The Birth Paradox

On my first day of Stats 316, my prof said that there was a 99% probability of finding two people who shared the same birthday in our class of 57 people. This is known as the "Birthday Paradox". Well, I think I was hit with the doula equivalent today.

I walked to my visit this morning. As I got closer to the couple's house, I thought, "This is really close to where Julie and Trevor lived then they had their baby in 2001." I walked another block, checked the address...and, it was EXACTLY where J&T lived. The same green house on the corner. I know the bathroom where she laboured...the stairs she walked down as she headed to the hospital. Wow! I know this home has good birthing energy.

Funny thing is...I am working with ANOTHER couple right now who ALSO live in the same house as former clients. And neither of these couples have ANY connection to the former clients who used to live in their houses. No connection...

So...that's TWO repeat houses at once...after 21 years as a doula...after 800 births. Is it some sort of record? Or does it say something about the folding of time, the paradox of time? Or does Jacquie energy remain in these houses?

Let's call it the Birth Paradox.

- Jacquie Munro, Vancouver Doula

Gentle Birth, Gentle Mothering

I've just ripped open my delivery of new books. I love new books. Shiny, unmarked. I have this crazy habit of wanting to keep the books that way, so I never crack a spine. The only book that is messy and crazy bent is my old edition of "Your Baby and Child" from 1983 that is now in the safe-keeping of my daughter.

So, with the packing dumped on the floor, I curled into my big chair to look at Sarah Buckley's book "Gentle Birth, Gentle Mothering". I've been wanting to read this book for a long time. As a lurker on the Maternity Care Discussion Group (MCDG/Matrix) email list, I read Dr. Sarah's posts from Australia and know that I'm going to love whatever she's written. She gets birth. She just gets it.

So, I started laughing when I read the blurb on the back of the book...she writes about "undisturbed birth", the need to surrender, the need to turn off the clocks... Hey, that's what I say to my clients! Those are my words! I've been using these words for over 20 years!

But none of this is ours...it all belongs to birth. Birth, if we listen closely, tells us the truth about us, our bodies, and our minds. Sarah's words are my words because we both listen to birth.

I think I'm going to enjoy this book...

Later...(2/1/09)...I'm still reading Gentle Birth, Gentle Mothering by Sarah Buckley, but I think I'm going to have to make this required reading for clients (with Ina May Gaskin's Guide to Childbirth). Sarah discusses everything that I've been telling my clients for years, but she includes the updated research citations to back it all up. Read the "Undisturbed Birth" section, and you won't look at birth quite the same ever again. It is quite compelling...
Much later...(2/6/09)...I was sad to finish this amazing book, and handed it off to my daughter, Sarah, for her appraisal. I'm getting phone updates: "The gestational diabetes section is great - a bit overwhelming, but her conclusion is priceless." I'll get it back from her and start reading it again...

- Jacquie Munro, Vancouver Doula

Two baby girls in 24 hours

Well...it was a busy day. LL's water broke late Monday night (first baby), but there were no contractions immediately. She said that she'd try to sleep and call me in the morning. Only a few hours later, the phone rang. I answered, thinking that the contractions must have started quickly...but it was LF in labour with her third baby. I knew she was going to be quick, so I crossed my fingers and headed off to meet them at the hospital.

This is always a dance for a doula...two clients at once. I knew I had backup at the ready, but I felt pretty sure that I'd be able to make it to both. I just had a feeling... I decided not to panic.

At about 5am, I was at the hospital with LF. She was at the "I really don't like this any more" point, and feeling more "pushy", and I knew that the baby would be born around breakfast time. My phone rang...it was LL's husband. They'd started contractions at about 3:30am but had held out, wanting me to get a good sleep. Ah...but I was already up and deep into another labour. I reassured them that my backup (daughter Sarah) would be there as my mini-me within 20 minutes, and that I would follow, probably around 9am.

Well, it miraculously worked out just like that. LF's baby came in pretty much one smooth push...amazing...beautiful. The staff were attentive and trusted her through and through (not even a vaginal exam to confirm full dilation - just a trust in the mum's own body wisdom) and the baby came so sweetly.

Not long afterwards, I heard from Sarah, "We're heading to the hospital" (not the same hospital that I was at...of course). I hugged the new mum who was still glowing (can I tell everyone that you're an amazing 50 years young, LF?) and headed through the slippery snow to LL. I found her in her apartment lobby, hugged my daughter, and followed LL and her husband to the hospital.

