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Posts Tagged ‘Medicine’

I’d like to order one epidural in the parking lot, please.

Friday, February 13th, 2009

During our initial phone call, many first-time mums nervously giggle, then ask me if I can just order them a fast birth “and one epidural in the parking lot, please.” It sounds like a drive-through order.

“Why?” I ask myself. Really fast births don’t allow the body to churn out all those wonderful pain-relieving endorphins (boy, do you want them!) Fast births don’t allow any time for the brain to keep up with what the body is doing. Actually, my least satisfied client had a 45-minute labour and birth. She said, “I waited 40 years to give birth, and THAT’S IT??? It was so fast, I missed it!”

Fast births may increase your level of fear, resulting in a greater likelihood of heavy bleeding, and many other complications. And fast births certainly don’t allow any time for your order of “one epidural, please”, even in the parking lot.

So, what to do? Wouldn’t you rather have a birth that’s just right for you? Not too long, not too short, just right. Kind of like the chair, or the bed, or the porridge in The Three Bears. Just right.

Isn’t a lovingly prepared meal that’s simmered on the stove much better than fast food? It’s harder work, there’s some prep time needed, it takes more time to cook, but it’s SO worth it.

We’re given nine months to prepare for birth - a good long prep time. But so many people just fill that time with classes and shopping and renovations and new cars and new homes, and paint (always paint.) All this, for one tiny being who just wants a warm body to hold him, and a couple of breasts!

Women often forget to take long slow walks on the beach, doing the inner work of pregnancy. Old fears, habits, and family dynamics bubble up as each week progresses, and need to be addressed. After twenty-one years of attending births, I see that unresolved issues can often stop a labour in its tracks.

One woman made it easily to the pushing stage, then everything stopped. No matter what she did, there was no urge to push, nothing, for two hours. After a while, the doctor said, “We’ll just leave. You might be worrying about something, or have something to work through. Why don’t we leave you alone with your partner for a while? Just come get us when the baby’s coming.”

We were called back half an hour later. She had been holding onto a secret since the age of 15. Once she released the secret to her partner, the baby came in just a few pushes.

The hormones at play during late pregnancy and labour have taken millions of years to develop to perfection. Hormones soften the body, making the joints feel like they are attached only by elastic bands. The uterus becomes more responsive, letting each woman know if she’s done too much that day, or not had enough water to drink. Women start to wake up more frequently in the middle of the night, in preparation for those moonlit nights with the baby.

The baby is an active partner in the birth, burrowing and stretching. One woman the other day said that she kept imagining a cartoon mole, pressing and wiggling deeper. Other women have said it feels like a pearl diver, pushing off the side of a rock, diving deeper.

Each labour takes as long as the body needs. Time is needed to allow the hormones to work, in concert, undisturbed. If there’s a slow beginning to labour, the body has its own reason, or the mind is keeping a lid on things.

Yesterday’s birth was another amazing story of trust and slowness and, ultimately, surrender. (Months earlier, she had been interested in that epidural in the parking lot, but she had educated herself, and now she wanted a slow birth.) She started to feel things a few days before the baby finally came. With the help of long phone calls to me, pep talks, warm baths, lots of distraction, and good food, she made it through the days.

“This is not labour yet,” I kept reminding her. “Think of these infrequent cramps as your new normal.” She used her hypnobirthing techniques of relaxation and fear-release to accept the pace of her body and baby. We talked about the logic of the body, what to expect, how endorphins work, how all the hormones work in concert to move her through to the birth. She leaned on her loving partner to lift her spirits. When he needed a boost, he called me. “Jacquie, what do I do next?”

Then, in the afternoon of the second day of prelabour, she called again. “I’m getting discouraged.” She was finding it hard to surrender to the process. I encouraged her to move, to crank up the salsa music and dance, swirl her hips in the shower, to let go. I encouraged her to trust her body, to release any tension, and let the baby come.

An hour later, I called back, because I had the feeling that something new was happening. She said, “Something’s happening!” (Yay ESP!) So, I drove over quickly. She was really in labour now.

I found her at home, smiling and calm. “I’m at peace.” Her dancing and swirling had moved her into active labour. She was finally able to accept and surrender to the “surges” that were coming every three minutes. Within an hour and a half, we were at the hospital. She was already 8-9cm, and ready for a lovely soothing bath.

“Gotta get one of these tubs,” she said, as she laboured in the water. “I feel confident. I feel safe. I feel secure,” spoke the hypnobirthing tape from the corner of the room.

