Wednesday, March 25, 2009

Dare to be different

Okay...this is starting to become a real pattern...

After each birth, the lovely nurse sighs and says to my client, "I haven't seen a birth like that in ages. Thank you!" Well, actually, yesterday's quote (by a British nurse) was, "I haven't seen a birth like that since I came here!"

Then, I ran into a nurse who had helped us at a birth last week, and she still was in shock that my client gave birth standing. "I tried to get her back onto the bed, I ASKED her to get on the bed, but she just didn't! I had to think, how am I going to do this, where's my stuff? I hadn't done anything like that before!"

"Oh, come on," I said. "You're creative! Wasn't it good to think outside the box at work for once?"

"No!" She was laughing while she said that, but she really had been outside her comfort zone at the birth. Why didn't she embrace something new and dare to be different? (Understand that she is otherwise a fabulous nurse, and really never let on that it was outside her comfort zone to my client...great diplomacy!)

I checked my client stats since October 2008 (26 births). There have been only three cesareans (11% - one breech, one face presentation, one true fetal distress). The rest have been water births, standing births, hypnobirths, squatting births, hands and knees, side-lying, etc. Some just had one vaginal assessment, some none at all. A few (18%, which includes the cesarean births) had epidurals (that had been their plan all along). The rest (82%) used water, movement, singing, TENS, dancing, and, for some, just a little bit of nitrous oxide gas, to help them through labour. Their ages ranged from 30 to 50 (yes, 50!)

Isn't the hospital epidural average well over 80%? (Must check recent stats...) Anyway, it's not 18%!

How do we do it? Well, I do have clients who are able to eat well, go for long walks, stay fit. But they're not really much physically different from most women. And...they all have their own anxiety, fears, and baggage. Some have battled emotional demons, and some have overcome physical and sexual abuse.

What I offer is the long, slow approach. I try to work with my clients over many months (slowly building trust), talking to my clients about the most recent research on mothering, birthing, parenting. I find out about their lives, what drives them, what challenges them. I ask them to call me whenever they are worried or scared, or whenever they just want to have a good chat. A phone call that starts with us talking about diapers, might end in her telling me that she was abused as a child, or has battled depression, or that she hasn't yet told her midwives that she's seeing a psychiatrist and is on medication. I help my clients to feel and know that they are safe. We trust each other.

One recent client went from "I really want an epidural" at our initial interview, to using hypno-birthing...and laughing and chatting as she entered the hospital at 8cm.

Another client went from having post-traumatic stress symptoms and battling depression and anxiety, to a home birth with joy.

And yesterday? Well, this woman had a lovely slow birth. She was another who dared to be different. After about 14 hours of deny-it cramping, she asked me to come just after 2am. We spent the next 9 hours with her on the ball, in the bath, in the shower, back on the ball, doing walkabouts, climbing the stairs, lunging, swaying, swirling. That's 9 hours. No, we didn't bolt to the hospital. She was confident in her and her baby's safety. She had a loving partner who stuck by her through it all (and who I could reassure throughout). I talked her through most contractions (except in the bath). " are safe...your shoulders are loose...your muscles are melting...your bottom is is wiggling down...your hands are soft...your face is soft...your legs are heavy and warm...soft..."

We waited until we had counted off at least 5 hours of good regular contractions under 5 minutes. We waited until she'd had significant bloody show (not mucous plug!) We waited until she'd had over 2 hours of self-described "8/10 power" contractions (up until then, her 3-minute apart contractions had been at 5-7/10). We waited until she was moving, almost dancing on her tip-toes during each contraction. We waited until she was deep in a trance of endorphins. We waited until she was just beginning to feel a hint of pressure in her bum from the bulging bag of waters (we didn't wait until it broke, but we could have waited, if she wanted.) We waited until she said she was ready to go to the hospital.

Then...she said the word, and we were ready to go. But then, we had to wait until all the shrieking children in the school-yard across the street had gone back into their classrooms after recess! the hospital. 7cm. That number scores us the good rooms upstairs. Into the bath, then walkabout, the birthing ball...and back into the routine that we had at home. "Soft, you are safe, your baby is safe." And infinite patience. And a partner by her side. Throw in a lovely British nurse who moves silently and gently. Add a young family doctor who intuitively respects a patient's need for autonomy. And then we stay by the woman in labour, and trust her, and trust her baby, and trust her body...and wait. One hour. Slow. One hour. Slow. One hour. Gentle. Slow. And, right on cue, she starts to feel the baby coming. An hour and seven minutes later, out emerges a beautiful pouty face...then oh! a little hand...then a smooth vernix-covered body. Hands reach down and baby Maggie is on her mum's chest!

And then it comes, the nurse shining and smiling, finally happy..."Thank you. I haven't see a birth like that since I came here!"

That was a first baby who dared to deny the hospital statistics. She had laughed at the almost 30% cesarean rate, the 90% epidural rate. She was undisturbed, unmedicated, and was given a slow and gentle birth.

We owe it to our children to dare to be different. This changes lives, and it IS worth the effort.

- Jacquie Munro, Vancouver Doula, Slow Birth, Slow Planet


Anonymous said...

Thank you for your post- the last story lifted my spirts and encouraged me no end. I'm a British trained doula practicing in Israel. Brilliant! x

Rosie said...

Thank you Jacquie! I hope you write a book someday. Please thank this good mama-woman-strong birth warrior for me. - A mom and doula in San Diego, California

Kathleen Brannan said...

i love how you write jacquie! i still remember you chanting "low low low low" to me when regan was making her way into the world. you are such an extraordinary person!

Taryn said...

This is wonderful! If only all women dared to be different and trust a slow birth. :)