January Workshop: Partnered Positions for Labor & Delivery

January 9th, 2015 3:30-7PM at Area Yoga in Brooklyn Heights $125

In this 3.5 hour workshop, pregnant persons and their birth partners (whether it is a life partner, parent, sibling, friend or otherwise) will gain the necessary tools to get through labor and delivery.  We will practice breathing techniques, positions to help labor progress and facilitate pushing, hands on comfort techniques for birth partners, and meditations to calm the mind and body during your most challenging moments.  A third of the workshop will a discussion about the anatomy and stages of labor. Snacks and props will be provided.

Register here: http://www.areayogabrooklyn.com/workshops.html

The Village

Parenthood is a lot of things: amazing, exhausting, hilarious, smelly, challenging, moist (yes--it's nothing if not damp), beautiful.  But what many new parents, especially moms, find most about parenthood is that it can be so lonely and isolating. Here's a scenario: 

The change starts when you are pregnant.  The first few weeks of pregnancy you begin to avoid going out--you are exhausted, nauseous, unable to drink alcohol, and you haven't made your pregnancy public, so being out and keeping the secret is agonizing.  Eventually, friends stop inviting you out, assuming you'll say no. As you get into the second and third trimesters, when you do go out, the conversation always turns to your belly, to your baby.  You begin to feel your individuality, your identity slipping away. But you are still working, you have your baby shower to look forward to, you are independent and able to be selfish when you really want.  

Then baby comes! Yay! A herd of visitors tramples through the hospital and into your home in the first few weeks after baby's arrival.  Everyone wants to meet her. You don't care about how you look, how your apartment looks: you've got the ultimate trump card. But slowly, the flood turns to a trickle, and then it's been 8 days since you saw anyone other than your baby, your partner and maybe your mailman.  You are so distracted with baby and being a new parent that you forget to return texts and calls. You are up at random hours and while you could text at 4am, you worry about waking friends up: they have work tomorrow. You settle into your little cocoon of parenthood, snuggle down, smell baby's head, meanwhile the rest of the world keeps spinning on without you. 

When you are finally ready to emerge, friends that are still around may offer to babysit, but you rather spend time with them than have them watch baby.  So you bring baby out, but baby has a blowout and you forgot extra clothes and have to pack it in before dinner even arrives.  Or baby gets sick and you decide to stay home.  Or you are just too damn tired to muster the energy to get out of your house.  You feel like when you do go out, you have changed so much and everyone else has stayed the same. How has it been two years and your friends are exactly where they were (literally, the same barstools) before you got pregnant?  

You lose touch with your partner. Your conversations center wholly around baby, her needs, what she did today, your goals for her. The most intimate time of your day is snuggling and nursing. But the constant physical contact means you just need a break come bedtime--not a chance you'd let your partner spoon you let alone make sexual advances.  You long for some sort of intimacy, but it seems hopeless.  Your partner becomes distant, you withdraw, the cycle perpetuates itself. 

We all know parenthood changes everything--especially the way we see ourselves and others. We spend so much of our time devoted to one (or two or....) teeny tiny person, that we cannot give what we used to to other relationships.  We lose ourselves in the process too, all of a sudden our identity is completely wrapped up in their personhood.  You are rarely physically alone--especially if you choose to not go back to work--yet, you feel totally, wholly and absolutely alone.  

This loneliness of parenthood, and motherhood especially, is unique to the United States.  The Enlightenment ideals that this country was founded upon cherish the individual over the village, champion the "every-man-for-himself" over the "all-for-one-and-one-for-all", and put the nuclear family over the community.  We are supposed to act as our own autonomous, self-sufficient systems--fully functioning and excelling at life every step of the way.  This is the American Dream.   

Not to mention what many refer to as the "mommy-wars", whereby we judge and fear being judged for our every choice and action in how we got pregnant, gave birth, and raise our children.  In this culture climate, how can we possibly find a village?

It's not impossible, though it certainly isn't easy.  Prenatally, join all the parents listservs in your neighborhood, go to prenatal yoga, take childbirth classes.  You may have to become an extrovert, but introduce yourself to everyone you meet there, get numbers, set dates. No one will understand you better than someone who is in the exact same situation as you. (Not even your best friend who already has three kids--they are too old, her amnesia has set in!)  Commiseration in infancy is the bedrock of friendship.  

Once baby arrives, GET OUT OF THE HOUSE.  This is challenging, yes.  It may even seem like an insurmountable obstacle, especially if you have a winter baby (too cold), a summer baby (too hot) or live in a somewhat isolated area.  Go to Mommy & Me yoga, go to breastfeeding circles and support groups (even if you don't need help), go to sing-a-longs, baby movement classes, storytime, new parent meet ups and happy hours. Again introduce yourself to everyone. Pro-tip: introduce yourself before you introduce your child--the person you are meeting will likely do the same--and don't be shy when you forget it nearly immediately, they probably did too, just ask again.  Set coffee dates, mani/pedi dates (wear your baby! No one minds if you nurse while you get your toes painted). Say yes to everything you can, even if staying home seems more tempting.  

