Tuesday, March 30, 2010

"Around the World, Down the Prime Meridian..."

As you sleep, Finn, I stroke the world onto your forehead
Circling, drawing the lines of our planet with my fingers
Transferring the love of your great grandfather into your skin
Just as we did to your mother.

"Around the world
Down the Prime Meridian..."

You sleep, your eyes playing beneath their lids
Soaking in the words, the touch.
Are you dreaming of where you were three days ago?

You were hiding behind your brother Jack
Feet down
Ready to make a surprise entry
like a parachuter.

I can't even remember what it felt like to believe
that your mother was having only one baby.
It feels...

We waited that bright Saturday
waited for "the baby"
sitting outside in the sunshine
in the buffeting wind
at a cafe table
outside Capers
where your parents met
We waited
watching two men play UpWords
the same game your grandad and I played
when I was in labour.

Every movement on 4th was a sign

The woman pushing a bicycle
The pregnant women heading
to Semperviva
yoga mats tucked under their arms
Heading to the noon class
where your mother was supposed to be...

...where you would have been
Child's pose
Listening to the music chosen by your mother.

But you weren't at that class
You were with your mum and dad
at home
in the tub
hidden behind Jack
waiting to be born...

...waiting to surprise everyone!

"Across the Equator
Tropic of Cancer
Tropic of Capricorn
North Pole
South Pole
Mount Everest
Mariana Trench..."

You have always been with us
and we never knew it
You have always been part of our bodies
our planet
You have always been...

...Blue Pacific"

Tomorrow I will stroke
the cartography of love
into your brother's face...

(Finn, the hidden water fairy, was only discovered a few minutes after his older brother, Jack, was joyfully born into his mother and father's arms, at home, on Saturday afternoon. Finn then declared his presence, kicking the midwife's hand... "Jack was not alone! I'm here!" Then, over an hour later, Finn, already master of the great entrance, responded to his mum's pushes and came, splash, feet first, before a large audience in the hospital...
Bright surprises can still happen in this world!)

Jacquie Munro - Grandma to Jack and Finn, Vancouver Doula, Slow Birth

Thursday, March 25, 2010

Silence, s'il vous plait...

No words
as we open ourselves to birth

Close your eyes
and feel the whispers of women

No words

Jacquie Munro - Vancouver Doula, Slow Birth

Wednesday, March 24, 2010

Slow Food in labour

Remember my very first client in the 1980's? Vaginal breech? Well, you might remember that I wrote about her stopping off to pick up a hamburger on the way to the hospital. Yes, her doctor was in the car with her, encouraging her to eat. All was well...and boy, was that birth smooth! During my early years as a doula, though, I discovered that the hamburger-eating client was not the norm. Eating in labour was discouraged. "The digestive system shuts down in labour..." "If you eat and then have general anesthetic, you might vomit and then aspirate the contents..."

Way back in 1993, one of the (apparently radical) studies presented at the International Congress of Midwives in Vancouver encouraged women to eat and drink as needed in labour, and argued that it was probably detrimental to the flow of labour to starve a woman during the process. The audience applauded. We thought this would start a movement to allow all low risk women to eat in labour. But, the protocol at most hospitals in our area remained the same. Women were allowed clear fluids only...water...ice chips.

In the 1990's, despite the general recommendation of "clear fluids only" in many hospitals, older nurses (most of them midwives from overseas) would still bring in lunch trays for women in labour at St. Paul's Hospital. I remember one nurse at Lion's Gate Hospital running the bathtub, helping the labouring woman into it, then passing her a big fat sandwich. "Oh, honestly, you need to eat!" she said, hands on hips.

Then, as the years passed, more family doctors would encourage my clients to eat as much as possible before they left home. One client took her doctor's recommendation to heart, and ate 6 scones in the car while heading into the hospital (she gave birth soon after). Another client made sure her husband and I (and her) cleared our plates of roast beef, yorkshire pudding, roast potatoes and loads of gravy, before dashing off to Richmond Hospital. She'd huff and puff and then eat some meat...huff and puff and eat a potato. She also gave birth soon after arrival at hospital.

