How much better that she was trying to push them away than lying there limp. What a strong little girl she created. 

So what's a mom to do? Why pump out 3 whole milliliters of colostrum. That's what! It wouldn't all fit into the teeny weeny syringe the nurse had brought. They had to go get a larger one. The nurse exclaimed. The lactation consultant exclaimed. The NICU nurse exclaimed. They said, "Why that's about a week's worth of food for such a tiny little person." Yippee!

Mom sent the milk down the hall to her baby. They carefully put some on a swab and ran it around inside her mouth. Now mom's immune system is protecting her baby even though they are apart. Her colostrum is stuffed full of antibodies which can help give her the best chance on life. Right now she is too young to be able to suck, swallow and digest breastmilk. That day is coming though. It is just around the corner. Not to worry, mom will be ready. At 24 hours from birth she pumped out this much liquid gold. Priceless!
so the flood begins...
Every day in the nicu is a scary, hopeful, exhausting roller coaster ride for a family. Neonatal Intensive Care Units across the country are filled with babies and families every day. Please take a moment to hold them in your heart.

Read Eleanor and Caroline's premature twins story

Thursday, June 5, 2014

When Home Birth Intentions Meets High Risk Birth

Thank you to Amanda and Jose for allowing me to share their story. 
Amanda hopes it will help other parents.

My third set of vaginal twins has a unique story. Like many of my clients Amanda came to me committed to a natural vaginal birth free of medical interventions, including pain medication. She wished for a home birth but she knew that wasn't possible in our area because she was carrying twins. So she settled on hiring a doula and planned to turn down as much medical "help" as possible.

But of course life rarely goes as planned...

One day, WAY too early in pregnancy, she begin to be concerned about how her body was feeling. Being a smart mama she listened to her intuition and took herself in to see her OB. Yes, her blood pressure was climbing dangerously. Before she could really grasp what was happening she was admitted to the hospital and begun on medication to bring it down.

I begin to capture Amanda's journey with my phone camera.
I came to the hospital and we talked for a long time about all the natural ways she could support her system and help bring things into a better balance, including her blood pressure. I reassured her I would come to give her birthing classes in the hospital. We strategized over how to deal with a long hospital bed rest.

One week later her water broke. Her body decided it was time to have her babies, 26 weeks or not. With contractions came climbing pressures. When I walked in Amanda was laying in bed surrounded by and attached to more medical contraptions than I have ever seen before. Blood pressure cuff, IV meds for blood pressure, IV fluids, heart monitor for mom, contraction monitor and 2 baby heart rate monitors. A bewildering array. The nurse was glued to the screen giving her all the info from all the machines. Amanda had to remain horizontal for her labor.

Let me explain. I have seen lots of moms hooked to LOTS of things but NOT a mom who was birthing without labor stimulants and/or pain medication. Here was Amanda in the midst of a high tech, high risk birth doing it "au natural".

So we labored. We breathed. We visualized. We relaxed. I sprayed the room with lavender and smoothed essential oil on her feet. We massaged her shoulders and gave her sips of water. Absolutely no food because of the high potential of an emergency cesarean. When her back began to ache I showed Jose how to use my purple rebozo to provide counter pressure with a mom on her back in bed.

The sensations were coming closer and getting more intense. With such tiny babies, with tiny heads the magic number of 10 as a goal for dilation goes out the window. You are ready to push whenever the cervix is pulled back far enough for a head to slip through. I was pretty certain we were closing in on pushing. Then Amanda began to make pushing sounds and spoke of pressure. I alerted the nurse and she did a vaginal check. Yep. No more cervix. Time to push out baby A.

Now everyone began to scramble. I don't know why they were all so surprised.

Vaginal twins are unheard of in some areas of the U.S. but here moms can birth vaginally as long as the babies are positioned right. Amanda's OB, stuck to that promise although he had plenty of opportunity to use the situation to send the birth down a cesarean path. He never once brought it up. When things got tricky he stayed calm and talked mom through exactly what needed to be done, including the urgency of the situation, enlisting her help without scaring her.