Oftentimes the relationships we forge in the early days of parenthood seem so shallow and based on the singular fact of your child's existence.  But these relationships can truly develop into a deeper camaraderie, friendship and community than any you've had before.  If you find yourself only talking about the kids every time you get together, make a mental list of possible discussion topics and casually drop them in, even if they too, are shallow at first: "did you see the new Game of Thrones?" Eventually, you will get into the deeper stuff.  

Most importantly, be open, gentle, kind but honest with these new friends. Value yourself and your time and surround yourself with people who also value you and your circumstance.  Avoid mommy-wars, be respectful.  Introduce your friends to each other, especially if one seems to be battling the loneliness--this is a kindness that cannot be overstated.  

Time will ease the loneliness and someday you will feel like you again--maybe a different version of you, but still you.  But if you can build your village before baby even arrives, maybe you will never know the deep sorrow that parenthood can bring, and even if you do feel this, you will have people to hold you up, to carry you, to shine light down the cavernous halls of parenthood.  

September Workshop: Partnered Positions for Labor & Delivery

September 26, 2015 3:30-7PM at Area Yoga in Brooklyn Heights $125

In this 3.5 hour workshop, pregnant persons and their birth partners (whether it is a life partner, parent, sibling, friend or otherwise) will gain the necessary tools to get through labor and delivery.  We will practice breathing techniques, positions to help labor progress and facilitate pushing, hands on comfort techniques for birth partners, and meditations to calm the mind and body during your most challenging moments.  A third of the workshop will a discussion about the anatomy and stages of labor. Snacks and props will be provided. 

To register: (718) 221- 9642

Beautiful Births: A Homebirth Story

Note from Jesse: Birth stories are written by mothers, in their own words.  The only edits I make are to preserve their privacy and keep their identities anonymous, if they wish to. These stories may include very real moments of emotion, trauma and emergency situations.  All births are variable and unique, I hope to show that by sharing these stories. If you wish to share your story, please email jessempournaras@gmail.com

On a Sunday in early June my labor began.  That night I had 2 or 3 contractions every hour, and that pattern continued through Monday.  By the early morning on Tuesday active labor had started. It was mostly back labor and it was hard to decide sometimes if I was having a contraction or if I was experiencing general discomfort.

At sunrise we went up to the roof and walked in a circle and my husband took pictures of me. When I came downstairs I labored sitting on the exercise ball leaning over the kitchen table. We tried having me get through contractions while lying on my side on the couch, but not being able to move/rock/sway through a contraction didn’t work for me and triggered me throwing up.

In the early afternoon, after our doula had arrived and my husband had gone back to bed, our midwife came and checked me and then left again because I wasn’t that far along. Through the afternoon I went back and forth from laboring in the shower to laboring out of the shower. My last shower my husband joined me for and it was great to be able to lean on him, and it felt really calm and intimate to have those moments just being the two of us together. It was uncomfortable to sit down as the baby was so low and putting so much pressure on my bum and my contractions were really uncomfortable because I felt all the pressure in my butt.

After the shower that I tried to pee a little and got enough in a cup for my doula to check for protein and everything looked good. They made me a little pillow fort on my bed and with the blackout curtains drawn, my husband next to me and my doula lying on the bed by my feet, we spent a relaxing hour together with her doing foot reflexology and I managed to pass out for about 40 minutes, thus commencing the part of my labor that I refer to as the “spa afternoon”.

When I woke up I noticed with shock that my belly had changed shape! It was obvious that the baby’s head had blocked my urethra and my bladder was unable to drain. Having thrown up a few times already, I had been focusing on fluid replacement, so at this point there was a painful amount of pee in my bladder, everything was pressed all the wrong way, I felt like the baby had moved up instead of down, and my contractions had all but stopped.

My doula called my midwife, I got in a warm bathtub to see if that could help things open up.  My midwife was unavailable so a back up came to catheterize me. Around this time my water broke. When the back-up midwife checked my cervix after the catheter came out she discovered I was 10cm dilated.

I was confused that my labor had progressed to 10cm and asked her if I had gone through transition. She replied that I had. I don’t know when this was. I know that there were times that I became more focused on my work, and that there were times that I had to be reminded to keep my voice soft and calm, but I never had a moment of true panic or fear, and I never held myself back from any of my contractions, which was what I anticipated to be my “symptoms” of transition. I think the months of preparing my body and my mind for the labor served me well when faced with working through was must have seemed insurmountable at the time.

