Ella's Birth Day

Today is Ella's first birthday ~ Happy Birthday to Ella ~ and thanks so much to her mom and dad, Sarah and Ryan for sharing a great birth story!

My Birth Story

When Ryan and I first started trying to expand our family we had two miscarriages and it was during that time I really started thinking about what I wanted in my pregnancy and birth.  When we got pregnant the third time my ideas about birth and what I was looking for had changed drastically from before we were trying.  During my miscarriages I felt a bit looked over, unfortunately my OB went on maternity leave 2 days after my first miscarriage and didn’t return until a few weeks after my second miscarriage.  I felt like I had to press the office for answers and results and really just feeling like I was my only advocate.  It was a hard time made even harder by these feelings.  I reached out to a midwife and seriously contemplated skipping the OB all together, I loved (and still do adore) my doctor, but was hurting and scared at how much a felt like a patient and that I was not being heard.

My sister-in-law had been through the same things I had with miscarriages and had a midwife with hospital privileges for her pregnancy’s and had been singing her praises for several years.  I quickly found that there was only one midwife with hospital privileges here and to me, the hospital was a non-negotiable.  I really wanted to be in the hospital for my own piece of mind.  I think Ryan gave a sigh of relief when I assured him I would like to have our daughter in the hospital; his biggest fear was me giving birth in the canyon!

The third time I got pregnant I wasn’t expecting it and decided to give my doctor’s office one last shot.  My doctor had returned from maternity leave and having her back made all the difference. By this time my ideas for my pregnancy and birth had changed drastically, while I had once said “Give me the drugs” I was now curious about if I could have our baby without drugs.  I had become more cognizant of what I was putting in my body and was more aware of my options.  In my quest to find more information about giving birth naturally I was lucky enough to stumble upon the Bellabirthing website and immediately wanted to enroll in Sasha’s birth class. 

Needless to say once we met Sasha we loved her!  She was everything I had been looking for, she challenged my preconceived notions and allowed us to open up to the many options we had.  I never felt judged by her and she truly opened my mind and heart to choose what I wanted to do rather than what I felt like I should do and what other people wanted or expected from me.  I had not thought much about hiring a doula, it had crossed my mind once or twice after deciding I wanted to try and give birth naturally, but I had feared that having a doula would make Ryan feel left out or that it would somehow make it less between Ryan and I.  On our way home from our hospital tour Ryan asked if Sasha was accepting clients, we decided we wanted a doula, but only if it was Sasha, she was the right fit for us.  Luckily for us Sasha really needed to add a Zamboni driver on her list of clients J

No matter how many times someone told me labor isn’t like the movies I couldn’t quite process what it would be like for me.  So when the doctor told me to think of 5-1-1, contractions 5 minutes apart, 1 minute long for an hour I took it pretty literally.  I woke up the day my due date very early with what felt to me like light period cramps which had happened to me quite a bit during the last two weeks with two back to back bladder infections so I was just thinking to myself that I needed to drink some more water and not miss an antibiotic.  I was still cramping periodically though the day; I kept track a little thinking that I would practice for when I was really in labor.  Who has their baby on their due date anyway? I did think it would be a good idea to carb up that night and made pasta for dinner, just in case, but again, who has their baby on their due date?  

Sure enough I woke up a few hours after going to sleep and was having much more intense cramps.  I didn’t think I was in labor because many people explained contractions as painful and that your stomach would harden with each one.  I wasn’t having that so I just thought I would go stretch out on the ball downstairs and no need to wake up Ryan, that would just be a drag if we were both tired the next day right!?  Well stretching didn’t help me much and I really wanted to sit in the bath, so I got it going and hung out timing what I though was my very early labor contractions for something to do and to pass the time.  I must have been delusional because when I looked back at the log my contractions were on average 45 seconds long and throughout the night went from 7-5 minutes apart.   The bath helped me relax and so I decided to try and fall asleep for a bit longer in the guest room so I wouldn’t wake up Ryan with my tossing and turning.  I fell asleep for a few hours before Ryan woke me up and I went back to our room.  I slept again for about 2 hours and woke up when Ryan was getting ready for work.  It was at that point that I was in a fair bit of pain, I asked Ryan to stay home with me and not to go to work.  He agreed and suggested I eat some breakfast in case today was the day. 