But, the majority of women in hospital found it very challenging to get any food to eat during labour. One woman became so distressed when she wasn't allowed to eat during her induction. She started crying...couldn't stop...and her contractions disappeared. "I just want peanut butter on toast!" We eventually got an official "go ahead" from her obstetrician. The toast came...she ate...labour started again...and she had progressed from 2-10cm in about 15 minutes. Now, I'm sure not every woman is going to have such remarkable results after eating one piece of toast, but the emotional benefits of being able to eat and drink as needed in labour cannot be questioned.

At home births, women have always been able to freely eat and drink throughout labour. Homemade soup, papaya, omelettes, coconut water...even one client's beloved peanut butter chocolate chip muffins (eaten in the shower)...these are what sustain women. I would love to see a world where there is no difference between home and hospital (I hope I'm not a dreamer!)

So, it was heartening to see that a January 2010 Cochrane review identified no benefits or harms from restricting food and fluids during labour in women at low risk of needing anesthesia (Singata M et al. Cochrane Database Syst Rev. 2010;[1]:CD003930). The authors concluded, “Since the evidence shows no benefits or harms, there is no justification for the restriction of fluids and food in labour for women at low risk of complications. No studies looked specifically at women at increased risk of complications, hence there is no evidence to support restrictions in this group of women.”

Thank you. Now, let's go eat!

Jacquie Munro - Vancouver Doula, Slow Birth

Wednesday, March 17, 2010

Outside of time/The whisper of water unites us

Slow Birth lives outside of time. Women in labour are often supported by caring people who are unwittingly blocking the slow birth process by writing down the time, charting, calculating, commenting on the progress of labour.

We are all guilty of this. We turn our heads to the clock. We look at the numbers on the monitor. We whisper of our own need to eat lunch, dinner, breakfast. We are stuck in time. But a labouring woman needs our help to stay out of her left brain, her 21st century mind. If we help her to labour without time constraints, her autonomy is supported. There is no pressure. She is undisturbed.

What happens to a woman who is hampered from entering her labour trance? What happens when she becomes fixated on time? The more we note the passage of time, the more she might start to calculate..."Okay...1cm per hour...and I'm at 5cm now...that could be five more hours...I can't do five hours!" She may become so anxious that her labour may stall...

But, give her a quiet, cave-like space, the sound of water, and the rhythm of swaying hips - all that will help her to labour outside of time. Add a calm, quiet voice if she likes it... "How about trying the shower again...listen to the sound of the water...listen to the sound of your breath...in...out...live with your breath...you are safe...your baby is safe..."

She steps into the shower. "Oh, this is lovely!" and she has finally left time behind. An hour later, and she is deep in a trance and her birth sounds are becoming deeper. She is progressing. Her eyes are closed. A man sits silently on the edge of the tub. Then the bathroom door opens, and someone leans into the dimly lit space. "It looks like you're doing fine right now. I'll be back in four hours," says a voice, and then it's gone.

"Four hours? Was that the doctor?" cries the woman. "I can't do four hours! That's a lifetime! Does she think I'm so early on that she has four hours to do other things?" The spell has been broken. It takes a long time to help her to regain her trance.

Hours later, a new voice whispers into the darkened shower room, "Oh, what a lovely calm space you have made here. How are you?" "Good...you stay..." It's the doctor, and she stays, silent, sitting cross-legged on the floor, totally trusting the woman. The shower sounds like a waterfall. We are all living outside of time now.

Outside of time/
The whisper of water unites us

And then she's suddenly pushing, standing, aware and present, and, as flawed humans, we are once again guilty of turning our heads to the clock. "It's now minutes, not hours! You are doing this!" And the baby tumbles out into her arms.

"8:12!!!" someone cries.

Will we ever be able to escape time? Perhaps not. We are humans, bound by time. Perhaps we should just laugh at our imperfect attempts to support women in labour, and keep trying to do our best...by turning the clocks around, keeping our words quiet and few, keeping our fears and impatience at bay, and trusting each woman to birth in her own way. Always reaching for a slow birth, outside of time...