Four hours later, the baby was born. Quietly. Slowly. Gently. A lovely pink bundle of a baby girl.

SlowBirth, or doing it the “Old School” way

Monday, February 9th, 2009

I was in a local “lifestyle” store the other week, standing stock still, looking at a phone that reminded me of the lovely, heavy black “old school” phone that we had when I was little. You know, the one with the rotary dial that, when you dialed 911, took such a long time for that 9 to rotate. No wonder North America didn’t stick with the British emergency code of 999 - the emergency would have been over before the dialing was done.

So, there I was, in a trance (yes, I’d been up all night at a birth), thinking about my low-tech childhood in the ’60s and ’70s, how I skipped to elementary school in my skirt and walked through an old door marked “Girls”, and how my parents decided that it was totally unnecessary to have any of the new high-tech things that were starting to come into the stores (they made it through the Manchester blitz in WWII, so they could do just fine without, thank you very much). 

I remembered that we shared a party line (Watergate for kids), had no answering machine, no voicemail, no calculators, no computers, no videos or DVDs, no recording devices, dishwasher or washer/dryer. We just had one little black and white TV with rabbit ears, a clothes line, and a hand cranked mangle to make life easier. Our car was so slow that we had to have a police escort whenever we drove through our local tunnel. Mine was truly an “old school” childhood - life was slow, and time was our ally.

I finally realized that people were starting to notice me, staring at the old black phone.  But, I didn’t care.  I was in my post-SlowBirth zone.  I walked out of the store, and started to remember the birth that I’d been at through the night, and the day before, and the day before.

Seeing the phone had triggered a memory-tumble, which ended at some multi-coloured cut-out letters pasted onto a window at Women’s Hospital - “I DO IT OLD SCHOOL - ASK ME HOW”. I had kept those words in my head as I helped a client through an almost 48-hour unmedicated, uncomplicated “SlowBirth”. After 31 hours at home, hours of showers and dancing, walking the dog, giving/getting back rubs and marching the hallway, we had finally headed to the hospital. 

At the labouring mum’s request, the tools at hand were our hands and eyes and ears and wisdom (other than me, my client and her husband, “we” also included our nurse and the family docs who had the guts to turn their eyes away from the clocks, and go “old school”). Time, on this day, was our ally, for we needed a lot of it to accomplish this woman’s goal. The high-tech equipment didn’t seem to know how to behave with us. The blood pressure cuff kept pumping itself up even when no one was there, and that brand-fangled-new monitor didn’t work as well as the older doptone, so it was turned off.

Things were kept as simple as possible. We left linear time. The mum was dancing in the shower, rocking and rolling on the birthing ball, just one contraction at a time, one breath at a time, listening to music. To get rid of a puffed-up cervix (kind of like a fat lip) at 9 centimetres, we had her lie on the bed with her feet higher than her head (no epidural necessary) and gave her LOTS of encouragement. We used hip squeezes, hip shakes, swirling and spiraling, visualization, trance-inducing techniques, foot rubs, squatting, kneeling, walking, tears, hands, eyes, and love, liberally (then repeated). Her body’s endorphins helped her to sleep and dream in between contractions.

This amazing labouring woman drew on all her past life experiences (with the aid of a few sherpas), and did what all women have the power to do, climbed the highest mountain ever, and birthed her baby with arms outstretched to touch his body.

And when that baby came, it was pure joy! No exhaustion, just sparkling laughter and smiles and a giggling shout of, “I’m as high as a kite!” (love those endorphins) and an eager, wide-awake little boy who came out with his meaty fist stretched to the sky. Ahaa! That was the culprit! His little hand had slowed things down.  By taking it slow, and using time as their ally, this little man and his mum had worked it out.

When the bustling pediatrician came later to say “Hi”, she actually bowed down before the new mum, saying “I am not worthy.” The doctors all agreed that, if any drugs or technology had been used, it would have been a different story.  Mum and baby would have been in the OR, having a cesarean. All the nurses on shift that day were in awe, knowing that there’s a new initiative in our local hospital to reduce the intervention and cesarean rates by encouraging low tech/high touch birthing, and wishing that they could have seen how it was done.

I am in awe of the couple at the centre of the whirlwind, this vortex of birth. I thank them for trusting in birth, for trusting in the body, for trusting their baby, and for trusting me to calm their spirits and their wild eyes, whenever I’d say, “It’s fine, it’s normal, you are safe, you can do it, just take it slow.”

On this day, I think all three crossed the portal, the “Old School” way. They had discovered SlowBirth.