Tag Archives: labor

Natural Disaster Labor

In the wake of hurricane Irene, the US’s East Coast is riddled with anxiety and fear. It’s been a tough week for us, given that natural disasters really aren’t our thing. The last hurricane to threaten the eastern seaboard was over 20 years ago when Gloria gifted us with a tropical storm in 1985. Add to that Virginia’s earthquake earlier this week that sent risidual tremors along the East Coast and many southern states, and we’re in panic mode here. News reports tell us what we should have on hand in the event of an emergency, but what about women who are full term in their pregnancies?

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Lakeisha Dennis, of Lighthouse Birth Services @DoulaonDuty, brought natural disaster births up on Twitter this morning. What happens to a mom if she goes into labor during an earthquake, hurricane or snowstorm? What does she do if she can’t get to her support, or if her support can’t get to her?

Here are a few things you should consider including in your emergency birth kit in case you go into labor without the ability to head to your birth place (or have your team come to you).

1. 3 gallons of water – mom will need to stay hydrated during labor, and will need extra water for cleaning both during and after the birth if she desires. Keep an additional gallon of water for each person present.

2. Canned fruit, nuts, vegetable chips, and other non-perishable healthy foods to last at least 3 days.

3. Disinfectant – in the event that you have no running water, you don’t want to waste your drinking water washing your hands.

4. Dental floss – you can use dental floss to tie off the umbilical cord once it stops pulsating if you choose to detach it.

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5. Large garbage bags – aside from their normal use, plastic bags can be used as lining for your furniture or floor as a protective layer against fluids.

6. Sheets that you don’t mind ruining – you can use these on which to labor, in addition to staying dry and warm. Old sheets are also great for cleanup, because you can toss them when it’s all over!

7. Towels – have several on hand for cleanup and staying dry/warm for both mom and babe.

8. A few sets of clothes – there’s nothing like searching through a dark, flooded or otherwise damaged home to find clean clothes in an emergency. Keeping protected, clean sets with your emergency birth kit will help you greatly in your time of need. Remember to include baby clothes and diapers

9. A mirror to go with the flashlight you’ve already got in your emergency kit. During labor, you may need to see what’s happening around your vulva, especially if you are birthing alone. With a 40-week belly, a mirror will help you get a handle on what’s going on down there.

10. An extra fully charged battery for your mobile phone – in the event that you have service, but no electricity, you’ll be happy that you set this aside to be able to reach out for help!

Although these are some great things to keep in your kit if you can, you’ve also got to be prepared to use them! Check out Penny Simkin’s Birth Partner; she’s got great advice for what to do during an emergency birth.

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Also, speak with your provider about a contingency plan. If you’re birthing at a hospital or birthing center, what happens if disaster strikes if you are either already there in labor or in labor at home en route to your birthing place? Speak with your midwife about what to do in the event that neither she nor her backup can make it to you during a disaster. Ask your doula about how her services might change during an emergency.

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Preconception Planning III: More Trying and Less Conceiving

TTC can be the most emotional time of a woman’s life, especially when trying for several cycles. The moment your uterus begins to shed its lining you feel that nature has betrayed you. For some, it feels as deeply as the loss of a child.

We’ve all memorized Taking Charge of Your Fertility, and know by heart which links to click on Mayoclinic.com. We can read basal body thermometers in the dark, and chart temperatures with our eyes closed. And when we realize that we touch our cervixes more frequently than scratching our noses, it’s clear that we’re experts in knowing what’s going on with our bodies to recognize ovulation signs.

There’s advice about the best time to take your temperature, how often you should check cervical mucus (CM), how to interpret your charts, and the best time of day to use an ovulation predictor kit (OPK). But what happens when these things aren’t coming together like the beautiful celestial chart that they’re supposed to form? Shouldn’t these methods be fool proof?

Here’s what you don’t get along with the advice: not every woman has egg white cervical mucus (EWCM), and the OPK may not detect your hormone levels clearly.