Now let’s get something straight, I had watched Kourtney Kardashian give birth and she took a shower, blew out her hair and put makeup on before heading to the hospital.  This was my plan, for heaven’s sake if she can do it I should be able to right?!  Well, I asked Ryan to time my contractions so I could get in the shower.  By this time I figured this was labor, however still thought it was pretty early, not so much the case.  After me calling to start and stop the timing of contractions a few times and moving around very slowly I heard a bit of an edge in Ryan’s voice.  My contractions were still 45 seconds long but more like two and half to three minutes apart.  This was not part of my well planned labor plan, I had a one page typed birth plan that I was hoping to follow and I still needed to take a shower!  I didn’t want to go to the hospital too early but Ryan coaxed me into calling the hospital to see what they thought.  The doctor had the same edge to her voice when I told her I lived in Big Sky, that my contractions were about two and a half to three minutes apart… but only 45 seconds long.  She had to explain to me, twice, that the one minute is just a reference, and that I should head in to the hospital.

Well, I texted Sasha, and told her we would call her from the hospital.  Oh by the way, I had no gas in my car, nice move right?  Ryan was not pleased considering the roads were not great, I was not enjoying my contractions and he had to stop to get gas on our hour ride to the hospital.  But seriously, who has their baby on her due date?!  (I had checked and it is something like 5%, I really thought I had time ot get gas)  Once we got that taken care of and made it through the canyon I had a change of heart and decided it was unlikely they were going to send me home and I asked Sasha to meet us there.  The car ride caused my contractions to slow down considerably and when we got to the hospital if I wouldn’t have seen the slightly crazed look in Ryan’s eye I would have suggested we go to breakfast because I thought my labor had stalled.  I wasn’t hungry but figured anywhere would be better than sitting in the hospital.  Once I got out of the car, I changed my tune, the contractions were fast and hard and I moved like a snail.  I was still disappointed that I hadn’t gotten my shower, and done my hair and makeup.

When I arrived in labor and delivery I saw my doctor and completely lost it.  For some reason seeing her made things all real and what I remember through my sobs was her giving me a hug and another doctor, who turned out later to by my daughter’s awesome doctor, said, “Now that looks like a woman in labor.”  I am the type of person that likes to add something to my to-do-list that I have just done only for the satisfaction of crossing it off the list.  So I was all about them checking how far dilated I was.  I like to know my progress, it helps me to prepare and visualize my goals.  So when my doctor said I was 7 centimeters and that she had to go do a C-section but that I would possibly be ready to push by the time she was back I was thrilled with myself for getting to 7 cm before getting to the hospital.  Something I was very adamant about with myself was understanding that while I wanted to have a natural birth if I needed medical intervention I needed to be open to it.  I didn’t want to think of my child’s birth as a failure in any way if it didn’t go as planned.  Originally I had thought about giving birth naturally because I had heard that some women didn’t respond to epidurals and I knew if I planned to have an epidural and for some reason I couldn’t I would freak out.  If I planned for the natural birth and needed an epidural that was fine to me.   I really was hoping to not have a C-section but again reminded myself that if that is what it took to get my daughter into the world that was fine and that sometimes even the best of us need a little help.