After a quick assessment, we headed back to their home for extended shower time, then returned to the hospital hours later...and thankfully qualified for a beautiful room (5+cm dilated will get you the "Hilton").

Now, earlier in the morning, LL had told Sarah that she had a feeling that the baby's hand was up near the head. Well...12 hours later...after hours and hours of powerful pushing (we really pulled out all our tricks) we saw that baby...right arm crossing her chest and her hand up by her left ear. LL had managed to push out that baby, despite one of the more challenging compound presentations ever. She DID IT!

Two triumphant mums. Two beautiful girls. One thrilled doula...who tumbled into bed exactly 24 hours after she woke up. What a fabulous day!

Thanks to all the amazing staff who went above and beyond to help these two mums have the best experiences ever. And to the amazing doc who helped us squeak out the "let's think outside the box" baby...you are truly gifted. Thank you for trusting birth - completely.

- Jacquie Munro, Vancouver Doula

Myth #783 - Birth is Scary

After she had her baby the other day, this new mum said, "You know, once you're in it, labour isn't scary! You just do it!"

I have so many clients who have carried the fear of childbirth with them for years and years. Some even postpone the event for as long as possible, just because their friends (or families) have told such horror stories over the years.

I tell my clients that our bodies aren't going to spring something TOTALLY NEW on us when we're in labour. Birth is something you know! Contrary to popular belief, labour really feels like period cramps, low down, way down there, NOT all over your body. And it comes and goes (unlike period cramps which are continuous and can last for days). Yes, it gets very strong, but, as long as the birth is normal and you have continuous support, it is totally do-able (not totally fun). (Remember, the World Health Organization believe that 10% of birth should be cesareans, no more. That means that 90% of births should be "do-able".)

Surprisingly, labour can be frustrating, even BORING, at the beginning. Your body hasn't taken pity on you and started the endorphin surge yet (ah, when it comes, SO good). Until those endorphins kick in, you're fully present, fully raw, feeling and thinking and using your left brain (nasty left brain). You start to think, "If it's like this now, I'll never be able to take it when it's 10 times worse." It shouldn't be scary if your doula is talking you through this part on the phone, or popping over to your house, if necessary. But, hang on, if birth is undisturbed (that's the key!), then it never gives you more than you can bear. Active labour begins, your endorphins kick in, and your body goes into auto-pilot...no thinking...you just "do". And you can do it!

Your friends probably found labour scary because they didn't have the assistance of a doula or midwife, didn't have an undisturbed birth, didn't work through their fears in advance...nine out of ten times you'll find that the couple were on their own, left to stumble through it alone. Now that's scary!

So, the other day, we headed to the hospital when her contractions were close together and very strong. Bloody show - check. Feeling pressure - check. Contractions palpate as strong - check! She was at the "frickety! frickety!" stage (as one mum described it). She loved standing by the sink, both at home, then at the hospital. We got through the passing request for an epidural (always happens at 5cm) and out the other side (I was thankfully backed up by our amazing nurse). As her labour progressed and the endorphins kicked in (big time!), her face became smoother, she began to sway her hips, she became calm and quiet. The lights were low. It was beautiful to watch her labour progress undisturbed. I knew everything would be fine.

This is a woman who had thought that labour would be very scary. But, with support, she found that this was something that she'd done so many different times over her lifetime - labour was a challenge which she could meet. She had the mental fortitude, life experience, and the tools at hand. Birth was something she knew. I don't think she'll be scared about anything again.

Crashing through our fears and our cultural myths is what's scary - Birth isn't.

- Jacquie Munro, Vancouver Doula

The Girls!

Man, I do love working with clients for a second (or third or fourth) time!

I get to really connect with the mums, dig deeper into what makes them (and their labours) "tick", and watch the emergence and transformation of a mother.

I love the postpartum visit, where I always manage to have a tea-party (or, in this case be presented with a wooden mixer and a plate of wooden toast, wooden egg, and a special spoon) laid on by a little sparkling one in a tutu, play a song or two, and hold a crying baby.

It's a wild and wonderful visit with lots of laughter, and tears so close to the surface that you can almost touch them.

I love to see these mums finally understand that their first (typically LONG) labours were just normal for them (and their baby) on that day (no one's fault, no guilt, it was what it was)...and that their second labours were glorious life-affirming gifts. What healing! What depth of understanding comes at this time!