But twin births are required to take place in the operating room, just in case. So here we go...
Heading down the hall at Sierra Vista on the way to the OR.

On our way to push out two babies sans pain medication or pitocin.


At the last moment they separated us and made Jose and I wait in the waiting room while they got mom "prepped". I nervously wondered what they were prepping her for? Usually they make us wait outside while they put in an epidural before a cesarean. Poor Amanda was told to not push, even though you can't stop your body from pushing once it begins. A doula can really make a difference when this chaotic circumstance arises, but there I sat in the waiting room, waiting. So I snapped this handsome photo of dad sporting his hazmat birth suit.

At last we were reunited. The room was FULL of people. They had to have the whole OR team as if she was having a surgical birth just in case it suddenly became a surgical birth; obstetrician anesthesiologist, surgical nurses, labor nurse, plus 2 sets of recovery teams for the babies, respiratory specialists, Neonatal Intensive Care Unit (NICU) nurses, and pediatrician. Jose and I squeezed our way in next to Amanda's side.

Pushing in the OR is very difficult. A mother has to block out everything going on around her and stay focused on her body's sensations. At the same time she has to tune into the directions she is given by her OB. It takes a tremendous amount of concentration. Plus she is flat on her back. Not an ideal position for pushing something out of one's body.

Keeping lovingly connected is also a challenge with so many on lookers; especially when your heart is racing with fear for your little girls. Jose's physical presence was a powerful support.

Soon a slippery teeny tiny Eleanor is born...

 to a room FULL of people ready to help.

A relieved Jose; one down, one to go!

2 pound 4 ounce Baby Eleanor gets help getting started

        Is there a baby in that bundle?

Mom meets Eleanor outside her womb room.
   Now we wait for Caroline to make her entrance...

Mom's blood pressure is up; Baby's heart rate is dropping.
Time to get serious about birthing this baby.

Forty minutes after her sister tiny Baby Caroline arrives;
 raising her fist in the air to say, "I made it!"

A very short cord makes for a very rough trip.

         Whew two babies born!            A relieved mom and grateful dad celebrate.

Two pound Caroline gets help getting started.
Preemies have no body fat and lose heat fast.  Saran Wrap traps heat.     
 Daddy gets as close as he can.

First father daughter photo with Caroline.
It's official! They're here.
I'm so blessed to be part of miracles.
I am grateful to all the many people who helped at this birth and who continue to help provide care to these teeny weeny babies. When I first began working as a doula these babies would have been flown to a hospital with a higher level of care than we had in the county at that time. Mom and dad would have been left behind to wait and worry until Amanda was healthy enough to discharge from the hospital.

Don't get me wrong. I still feel way too many babies born at Sierra seem to "need" to be taken to the Neonatal Intensive Care Unit. Almost all my clients have their babies spend at least a short period in the NICU for observation before being given the "all clear" to reunite with mom and dad. Please keep in mind most of my clients are not high risk and birth their babies vaginally. The conundrum for me is when a baby truly needs NICU care I am eternally grateful they can receive high quality, high risk care right her in our community. I am also grateful they are trying to move the NICU in a more family-centered, baby-friendly direction. 

Three days later I snapped this photo of an exhausted dad getting skin to skin time 
snuggled up with Caroline in the NICU.   
Shhhhh!!! Don't wake the baby.


Throughout it all Amanda has stayed strong. Threading her way through her increasingly complicated birth and postpartum period. She stuck to her goals of having as natural a birth as possible while never forgetting to safeguard her babies. The nurses at Sierra are blown away. They say, "You birthed preemie twins vaginally with no pain meds? Amazing!" It brings home for me the difference in our frame of reference because I never doubted Amanda a bit.

Twelve days old 
Cuddle time with mom at last!
 With all the stress Anna unfortunately ended up with a cold. 
She had to delay the sweetest of moments in a mother's life.