So I arrived at the hospital at 9am with Sasha, Ryan and my OB in tow.  I had a great nurse and one of my favorite memories is when I decided I wanted to get in the tub I got undressed to my underwear and bra and wanted to get in.  My nurse looked at me and motioned to my underwear saying, “Sweetie, you know you are going to have to take those off to have this baby right?”  I guess it was her way of saying, “Girl, pretty soon you are going to not care what you look like, sound like and your modestly will go out the window.”  I was not there yet.  I got in the tub, the second to last place I thought I would want to be (last place to come later) with my underwear and bra on.  I think secretly that nurse just giggled at me, I would have too, I must have seemed ridiculous.  Oh well, modesty got thrown out the window later.  The doctor came back around noon, three hours later, and I hadn’t progressed at all.  I didn’t want my water broken and so chose to get out of the tub and try to break my water on my own.  Another one of my funny labor moments was after being checked and deciding to try and get my water to break I asked someone to grab my yoga pants so I could put them back on.  Sasha looked at me with a smile and told me that I was the first mom in labor that had asked to put her pants back on.  She helped me get back in my pants and get on the ball, which was absolutely awful!  The one place I thought I would love turned out to be the worst place ever.  I found my favorite location, much to my dismay, was the toilet.  But once I had a foot stool and pillow behind me it was the best spot in the room, maybe even better than the tub.  By two in the afternoon I still hadn’t really made much progress, I was at 8cm and I decided that breaking my water should be the next step.  By 2:15 my water was broken and I went from 8cm to 10cm by 3pm.  My poor husband was mortified by the noises I was making, I remember one moment where he looked like he was going to shush me, and through better of it and just held my hand instead.  I started pushing on the bed with my upper body draped over the top of the bed.  They did eventually ask me to lie on my back and I agreed as I just didn’t care anymore and wanted my baby out of me.  I am fairly certain I even yelled that a few times.  Again, poor Ryan was just mortified, but kept his mouth shut.  

At 4:01pm February 23^rd my beautiful baby girl was born.  We were so blessed that it went so well, I was able to do immediate skin to skin, waited for the cord to empty before having it cut and work on breastfeeding right away.  

They aren’t lying when they say once the baby is out the pain is gone, I don’t know if it’s because we were just in awe of our little peanut or if really there was just no more pain.  While I wanted as few interventions as possible, I did change my mind about the Pitocin IV after birth.  Having had a friend that had very recently nearly bled out we felt that for us it was the right choice. 

My birth was perfect for me, I went into it with a plan, yet was open to wherever my birth took me and I think that is what has allowed me to embrace the birth of my daughter and cherish the memories of it.  I had people tell me that I wouldn’t win a medal for not having the drugs, that it doesn’t make me a better parent by having a natural birth, but for me that wasn’t what it was about.  I had wrestled with the decision for a long time and had kept that part of my plans as well as my choice to have a doula private for most of my pregnancy.  While I didn’t hide my choice I also wasn’t shouting it from the rooftop.  I didn’t want to hear from people their opinion, whether in my favor or not.  There are always people with opinions, some that will tell you that you are silly to not have the epidural, some will say that you are irresponsible and somehow less of a mother if you have a C-section or don’t have a natural birth.  In the end for me it was really about what felt the best for Ryan and I.  If I had labored for 36 hours I most likely would have gotten an epidural, if for some reason I needed to have a C-section it would still have brought me my perfect little baby girl, it doesn’t make her being in my arms any less valid or real.  It doesn’t make my experience any better or worse than anyone else that I didn’t do something or did do something.  I wanted a hospital birth, I wanted to try and have a natural birth but in the end it was what felt right to me, not what anyone else said or thought I should do.  That to me is what made it amazing and truly the perfect birth.

 Happy Birthday sweet Ella

Freedom for Birth

Birth as a Human Right?

On September 20th, Improving Birth National Rally for Change, ICAN of Bozeman, MT and the Montana Childbirth Collective hosted a showing of Freedom for Birth, "a new 60 minute campaigning film that re-frames Human Rights as the most pressing issue in childbirth today."  This film shows how choosing the way in which she births is a fundamental human right for all women, and how this right is routinely violated, all across the world.  The film is amazing and we highly recommend you view it, and show it to others, especially women.  We had a lively and thought-provoking discussion afterward, about birth as a human right (something many of us had not pondered before), about the violations in the film and about birth in our own community.