No wonder we're all smiling (all except that wee one!)

- Jacquie Munro - Vancouver Doula

And Charlie makes it 800!

Welcome to Charlie, the bonnie lad who has the honour of being my "800th baby"!

His mum was amazing, surprising even herself with her stamina, strength, and power!

His dad surprised himself at being able to stay in the room!

No interventions, no nothing, what a thrill!

- Jacquie Munro, Vancouver Doula

Van"cool"ver?

I was driving home from visiting clients yesterday, and the CBC radio host was talking to a guest, asking if she lived in Van"cool"ver. It made me laugh, but it also made me think about one of my clients had been talking about her experiences at a Mum's Postpartum Drop-in. The women she had described sounded just a little bit to "cool" for a brand new mum to embrace.

I mean...imagine you're a brand new mum...you've made the first trek out after being trapped in your house by the snow for WEEKS. You've been looking forward to this first drop-in mum's group - "Maybe I'll meet some new friends...and we can go out for coffee...our kids can have fun..." You get your baby tucked into her stroller. You dream about how great it could be as you sweat and grunt and push that stroller through the snow and ice.

Then you arrive, feeling pretty good about yourself. It's the first day of the new class... You look around, still unwrapping your scarf from around your face - and you realize that everyone there looks like they know each other. You realize that you're the "new kid".

Inside jokes are flying back and forth. One mum suggests to the group that they all trek over to the North Shore to take in a "Mum and Babe Snowshoe Trip". "They even have a breastfeeding tent!" Another mum turns and asks if you know any new spelt recipes...

Van"cool"ver is right. And now you've lost all the happy expectant energy that you had...

Now, I know that there's a point in the life of a new mum where things have finally fallen into place, and you can happily head over to Cypress and strap on those snowshoes. That's fantastic! But should you (with your seven month old) be in a newborn drop-in class still? Or, if your talk about snowshoeing is masking your inability to cope, and you still really need the support, could you please spend some time including the new mums in your conversation? Those new mums would really appreciate it.

I have to thank my best friend of 25 years for being that stranger, that veteran mum (her daughter was a whole 5 weeks older than mine), who welcomed me with open arms at my first drop-in. She had just watched my daughter throw up ALL over me (I mean, drenched!), and saw the look on my face. She came right over and said, "Would you like to come over to my place for tea and muffins afterwards?" Her invitation made me smile, so I just grabbed a receiving blanket, and mopped up the mess without a bother.

My mum's group got me through many months of struggle. We started out as a diverse bunch of strangers, and then became friends. The veteran mums told me to turn on the fan over the stove - great white noise to help the baby sleep. They helped me negotiate the emotions of those first few months. They'd come over to my house, and we'd sit on the kitchen floor, watch our babies learn to roll over each other, and burst into tears at random points - but it would be okay....better than okay...it would be wonderful. We graduated from the mum's group when it was the right time to go, and organized our own group play-dates for another few years.

So, to the new mums who didn't take notice of that new mum in the corner, didn't notice that she'd been really courageous that day, didn't notice her personal feeling of triumph after making it through the snow to her first mum's group...please say "Hi" to her next time - she's quite amazing! I was her doula, and she was powerful in labour, and is a wonderful mum. She's just not ready for baby snowshoeing or spelt...yet.

Haiku

The birth cry
between my thighs/
stretches into budding tree darkness

Mikajo Yagi (1924-)

On Keeping Tidy

Myth #3297:
"You shouldn't have a home birth because it's too messy!"

One client's mother, a surgeon, was concerned about her daughter's decision to have a home birth because, "I walk around the OR with my boots covered in blood, dear. It would be SUCH a mess!" I asked her if we walk around our houses during our periods with our boots covered in blood. "Well, no," she answered. "That's silly. We wear pads or tampons." After her daughter's home birth, the surgeon Grandma was amazed..."I guess it's the docs that cause the mess!"

Well...labour at home (even when planning a hospital birth) is clean because we are used to keeping clean when we bleed on a monthly basis. Labour is no different. And, for some reason, women seem to lose WAY less blood at home births - a matter of fully functioning hormones, perhaps?

