Vancouver Doula (...and Slow Birth)

The challenge of slow birth

2012-01-19T18:56:00.000-08:00

I spent today delivering the new Slow Birth doula cards to different practitioners' offices. One supportive physician read the words "slow birth", and laughed - "Some of our doctors won't like that...they're always talking about births that are progressing too slowly!"

...slow...birth...

These words might prove challenging for some people.

I am an example of Slow Birth. This is my 25th year as a doula, and I will attend my 1000th client's baby's birth this year. And I think maybe, just maybe, I'm starting to understand birth. It has been a slow gradual process. Each birth teaches me what I need to know for the next birth. Birth forces me to slow down, then stop, then really look at it. I feel like I'm just starting to fully appreciate the nuance of birth.

It shakes me and demands my respect.

I have heard some people say that I know birth. I don't. None of us can truly know birth, because each birth is totally different. But, I know this much - Birth takes its time. Birth is challenging in every way. Birth doesn't respond easily to control or what we want. Birth loves surprises.

...slow...birth...

So, think about it. Slow Birth is not about having a slow labour, or having a fast labour. Slow Birth is about honouring birth and surrendering to the rhythm of the body and the baby.

Slow Birth reminds me to take whatever time is needed to prepare each family for the early years of parenting. This takes time. Time on the phone. Time in person. Time texting back and forth. Time talking, laughing, crying. Every client requires a different approach. This is not a conveyor belt. It's not textbook. It is a creative process. It is bespoke. It is organic. It is slow.

As a Slow Birth doula, my job is to remain aware, to remain flexible, to read the body, to translate its messages, to listen to each woman and family, to remind each woman that she can trust her body, to help her draw on her life lessons, to help her build her own community.

Slow Birth, as an extension of the slow movement, is my commitment to each doula client and her family to nurture stronger connections, and to discover each family's pace, each family's needs. Slow Birth is about supporting the birthof each family with time and care. Ultimately, the aim is to help clientsbuild their own connections within their community, slow down, and enjoy thefirst years of family life together.

Whatever is needed...as long as it takes...that's what Slow Birth is about.

- Jacquie Munro - Slow Birth, Vancouver Doula

On Surfing...and Facebook...

2012-01-03T17:45:00.000-08:00

Googling during pregnancy can be a big bad scary activity. For sanity's sake, I encourage clients to avoid general googling of pregnancy topics at this time. I do, however, encourage clients to become informed about birth, breastfeeding and parenting. How can you filter all the information? My favourite books and research resources are linked on my site, so that's a great place to start.

But, another easy way to have a steady flow of current research and opinions and an overview of "best practice" is to "like" some of the great sites below on Facebook. And don't forget to bookmark the best birth and parenting websites that I have linked in the sidebar (for those burning questions at 4am!)

In no particular order, here are some recent articles/sites/videos that I recommend:

The Alpha Parent The Timeline of a Breastfed Baby
KellyMom (!!!) Sleeping Through the Night
Lakeshore Medical Breastfeeding Clinic (Dr Jen) Just One Bottle and Breastfed Newborn Weight Loss
TED Talks The Shocking Truth about your Health and What We Learn Before We're Born and The Linguistic Genius of Babies
NPR What's Behind A Temper Tantrum?
Mother-Baby Behavioral Sleep Lab Dr James McKenna
Infant Sleep as a Public Health Issue (10 parts) Dr Wendy Hall
Mothering Car Seats are for Cars

These are some great Facebook pages that you can "Like":
Power To Push (Best Birth Clinic)
Family Practice Maternity Service (BirthDocs)
Science & Sensibility

Enjoy the surf! More to come...

12 Times a Day...

2012-01-02T22:18:00.000-08:00

I have a dilemma...after 24 years as a doula, I'm still trying to discover the best way to help pregnant women have a successful start to breastfeeding.

Breastfeeding classes are great, La Leche League meetings are supportive, our talks over months of pregnancy provide continuity, the breastfeeding books are inspiring, kellymom.com and Dr. Jack Newman's videos are linked on my blog. But one client just nailed the problem on the head in a phone call tonight: "It feels like I'm putting the cart before the horse if I try to think about breastfeeding now! I'm trying to finish up at work! I feel like I'm not prepared to have the baby yet! I have to get the baby born! I can't think about breastfeeding now!" (Yes, I know, I'm paraphrasing, but the exclamation marks were certainly there.)