I can’t stress enough how important it is to begin charting your temperature months before you begin actively TTC, especially if your cycle isn’t very predictable (I hate to think of my cycle as irregular!). Become comfortable with analyzing your charts, and seek expert help when things don’t make sense to you. Pay attention to the moistness of your vulva the days following menstruation, and try to notice whether or not you feel any slight cramps the more moist you become (without stimulation). Before you know it, you’ll be able to feel your body releasing an egg (or two!).

Learn to differentiate between your own CM. Recognize that as your body matures your CM can change (I haven’t had EWCM since my early twenties!). Some women go from dry, to watery to creamy and never experience sticky or EWCM. Some women go from dry, to watery, to EWCM, to creamy then sticky. Some women’s bodies may do something different all together. If you’ve been paying attention to your body for months before trying, you’ll know your cycle and won’t be waiting for EWCM when watery may be your ovulation sign.

Practice peeing on different brands of OPKs. You may notice that as you approach ovulation a faint pink line appears, grows darker over the course of the next 3-4 days, but never quite matches the test line. Does that mean you’re not ovulating? It could mean a number of things, and you should speak to a specialist to help you understand what’s going on. Some women never match the test line, and the faint line is their ovulation sign. I’ve only tested positive once with an OPK, and the positive result appeared after my temperature had already spiked. Go figure!

Sometimes we end up trying so much (unsuccessfully) because we aren’t interpreting our signs accurately. Sometimes we don’t trust our bodies enough to believe what they’re telling us instead of an OPK or someone else’s assessment. There are also times when this isn’t so cut and dry, and that may be a sign of something else going on. It can be hard to stay positive when you try cycle after cycle, especially when it seems like people around us get pregnant without even trying. But staying positive is a must!

Here’s to more conceiving after so much trying.

Don’t Give Your Voice Away, Not Even to Me

Every once in a while during a consultation a mom will ask me, “…and you’ll be able to speak to the hospital staff for me, right?” In response, I smile and tell her that I do not speak for her, but rather show her how to advocate for herself and her baby.

Communication is key in everything we do. Sometimes, as women, our voices have been silenced – by our families, society at large and even by our partners. Someone often thinks they know better than we do, and can show us the best way to handle a situation. A lifetime of learned helplessness doesn’t vanish when we become pregnant. If anything, our insecurities are multiplied. We learn to distrust our instincts and our bodies.

What does mom need to speak up about?

I always tell moms to research any information they’re given, even when it’s coming from me. All too often, we listen to “experts” without using our critical minds to question what’s being said. We spend more time researching the kind of car we want to buy than we do research regarding our health and wellbeing. It’s important for moms to question and ask for more information from their care providers, because care providers often turn questions into statements or commands.

For example, “I’m going to break your water now, because this will really help things get going.”

This should be a question: “You’ve been at 7 centimeters for 5 hours now. I think breaking your water will help to speed things up. What do you think about that?”

See how the latter asks mom for her input? She even has a chance to decline. The former, on the other hand, leaves no room for discussion. This is where mom has to feel empowered enough to advocate for herself. She could stop and ask for more information – risks vs. benefits. She could also ask what other interventions, if any, the recommended intervention may lead to. Breaking the sac before mom is 10 centimeters often leads to a fetal scalp monitor, an intrauterine pressure catheter and a foley catheter to channel urination. These interventions are often left out when the care provider walks in with a smile ready to rupture your membranes.

Why can’t the doula ask these questions?

There are some doulas who offer to speak for their clients. I think that’s just as much of an injustice as the rest of the world taking away a woman’s voice. The issue with asking or expecting your doula to speak for you is simply that she isn’t you! You run the risk of turning your experience into someone else’s when you give up your voice. You may be opening the door to allow your doula to relive her own birth experience through you. You create an atmosphere where it’s possible to not have your best birth when you give up your voice. If you relinquish your voice during labor, with what voice do you plan on raising your child?

So what do I do?