I think of all the clean and tidy home births that I've attended over the years, and compare them to the memories of some messy (read "gory") hospital births that I've seen. Women just don't realize how fun it can be for the doula and midwives to keep a house tidy during a home birth. All the supplies are laid out on a table (basically, like a modern Mary Poppins, the midwives open their bags and bring the hospital to your home) and two large bags (one for garbage, one for laundry - see photo) are at the ready. The woman in labour wears pads, uses the shower or bath to stay clean, and we make sure the bed is double-dressed with good sheets (for a glorious postpartum - see photo) under waterproofing. Within an hour of the birth, the bedroom looks like it does in the second picture.

I make sure that, by the time the woman has finished her post-birth shower, I've provided the "turn-down service," any dirty dishes (from the post-birth lasagna) are in the dishwasher, and any dirty towels or clothes are in the washer. The joyful swish-swish of the dishwasher, and the thrum of the dryer even sound clean. Family members can come for a visit and not believe that a birth took place right in the middle of the living room!

Hospitals can afford to let the birthing rooms get very messy - someone else is going to clean up (though I do try to make sure that things are tidy throughout - I'm a neatnick!) Floors can be sanitized, and sheets are just thrown into the hamper for industrial cleaning. No one gets into trouble for tracking blood/fluids all over, and the placenta just hangs out in a bowl on a table (not fun for visitors!) (Notice that I'm not going to start a discussion about the possibility of infection at the hospital.)

I've attended some rather impromptu home births over the years (a speedy labour with no way to get to the hospital in time), and have managed to keep things together with just one Canadian Tire waterproof blanket (right, Laurel?) Chuck the blanket away and the cleaning is all done!
And, no...you don't have to clean up after yourself! Just one client tried that. We caught her on hands and knees, half an hour after birth, cleaning the tiles in the bathroom, "so the dog won't know I had my baby in here!" She was just supposed to be going to the toilet!!!

So, let your decision to have a home or hospital birth be based on information that matters. Where would you feel the safest? Just do your homework, then know that, if your baby is born at home, all will be tidy, and your bed will await. You will just have to walk to your bed, and climb in - it might even have a chocolate on the pillow!

Rituals

When my daughter and her husband were married, a strand of beads was held in their hands. From a crystal bead that came from Great-great Grandmother Sarah's necklace to a stone from their favourite beach, each token holds a message from those who will support them in their marriage.

Just like birthing beads in Africa, where each woman attended by a midwife adds a bead to the midwife's strand, increasing its power and significance, this strand of beads gains its power from the wishes and love of each person who contributed a bead.

I have always loved ritual. As a child, I was more in love with the ritual of the Anglican church service than the Christian faith itself. I loved the music, the chanting, the link with history. When the church dropped the Book of Common Prayer and the use of Latin in daily service, I was ready to leave. I had to be content with the occasional trip to Europe, where, slipping into a Catholic Mass in Rouen, I could feel at home and recite the Latin words without thinking. In labour, I sang the Gloria without even realizing what I was singing. The ritual of recitation (not the faith) brought me strength.

In labour, these remembered rituals can be so potent. I often hear women in labour singing old hymns or songs or nursery rhymes in the shower. Women often revert to their mother tongue in labour, even if they've been speaking English for years. A Ukranian nurse shouting in the hallway has the power to make a woman from Kiev smile and relax. Sometimes, hair brushing, just like a mother will do for a child, will be the link to the past that calms a woman in labour.

At a cesarean birth long ago, Tibetan monks brought in a fuschia-coloured silk scarf, or kata, that had been blessed by the Dalai Lama. That was the first piece of cloth to touch the baby after birth. The OR was transformed by this ritual. The walls seemed to fall away...the surgical steel disappeared. All that seemed to remain was the baby, shining in the light.

Birthing beads, a mala, a blessed kata, a song, a whisper in the ear...these rituals mark our important life events. I wonder what rituals my own children will use to mark the birth of their own children...what rituals I will witness at the births of my clients this year... I wonder.

Summertime...and the living is easy...

It's still snowing outside, so I'm just going to think ahead to the summer. I'm really sad (but, oh, so happy) to say that we'll be away in Scotland, England, and France from August 3rd until September 8th.

Returning clients have already started to call for the month of August, and I've had to break the news gently. I do hope that any other returning clients who are due in August will still call and use me as a resource (I'm always here for you to call!) But, you may want to consider working with my favourite midwives for this pregnancy! You'll be in amazing hands.

- Jacquie Munro, Vancouver Doula