My clients say that everything flies out the window as soon as the baby is born. In the first few days, despite my encouragement to each woman to feed her baby skin to skin, and to feed early and often (12 feeds per day gets you a gold star!), both sleep deprivation and the overwhelming nature of being a new parent can shatter prior learning and all self confidence. Add to that a stream of visitors, and you have a perfect storm. No wonder the breastfeeding relationship suffers or sputters to a halt.

So, what will work? Talk to each other. Find yourself a friend who will be your breastfeeding mentor. Put the cart before the horse. Start to build your breastfeeding community!

To start you on the right path, I've asked some of my clients to write down their words of wisdom after a year of breastfeeding. Many clients are ready and willing to offer their support and be your mentor. So, first up, let's hear from Abby!

"When I gave birth to my daughter I, like every other new mom, was completely exhausted. I was (and still am) dedicated to breastfeeding my daughter so when the nurses in the hospital told me to breastfeed 8-12 times per day I made sure to feed her at least 8 times per day (sometimes 9) and I thought I was doing great! 3 weeks later she wasn't gaining enough weight and I was diagnosed with "low milk supply." I was devastated and I couldn't understand it -- I was doing everything right, wasn't I?
After many visits with lactation consultants, many hours with my pump, and many breastfeeding articles later I had a realization: I should have been feeding my baby AT LEAST 12 TIMES A DAY, or even better every hour. You're going to be tired anyways, so buy a good breast feeding pillow, sit back, watch TV, snooze, avoid visitors, and feed your baby all day! You'll be surprised how relaxing it is. Your breasts need the stimulation from your baby and your baby's brain needs nutrition constantly. It took me months to learn all this so I hope that my experience can help other new moms learn this in minutes instead of months. My daughter is now 1, and I have met many women who were diagnosed with "low milk supply." Every time we went to a baby class there was at least 1 or 2 women who had the same problem as me. That just can't be right. We were made to feed our babies to it can't be possible that so many women "can't make enough milk." Many women may be able to make enough milk with minimal stimulation (i.e. 8 times a day), but a large minority of us cannot. So PLEASE FEED YOUR BABY AT LEAST 12 TIMES A DAY!" - Abby, mum to Ellie

(One way to keep track of those 12 feeds per 24 hours, without relying on a clock, is to have two bowls by your breastfeeding "station". One bowl is filled with 12 pennies. Just move a penny over to the second bowl after a feed. At the end of 12 hours, just look and see how many of the pennies have been moved to the second bowl. How are you doing? Will you be able to make 12 feeds in the day? No worries if you're a bit low on feeds. You can just pick it up. No need to write anything down. No need to look at the clock. No need to stress! It's just a great way to feel the rhythm of breastfeeding your baby in the first few weeks.)

Slow Birth return!

2011-11-15T13:44:00.001-08:00

Look who's back at Vancouver Doula ...and Slow Birth! My daughter, Sarah, is returning from her maternity leave to provide doula services to clients, as well as providing additional breastfeeding services. Welcome back!

"Born and raised in Vancouver and mentored by my doula mum, Jacquie, I have always been passionate about women's health. Since the age of 4, I have watched my mum care for hundreds of families -- slipping out in the night to attend births, coaching women through breastfeeding struggles, chatting with them over tea about the life changes a baby would bring.

As an adult, I initially (and naively) resisted the calling to support childbearing women and pursued graduate studies at the University of British Columbia, studying women's sexuality and reproductive lives in early modern literature. This work naturally evolved into more contemporary studies of childbirth and in 2007, when I completed my Master's degree, I began working actively in doula care. In 2008, to better support mums postpartum, I gained my certificate in Breastfeeding Support for Health Care Professionals from Douglas College.

I've pursued my other passion, academic research, in parallel with my doula and breastfeeding practice. I am currently on leave from doctoral studies, in which I explore informed choice in the childbearing year. Through my work with the Rural Maternity Care New Emerging Team at UBC, I have published qualitative (interview-based) research on midwifery in Canada, decision making for caesarean delivery, and sustainable rural maternity services. Slow birth and slow parenting are also a research passion, and I weave those philosophies into my doula and breastfeeding practice.