This got me thinking about what we are doing right - and what still needs improvement - in our own community.  One of MCC's members at the film premiere said "We are so lucky to live here - we have so many choices other women do not have."  Absolutely.  In Bozeman (and surrounding towns) you might choose a homebirth midwife - we have several with great reputations and many many years of experience.  They will attend you in your own home with kindness and compassion and a high level of care.  We have two beautiful birth centers, The Bozeman Birth Center and The Birth Place, each staffed by highly trained, experienced and well-regarded midwives.  Both offer a lovely facility as well as compassionate and safe care.  These are all excellent choices for VBAC moms, or other moms who've had traumatic previous births.  About 10% of families choose either home or center births, the highest in the state, and Montana has the highest rate of out of hospital birth in the country.

Home or center choices here give women the choice of a low to no intervention birth, a family centered birth, a birth where the mother is firmly in control of her experience.  And we know from years of research studies that these are safe choices, the most recent from the Cochrane Review, concluding "Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications."  Less interventions and fewer complications mean fewer cesareans, less separation of mother and baby, fewer problems with nursing, less tearing of the perineum, less induction, less pain medications and much happier birthing experiences for families.

What are the problems?  Some insurers still won't pay for these choices, or will pay for only some.  Women deserve for their insurance to cover all the choices.  And this makes good sense for society too, as these choices are tremendously cheaper than even natural hospital births (and since they result in so many fewer interventions and complications, they are obviously cheaper than highly interventive births).

Not enough women know that home or birth center births are safe.  Not enough women know that they probably wouldn't need pain medications (like epidurals, which are not available outside of a hospital) if they didn't birth in a hospital.  And not enough women have trust in the birth process to take total responsibility for their births, which one must do to birth out of hospital.

Finally, we have a small choice of hospitals, Bozeman Deaconess, St. Peter's Hospital in Helena (about 1 1/2 hours away), Livingston Community Hospital (1/2 hour away) and St. Vincent's or Billings Clinic, (Billings, 2 hours away).  Most women in Bozeman choose our local hospital.

What are they doing right?  Moving in the right direction - toward a gentler and more patient centered kind of birth.  Bozeman is becoming Baby Friendly, which means a huge step toward better breastfeeding rates and help for mothers who want to breastfeed.  Some mothers are now able to keep their babies with them when they have cesareans and nurse right away, rather than have the newborn and partner whisked off to the nursery for hours.  Mothers who want low intervention births are more likely to be met with encouragement and support.  Doulas are warmly welcomed.  Two nurse midwives are now on staff at Billings Clinic's Bozeman OB practice, offering a level of care more based in midwifery.  Women choosing them would have one of two midwives attend them (instead of one of very many doctors, whomever is on call).  This makes a big difference to many women.  The maternity care nurses are well-trained to help mothers who want a low intervention birth and happy to support that with compassion.  VBACs (although called TOLACs - trial of labor after cesarean) are now "allowed," at least for some mothers.  Women transported from out of hospital births are generally treated kindly and with respect.  There are a number of doctors who are patient and support natural birth and who refrain from intervention.  This is all cause for celebration.

What still needs to be done?

• All mothers who have cesareans need to keep their babies (except the very rare baby who needs intensive neonatal care) for the duration of their surgery and have help latching on right away.  Separation needs to be as close to zero as possible.
• The cesarean rate is too high - the hospital reports a rate at the national average - about 30%.  This is at least 15% too high.
• VBACs need to be openly celebrated and encouraged, not treated as train wreck waiting to happen.  The research just doesn't support this panicked mentality.  VBACs are very safe.
• Far fewer inductions.
• A doctor/patient system that puts the patient first.  Birthing women need to birth with the caregiver they've seen for 9 months, not the stranger who happens to be on call.
• A return of breech births for the majority of those cases.  Again the research supports this as a safe practice (and can help lower the cesarean rate).

Our community can continue to support women's choices about birth, as a human right.  We can all respect the value of mothers by letting them choose what they know is best for their families.  And we can encourage our community hospital to continue taking steps toward improving its care of mothers and babies.