This then started the second phase of spa afternoon. My desire to push never came and I wasn’t having that many contractions, and knowing that I was fully dilated I wasn’t concerned that there would be a lot longer to go. The pressure against my bum was excruciating if I tried to sit down or if someone kindly tried to rub my lower back. But all things considered my labor was great. I was being fed apples and peaches in the pool. We were chatting. I was relaxed. My doula never stopped working on my feet and shins. My husband was taking photos. I felt so spoiled!!! I knew I made all the right choices for this birth.

In a few hours my midwife came and the back-up left. I was again catheterized as my bladder was full and the decision was made to start my labor moving again. I walked up and down our little hallway and leaned against the wall with my head against my hands when I had contractions. I still didn’t have any urge to push. My midwife encouraged me to sit on the toilet when contractions came try to pretend like I was trying to poop, I followed her directions, put my feet up on some foam yoga blocks to keep myself steady and did what I could, but still the urge to push didn’t come. I was just putting pressure down on my bum, it was not pleasant, and I felt like instead of having a baby I was trying to push my rectum inside out.

My husband put some ice in the blender for me to suck on between contractions and he held my left hand while I held the door frame with my right hand during contractions.

A few hours before midnight my midwife decided that it was time for this baby to be born, and came into the bathroom to coach me on how to push. With every contraction she put her fingers inside me and helped guide the baby down. When she told me how I was bearing down wasn’t working I found a way to move my breath down to my vagina in the most productive way she told me. I think that all these years of “doing the breath is doing the pose” in yoga helped me to keep pinpointing where to send my breath after my midwife helped me identify it.

My sense of time is completely lost at this point, but my midwife asked me if I still wanted to deliver in the pool and asked if I wanted to make the baby come today. I replied that I did. I knew I was working as hard as I could to push, especially as I wasn’t developing this spontaneous desire to.

My midwife continued to coach me through my contractions with her fingers inside me and I felt her trying to make space for the baby’s head to come down into and trying to protect me from tearing. I felt the baby’s head moving down through my vagina and it felt like the birth was imminent and so far away simultaneously. I was working so hard, but the two steps forward, one step back was sadly as true for me as every other woman who has labored before me.

I felt so taken care of and loved. With oxytocin being the love hormone, I don’t know how I could have felt more loved, and my contractions were strong and close together.

Finally, the baby was crowning.  Throughout my labor, my midwives used their dopplers to check the baby's heart. Sometime it was difficult because my bladder was in the way, but whenever it was checked the baby’s heart rate was good.  But when she checked this time there was no sound from the Doppler. My baby’s heart wasn’t beating anymore. My midwife told me to stand up and push my hardest, and as quickly as possible my husband grabbed me to my feet, which made a contraction happen, and I pushed with all the strength I could find, holding my breath and focusing it down until my baby came out. In my memory it feels like it couldn’t have been longer than 30 seconds, but this last contraction was the strongest and most productive contraction of my whole labor and so it might have taken a full two minutes. I just know that I pushed and my midwife pulled, and my baby came out. It was 11:58PM on Tuesday. There was no cry.

I was in the pool with my shins up over the water and over my legs was my limp, silent baby. My husband grabbed me and encircled my shoulders and head with his arms and told me over and over that it was going to be ok.  My midwife cut the cord and performed CPR on the baby on the floor. My doula called 911, gave our address and repeated that there was a newborn who didn’t have a heartbeat and wasn’t breathing. Then the baby gasped.  My midwife told us it was time to pray to our gods and I just shouted at my baby how much I loved her and how I wanted to give her the best life possible.

My midwife continued to resuscitate our baby. There were more gasps. There was more shouting at the baby. There were more little sputters and eventually our baby started to cry.

I asked if the baby was a boy or a girl. My husband said boy, my midwife said girl. Our baby was a girl.

I believe that our baby had a choice, and her choice was to stay with us and to be our daughter. I will be forever grateful that she chose to be ours.

A few minutes after midnight the firefighters and EMTs arrived and a second part of my labor that I hadn’t imagined began.  The EMTs wanted to transfer both the baby and me to the hospital as patients as soon as possible. I told the EMTs that as a family we had already decided that in case of an emergency that my husband would stay with the baby and so they didn’t have to treat us like a package. The first female EMT on the scene took my blood pressure while I was in the pool.  My husband stayed in the living room with the baby wrapped in an old blue towel that he had from before we moved in together.  And I was brought to the bedroom by  my midwife and doula, where the bed was already set up with a shower curtain and those absorbent pads because of the catheterization earlier in my labor.  My husband brought me our baby girl, all wrapped up, and placed her in my arms. I got to unwrap my baby – the best present I have ever gotten – and she was put on my chest.