Since the birth of my twin boys, Jack and Finn, in 2010, my desire to support new mothers has only intensified and I am excited to return to doula care with some new experiences under my belt, including both a home birth and a hospital delivery, and nursing twins into toddlerhood (we're still going at 19 months).

I am honoured to be part of Jacquie's practice again and to support families through birth, breastfeeding, and beyond." - Sarah Munro, BA (Hons), MA

I'm back and ready for babies!

2011-09-28T10:26:00.000-07:00

I'm back from the land of scarves (Paris) and gelato (Italy), art, churches, sparkling seas and rolling hills...and so many babies!

We saw babies in Paris, Tuscany and the Cinque Terre being carried in slings, Ergo carriers, and wraps (so much easier on cobblestone streets than strollers!)...children singing while skipping home for lunch...restaurants welcoming children of all ages...children being greeted and twirled around by Nonnas and Mamas...and many playgrounds tucked into tiny squares.

Birth issues seemed to be everywhere...even on Medieval streets...

One street in Volterra, Italy, was decorated with branches covered in blue ribbons. At first I thought the branches were a local custom, announcing a home birth of a baby. But, it turns out that there has been a big fight to retain birth services in Volterra. A pilot project allowing women to give birth locally had been scheduled to end in July. So, why were the branches on this street in September? Had a woman given birth at home recently, against local recommendation? Or were the branches part of a protest against the removal of services? I'd love it if any Italian-speaking clients would read local news articles and let me know!

But, I learned that, no matter where I am, even when I'm on holiday, my thoughts do not stray far from the focus of my passion...birth, babies, mothers...

So, please don't hesitate to contact me by phone or email now... I'm home, rested and ready for babies again!

Nine Months of Babies (or...and so we embark on a slow travel journey...)

2011-09-01T23:13:00.000-07:00

It's been 9 months of babies...35 women, 35 births...since I last wrote a blog post. Three sets of sparkling twins, 2 out of 2 successful and life-changing VBACs, six joyful home births (one with only 16 recorded active labour contractions!), one surprise vaginal breech birth, a few fourth babies and many first babies, eight wonderful repeat clients, more than a few speedy car rides, and many sleepless hard-labouring nights...

These babies and their mums teach me about strength, acceptance and love daily.

In between the births, and the client phone calls (both pregnancy and postpartum), and the visits to help with breastfeeding, I get to be gran to a pretty great pair of toddlers. You can find us most days (in between some long stroller walks) at Rosemary Brown Park and Kits Beach Park. Join us if you like diggers and soccer balls!

Very early in the morning (and late at night) I try to stay current by reading as much birth/child-related research as I can, but you can also find me reading Kellymom, First the Egg and Dr. Jen as well as Paris by Mouth, Joel Henriques and Apartment Therapy. It's all about balance, right?

Ah, balance...

To that end, we're off to Europe on our annual slow travel journey. So many clients have told me that they were married in Siena (or got engaged in the Cinque Terre...or conceived their baby in Florence), that we decided we just had to find out what the fuss was all about. So, Italy awaits! Oh, and Paris, too...

This is my only chance to take a break during the year (mine is a 24/7 on-call life), so please understand that I won't be receiving calls until the end of September (the 28th should be fine). I still have room for a few more babies in November (why is November always a slow month?), and in February (and beyond!)

Please don't hesitate to email me at Vancouver Doula, but expect a sloooow response until my return from la dolce vita.

- Jacquie Munro, Vancouver Doula

The Sweat Lodge

2010-12-25T13:23:00.000-08:00

This Christmas Day, I offer you the gift of a story told by a new client:

I see that going into the sweat lodge in remote northern Ontario when I was 17 is something that I can use to propel me through birth. The experience was a powerful one then and now, as I face a long pregnancy and its culminating labour, the event is taking on new significance and its power is spinning in the expanding darkness of my womb.