Jacquie Munro - Vancouver Doula, Slow Birth

Wednesday, March 03, 2010

Slow Birth Preparation

There's so much expectation surrounding the preparation for birth in our culture. Strangers will ask, "Have you signed up for your prenatal classes? Have you prepared your baby's room?" Friends and family can press all the wrong buttons, too. "You shouldn't even think of labouring without taking the Inner Barracuda Course"...or whatever the prenatal class of the day is called.

I've had three phone calls in the past 36 hours from women whose hearts tell them that they shouldn't take any classes for this pregnancy. "I didn't need to read books before I made love for the first time, did I?" These clients are well-informed women who have chosen great teams for their birth. They are insightful, intuitive, and deeply trust their own bodies. They understand that birth is a triumph of the reptile brain over the analytical brain. And because of that, they are concerned that prenatal classes might hinder their reptile brain from being in charge on birth day. They've thought long and hard, and, for them, prenatal classes aren't the best option.

And I completely support them in their decisions.

A recent client laboured without any preparation for vaginal birth. She had chosen a cesarean for her first baby - a glorious breech baby girl. She had been anticipating a repeat cesarean for her second baby...until she decided that she would cancel her surgery, and just see what happened. After a slight panic over her lack of "vaginal birth training" ("Shouldn't I read some books?!" "Shouldn't I study up on birth?") she went into labour all on her own the next day. It was beautiful watching her labour without expectations, without the clutter of book knowledge. I talked her through each contraction, reminding her that this was something that she already knew on a deep level. She drew on her inner wisdom and breathed through each contraction. It was like watching a preschooler dive into a challenge without fear. She was strong, intuitive, capable.

When her baby was born into her arms (yes, it was a vaginal birth!) she looked awestruck by what she'd achieved. I don't think she'll ever question her own abilities ever again. And she'd done it all without studying.

We're given 9 months to prepare for our baby's birth. In that time, we have to process so much. We have to consider our changing selves, our changing relationships with our partners and families and friends. We have to draw on our past life experiences, both physically and emotionally, to gain the strength and will-power required for the transition to motherhood. We have to examine our family boundaries, understanding that the birth of a child will turn us from being a daughter...into a mother. We will weather the changing emotions of pregnancy, and watch our single girlfriends draw away from us. We will worry about our ability to maintain our core self, to maintain a loving intimate relationship with our partner... We may become overwhelmed by how we are now connected to all living things...to the entire world.

Too much.

And add to that working a five-day week, organizing finances, perhaps moving, perhaps buying a new car, attending exercise classes, yoga classes, buying baby supplies, strollers, carseats, painting, and weekly prenatal classes...

Too much!

I call on you, each of my clients, to slow down, take time to do nothing, take time to empty your brain. Walk on the beach. Sit on a log and meditate. Breathe in the wind. Connect with your baby. Connect with your partner.

If you need to do yoga, go when it pleases you. Or do it at home. Turn on music, sit still, and let it enter you and calm you.

Consider delegating jobs to your family and friends. Give them lists of things to do for you. Ask for help. Many families buy nothing until the baby is born, then have family members make all the purchases and organize the house. Think about how that could give you the joy of release - could you do that?

Read books that speak to you. Poetry, novels, essays. And, yes, it's wonderful if you read inspiring writing by Ina May (and those on my recommended list). Call me for talks on subjects close to your heart. But, don't forget to look at the big picture... watch a TED talk each day (best start with Sir Ken Robinson...then Jamie Oliver) and enjoy discussing it with your partner as you walk on the beach after dinner.

Throw away all lists. Follow your heart. Leave work as early in your pregnancy as you can. Allow your pregnancy to draw you into the reptile world, as it must do.

Rather than following the crowd and doing what everyone else tells you what you should do, think about what really matters to you, to you and your partner, then decide what you need and what you want. What is essential for your new family? Remember, "do nothing" is an option.

Be slow,
Be conscious and conscientious,
Meditatively knit a baby blanket,
Then see if you still need prenatal classes.

Jacquie Munro - Vancouver Doula, Slow Birth