Wednesday, January 31, 2007

"We go intertwined..."

Hello Jacquie,

I have been thinking about you today so I thought I would email. Today I was especially amazed by the miracle of Ethan and the amazing little person taking shape before my eyes. I was just on your website reading your wonderful writing and I realized what gratitude I feel for having had your warm presence at my labour. I will never forget the feeling of your sure hand on my foot. Just recently I find my mind wandering back to Ethan’s birth and wanting to dwell.

Well, Jacquie, I hope you are well and it amazes me that every day of your life is spent supporting, and surrounded by, the beauty of birth. You are truly blessed.

- Jolene

Thanks to Amber Hughes for this photo.

Friday, January 19, 2007

Expectation (ek'spek-ta'shn)

1. a. The act of expecting. b. Eager anticipation: eyes shining with expectation.
4. Statistics b. The mean of a random variable.
Hmmm... I love the various meanings. It suits labour and birth, doesn't it? People even say, “She’s expecting...” when a woman is pregnant.

So, is expectation a positive or a negative thought process? Does it help us to realistically anticipate the event? Or can it set us up for the possibility of failure and guilt?

One thing that I discuss with clients are their anticipated “roles and expectations” - of themselves, of each other, and of their caregivers. Clients share their dreams for birth, however varied. Then we compare their expectations to the many potential realities.

One woman said her expectation was to have me provide her with a perfect birth with no pain. Another expected that she would have to fight the medical staff to have her wishes honoured, so she presented me and her doctor with a hard laminated birth plan which included her wishes for an enema, early epidural, and episiotomy. Another client expected to hear “angels singing” at her home birth.

How could I work with each woman to bridge the gap between her expectations and the potential reality while honouring previous life experiences and addressing her current needs? I had to gently help each woman to see that, while she could have some control over her environment in labour, she ultimately had to open herself up to the “wild card of labour.”

Labour is all about surrendering to the power of our own body, letting go of expectations, and accepting the “mean of the random variable.”

So, you probably want to know what happened to these three women...

The first woman also happened to be a therapist. I told her that I was uncomfortable with the pressure of her expectations. I said my role was only to support her, to help her gain the strength to make her own decisions, to have the birth that SHE was meant to have - not one that I “provided” for her. Together, we drew up a worksheet covering our expectations of each other, and our roles. We expanded the worksheet to cover all her family, friends, and caregivers. The understanding which grew out of this worksheet - which became an amazing collage-like venn diagram - led her towards a better understanding of herself, and, ultimately, a 4-hour labour which was mainly spent in her hot tub.

The second woman had suffered a life of abuse. She had also been in foster care as a child, and had never felt the power of autonomy. I told her that I would honour her wishes, and trust her to make good choices in labour. I said she might only want to make one change to the birth plan (she furrowed her brow,) and add the sentence, “It is a woman’s prerogative to change her mind.” She laughed so hard when I said that. She wrote the sentence at the bottom - in indelible ink.

On the day of labour, she was so happy and open. She knew she could trust me, and the others around her, to honour her wishes. She found that she actually enjoyed labour (it was hers and hers alone) - and decided to NOT have an enema, NOT have an epidural, and NOT have an episiotomy. She trusted her body and her own ability to make decisions - and to change her mind. She said afterwards that, because she knew she could trust us, she could let go of her expectations, and it had changed her life.

The third woman...well, I had to tell her that home birth is a testament to a woman’s trust in her body...but...

I also had to tell her that we often imagine home births to be like “A Child’s Christmas in Wales,” full of nostalgia, angels singing, flickering candles, and beautiful music. But we have to open ourselves to the possibility of it being a lot more like Christmas when you’re grown up - no Santa, no angels singing, no fuzzy nostalgia. More often than not, it’s just like real life (which is why I love home births,) complete with the noise of the garbage truck in the back lane, the phone ringing off the hook, dad running up and down stairs to get an extra heater or an extension cord, the wheeze of the hot water dispenser, and lots and lots of raucous laughter. She said that she hadn’t thought of that possibility at all, and thanked me for opening her up to another perspective. She said that she would let the day be what it was meant to be, and let go of her expectations.

...and on the day of her labour, I put the lasagna in the oven, ran upstairs to be with her as she laboured in the bath tub, walked over the crinkly-sounding plastic covering the carpet...and I heard her humming...

“Well...whaddyaknow?” I thought to myself. “The angels sang!”

Yes, what do I know?

Birth is unknowable.

It defies expectation.

- Jacquie Munro, Vancouver Doula

Friday, January 12, 2007

Walk into the cold with your scarf on

Each birth has a central memory upon which all the others cling. Last night's birth has a central memory for me which sums up the power of this amazing woman having her first baby - cold night, crunchy snow, coat on, red scarf over her head, 7cm, keys in hand, "I'm going to the car"...


Just goes to show that you never can tell how it will all go - nine and a half pounds can be hard, but on some nights, it can just be like butter and slide easily and gently into the night.

The human body is a miraculous thing.

Saturday, January 06, 2007

Room 8

Was it just this week that I attended two labours in Room 8 at BC Women’s? Was it just this week that my daughter came with me for the first time to attend a birth?

Midnight on New Year’s Eve came while we were in the assessment room, during a contraction. Nurses blew horns while my client laboured. The nurses station was laid out with food. It was surreal.

Throughout the labour, my daughter held the space like women did a long time ago - knitting, crossed-legged, low to the ground - bearing witness to this sacred event.

Eighteen hours later, after many challenges and hard decisions, Samantha was born - all 9lb6oz of her. The sound of her mother’s voice the next morning will remain in my memory - “She’s beautiful! I feel wonderful! You should see her!”

Then, the next day, another client, 4+ days after her water broke, agreed to an induction of labour. The telemetry monitor afforded her great freedom of movement - to the shower, walking, leaning, kneeling on the same mat on the floor where my daughter had been knitting - as she danced the baby through her pelvis.

After another day and a half of unflagging effort from mum, and the loving support of her midwife, nurses, doula, and partner...she decided that the obstetrician needed to help her baby find a way out. And 10lb Thomas was born...

Two bonnie babies - two cesareans. Two new mums who need to be reassured that they made the best decisions that they could on the day, that they used the tools at hand effectively and wisely, that they can still trust their bodies and their babies.

The cesarean rate at the hospital was 37% for this past month (December 2006.) Typically, my clients’ yearly cesarean rate is 10-15%. In the past month I’ve attended 6 births...1 at home (8lb), 1 quickly at hospital (7lb4oz), 1 forceps birth (9lb6oz), 3 cesarean births (8lb11oz, 9lb6oz, 10lb.) Can we draw any conclusions from these numbers? You might think so, but I really don’t know. Each labour is so different. Each baby comes out exactly the way he or she is meant fit their personality and life path. We can do everything in our power to keep birth simple, calm, and wise, but ultimately, we must bow to the baby’s wisdom and honour their messages.

As parents, listening to our children and respecting their needs can never start too soon...