Concern grew because I wasn’t having any contractions, so the placenta wasn’t coming out. My husband found my vibrator and I held it to my right nipple while staring at my baby on my left breast [to stimulate contractions]. The EMTs wanted to take me to hospital with the placenta still inside but we kept on stalling, and eventually my midwife manually removed it. I don’t know how I held onto my baby girl through that, I was screaming out in so much pain.

At this point my midwife and doula began to clean me up as quickly as possible, and my husband, in the hall outside our bedroom, continued to stall us having to make a decision. He was wonderful, he knew just how to stroke everyone’s ego that needed stroking, while continuing to buy us more time to make our decision about going to the hospital or not. As time progressed we decided to refuse any medical attention, as our baby girl had latched on (sucking with her mouth!! And breathing with her nose!!) and we knew that any damage that had been done by the lack of oxygen, that being admitted to a hospital and having a barrage of tests run wouldn’t fix anything.  And I was healthy person - there was no reason for me to go to the hospital and have a multitude of tests run.

An EMT brought me a phone and I talked to the doctor at the ambulance station. He informed me that neither the EMTs nor he were responsible if anyone died after I denied care and that if there was another problem that I should call him right away. I told him that I understood that they were not responsible for any deaths and asked if he had given my husband his phone number. He told me that his phone number was 911. I signed an e-tablet a bunch of times for both myself and my baby, denying service and care. And by 2:30AM it was back to just me, my team, and our new daughter in the apartment.

We were all full of adrenaline and not ready to go to sleep. My doula and midwife cleaned up the apartment and put peroxide on anything that had blood on it. My husband and I put our daughter in the baby gown I had picked out to be our baby’s first outfit, we marveled at how soft her skin was, we admired her full head of hair.  We brushed our teeth, washed our faces, brought the rock and play from the baby’s room into our room, put our daughter to sleep next to our bed. We lay ourselves down around 4, and I promptly went to sleep.

My midwife stayed until 5, whereupon she tiptoed into our bedroom to take my pulse, liked the number that she saw and let herself out.

And that is the story of how my baby girl was born and chose to be our daughter.

 

Happy Mother's Day!

Happy Mother's Day to all the mamas, soon-to-be-mamas, planning-to-be-mamas, and mamas-at-heart!  

I am always so honored that people choose me to support them on their journeys to parenthood. As I watch babies being born, I get to witness the moment that women become mothers and men become fathers.  It is truly a miracle, every single time.  

So today I honor you! Thank you for letting me be part of your life, your moment, your miracle.  

On Pain (and Pleasure)

I'm on my third read through of "Natural Hospital Birth: The Best of Both Worlds" by Cynthia Gabriel.  Every time I read it this one sentence really speaks to me in the intro: "So many North American women have experienced the pain of labor, and then an epidural, that our collective memory about birth is now full of hurt but is missing the feelings of ecstasy and success that natural birth provides."  Now, I do not believe that all women that have medicated births or c-sections do not feel the accomplishment or the ecstasy of birth.  But I do think that this statement really is indicative of the prevalent dialogue we have going here in the United States. 

And THIS is why you hire a doula!

This fun/semi-horrifying little article on The AWL yesterday is the perfect example of why even women who intend to have medicated births should have a doula! "When the Only Way to See a Doctor While Going Into Labor Is to Tweet at a Brand" explores the story of BuzzFeed's Senior Political Writer, McKay Coppins' wife, Annie's labor at NYU Langone medical center.  

Long story short: Annie wanted an epidural desperately! It took hours for her to receive one because the hospital was at capacity and understaffed.  McKay stuck with Annie through each contraction but ran out in the short intervals between to try to get somebody—anybody to help! In the end, it took McKay tweeting at the hospital to finally get recognized by a doctor and for Annie to receive an epidural after having already fully dilated!

Had they had a doula, not only would she have been able to answer McKay's pleas for breathing methods to manage the pain, given information about other pain medications that they could request and just helped Annie through each contraction until she did get the epidural, but McKay would have been able to leave Annie's side for more than 2 minutes at a time to successfully track down a nurse, doctor or anesthesiologist.  As presumptuous as it may be to say, with a doula, Annie may have decided she didn't need the epidural at all! 

Not Ready to Get Pregnant Again?

You can get pregnant again almost immediately after having given birth.  The old-wives tales that breastfeeding prevents pregnancy are false (I personally know many women who have breastfed through pregnancy and tandem nursed once baby #2 arrived).   If you're not ready to go through the whole process again it is best to practice some form of birth control or contraception. 

The New York Times published a handy info-graphic on the effectiveness of different types of birth control.  Know your options and talk to your health care provider to see what they think is a good fit for you!

 

To Induce or Not to Induce?

So you've made it to the 40 week mark—congratulations mama! But now where is that baby? Everyone is asking, you are ready to meet your baby, and you are probably so done being pregnant. And now you're midwife or doctor is giving you the option of inducing at so and so date. It's a lot to think about!