During your prenatal visits with your doula, ask her to help you role play different scenarios. Start simple with things like drinking and going to the bathroom, to more complex like negotiating interventions and holding your baby. Create code words with your doula so she knows if you need help making a decision (and by help I don’t mean the, “What would you do?” kind of help – but asking the doula for more information about a topic to help you make your own decision). Write a birth plan so you can see on paper what you’re expecting from your birth. Use your birth plan to ask questions of your care provider during prenatal appointments so you have clarity before you go into labor.

Don’t be passive-aggressive about your desires, discuss them upfront. I’ve seen too many moms simply email their birth plan, or bring it to the hospital while in labor; these types of plans often go unread, and mom is displeased with her birth experience. Your care provider works for you! Have the necessary proactive conversations before you go into labor. You should also register for an out of the hospital childbirth education series to help you resolve communication issues.

“Birth is powerful, let it empower you.” author unknown

Preconception Planning

We often tell mothers to treat their bodies well while pregnant, but what about women who are trying to conceive (TTC)?

This article from MayoClinic.com has some great information about getting your body ready for pregnancy, but there is so much more to consider!

In my mid twenties I was the take-out queen.  I ate frozen pizza at least 3 nights a week, and delivery or drive-thru the other 4.  Cooking was a rarity that occurred on special occasions, and I thought the lettuce that came on my burger was a sufficient vegetable substitute.  For breakfast I’d have a roll with sausage, egg and cheese, or a bagel topped off with cream cheese – if I had breakfast at all.  I’d drink 3-4 cups of black coffee throughout the day, and eat a ton of sweets.  I didn’t think that I was doing that much harm to my body, because on the outside I looked healthy.  Oh, and did I mention I smoked?

As a part of my spiritual journey, I learned to take better care of my body.  I started cooking more often, and even brought my own lunch to work.  Bringing healthy snacks saved me from the drive-thru by giving me something to eat on the way home from work, and the temptation to stop became easier to resist.  And then I discovered free-range and organic food…although I continued to smoke.  Quitting was a tough battle to fight.

Now, when I cook, just about every meal has at least one vegetable, and often it’s a leafy green.  I stopped shopping at big chain supermarkets so my sweet tooth wouldn’t cry out for attention at the turn of every aisle.  I would say that 90% of what we eat in our house is organic, we don’t keep soft-drinks around, and the majority of our sweets are homemade.  It’s definitely not easy to eat healthy in African-American communities; not because people don’t want to, but because there are simply no healthy choices available.  Fruit stands are sometimes far and few between, and those that exist often have fruit of sub-standard quality.  Grocery stores don’t sell free-range or organic, and there are more fast-food joints (owned by outsiders to the community) than bookstores or libraries.  I was the fast-food queen in my twenties, because that’s all that I knew.  If I didn’t have a car, I would be stuck shopping at major chain supermarkets that are within walking distance with very little choice for whole foods.

Why am I ranting about supermarkets and diet?  It all goes back to what we learned as children: you are what you eat!  Eating healthy, staying hydrated and getting exercise are key to getting our bodies ready for the miraculous task waiting ahead.  If you’re TTC, the planning is so much more than charting fertility and falling in love with baby names.  The healthier you are, the better your conception chances.  The healthier you are, the healthier your pregnancy and subsequently your baby.  Don’t wait until you find out that you’re pregnant to get your body together; do the research and holistically prepare.

When my wife and I decided to start TTC, I became meticulous about my diet.  I’m not the biggest fan of pills, so I do admit to not being so great about taking vitamins.  However, I use herbs and try to eat well to give my body what she needs.   Here’s what I eat just about everyday to give you an idea:

Breakfast – oatmeal & almond milk

Snack – fruit

Snack – mixed nuts

Lunch – Soy yogurt & granola, or left-overs, and fruit

Snack – fruit

Dinner – starch, poultry or fish & vegetables

and TONS of water throughout the day.

and I quit smoking!

Not so bad, huh?  It just takes a little planning to treat your body well.  There have definitely been days when I rushed out of the house without enough snacks to get me through the day, and reasoned that stopping for fries wouldn’t be so bad (that is, until I read this article about fast-food decomposition).  But, most days I’m pretty on point.  With perinatal mortality rates where they are in the United States for Black women, we can’t leave anything to chance.  It’s never too late to get it together, but please get it together.

Purple Pushing: Just Say No.

What’s purple pushing (PP), you ask? It’s the moment in labor when care providers instruct you to hold your breath and bear down as hard as you can until they tell you to stop. Often, women are given just a few seconds to catch their breath in between bouts of PP. Some moms, depending on how light skinned they are, will actually turn purple during this stage.

So, why say no to PP? One of the things that we teach moms during childbirth preparation is to breath deeply, but not too quickly, to avoid hyperventilation. Mom’s breathing is the baby’s oxygen supply, and one of the last things we want during labor is for the baby’s access to air being compromised. Why, then, would we want moms to literally stop breathing during the most stressful moments of birth? No coach would ever tell their star athlete to hold their breath before making a play, I’m not sure why we think it’s a good idea for laboring women.

On second thought, PP isn’t about the woman at all! PP is part and parcel of managed care and the belief that someone outside of our bodies knows our bodies better than we do. PP usually happens in hospitals, where care providers have been trained to “deliver” babies of medicated mothers. In the hospital, things must be done as quickly and safely as possible. It fits perfectly into the equation when moms are instructed to push as soon as they dilate to 10, because the process will be over quickly once the episiotomy has been performed and your baby “delivered.”

During natural birth, a woman will feel the urge to push. It’s a natural, normal feeling that lets you know that something needs to exit your body. She will usually feel the urge when she’s fully dilated, but I’ve labored with some women who felt the urge as early as 4 centimeters. However, a mom who is numb due to medication won’t feel the urge to push. She will need to be told what’s happening to her body – when she’s having a contraction, when and for how long she should push. Doctors are taught to work with these moms, and so most moms are treated as though they’ve been medicated when it’s time to push. A natural birthing mom who has been educated and prepared for birth doesn’t need to be told when and for long to push. She will feel and be in communication with her baby.

Imagine, for a second, a comparison. You’ve had a meal, and 45 minutes later someone tells you it’s time to poop. You don’t feel anything, but you head to the bathroom anyway. 5-10 people crowd around your toilet bowl, and instruct you to push under bright lights. Not only are you uncomfortable, but now you’re working against your body that hasn’t yet given you the signal that it’s ready. You will have a traumatic bowel movement, and may even tear your anus due to excessive pressure. On the other hand, you can wait until you have the urge to go, head quietly to the loo on your own terms, and simply breathe out your waste without as much effort. Granted, a baby isn’t exactly the same, but the logic is.

When a mom is on her back, and being coached to PP, the baby is put in danger. Gravity keeps weight down on the baby, and increases the risk of compromised oxygen to the baby by creating pressure on the umbilical cord. This is true before mom even begins to PP. Add to that a mom who is holding her breath, and it’s no wonder that hospital born babies (those born to healthy, low risk mothers) are so closely monitored after they’re born.

Now, if I’m saying, “Say no to PP,” there’s got to be an alternative, right? You betcha! Left to her own devices, it’s extremely rare that a birthing mother will naturally bear down. She may grunt, scream, moan or simply breathe – all perfect ways to push. I’m reminded here of a mom who beautifully groaned throughout her labor, and finally pronounced, “I have you push,” to which her midwife responded, “You’ve been pushing.” The media, even when we think we’re beyond it, shapes our understanding of birth. Mom was expecting someone to tell her to hold her breath and count to 10. Realizing that PP isn’t the only way to push is half the battle.

We can take back our power! If you’re birthing in a hospital, there’s nothing that says you can’t take the initiative and get on all fours if you want, or that you can’t ignore the care providers when they tell you how to push. The key is having a great support system during labor – your cheerleaders who know exactly what you want the experience to be like for you under normal and safe circumstances. Hire a doula, take independent childbirth education/preparation classes, and have a plan for yourself.