I went into the sweat lodge to heal. I didn’t even know what parts of me needed healing. All I knew was that I was being offered a chance to experience something profound that might just change the course of my life. The sweat lodge itself was like a womb--dark inside but for the orange glow of rocks heated by fire until they took on their own light. The air was wet from water sprayed periodically on the burning rocks that would immediately vapourize and turn the tight dome into a small ocean that housed us all. There were perhaps ten girls and two men -- our first nations guides on this journey into the Sweat.

Once we had all gathered inside and been given instructions the animal skin flap of the sweat lodge was closed and we were cradled in primal darkness. I could feel the other girls breathing around me. I could feel the warmth of their bodies and their anxious energy. We didn’t know where we were journeying to or what sort of people we might be once we emerged from our process of rebirth. It was a moment very similar to what I have been experiencing in my state of early pregnancy, where very little has changed on the surface of things but I can feel strange ripples of energy coursing through my body and smell the electric smell of great change rolling in like a summer storm.

My memories of the Sweat are hazy. But images flash back to me like prophecies. I think there was a drum. The steady heartbeat of the world reminding us of our embodied state. The sweat has four stages each marked by one of the sacred herbs--sage, sweetgrass, cedar, and tobacco. At the end of each stage the lodge would be opened and we would have the choice to leave or to stay on for the next stage. We could decide that we had learned what we came to learn or that we needed to go deeper to reach whatever lesson was meant for us. Inside the sweat lodge I descended into the core of the earth to access the essence of myself. I imagine labour will be much like that--a spiralling downward into the most secret spaces of the soul where reserves of power you never imagined you had can be accessed and put to use.

I floated in the humid air of the sweat lodge as the ceremony commenced. It wasn’t long before I was soaked with the wet air and my own sweat that poured out of me like rain. My body slowly emptied itself of fluids and I’m sure that I became severely dehydrated. Stories poured out of us with the sweat. We told of our young lives’ greatest hurts, the things that were holding us back and torturing us. Tears began to mingle with the sweat. Girls cried out in pain or because they saw visions emerging from the blackness. Each time the flap was opened at the end of a stage some would leave, desperate for water, content that they had gleaned all they could, or simply exhausted physically and mentally.

I was becoming worn down myself. My body needed water and I was deeply aware of that. But I couldn’t bring myself to leave. I was sure that there was something at the end of all this that would be worth the suffering and somehow, amidst the agony of the Sweat I was able toembrace the experience as transformative. By the end of the Sweat I was deep within my own body and had become animalistic in my thoughts and movements. I was lying on the dirt floor of the lodge with my head in the lap of another girl. I was screaming a low animal scream that originated deep in my throat and resonated at my core. I clawed the ground like a dying creature letting the earth bury itself under my nails. I thought that I might die yet refused to leave until the flap was opened for the final time.

I find that my memories of the Sweat sound much like the experiences of labouring women who find intense beauty amidst pain, fear, and confusion. Labouring women connect to their animal selves just as I did in the suffocating final moments of the Sweat. And while I wasn’t comfortable or even fully conscious of the world around me I believed that I was safe. I believed that the guides wouldn’t let me come to harm, that the girls would hold me. This feeling of safety in the midst of chaos will be crucial to birth as well. I will need to feel that I am held in competent arms and that I will be told if there is real danger at hand. I think that if I can maintain a feeling of safety that I will be able to bear whatever pain or discomfort comes my way and hold on to the belief that bodily trial can be a gateway to spiritual truths.

When the sweat was finally over I lifted myself up off the earth and ate canned fruit that was being passed around. As liquid and sugar entered my body I felt deep relief and also a great sense of well being for having made it to the end. I drank water and water has never again tasted so pure and delicious. When I stepped out of the lodge I was given a moment that will forever be a part of my personal mythology. I emerged from the heat of that womb and into the cold fresh air of the northern summer night. The sky was spattered with stars and I walked carefully on unsteady legs to the edge of the lake where the water was black and silent. I let the air cool me and many of the girls swam in the midnight waves, coming fully alive after touching the edges of death. Time had lost all meaning. I have no sense of how long I stayed in the sweat lodge. It could have been minutes or hours. All I know is that I went in when the sun was still up and when I came out it was long past sunset.

I will hold on to the sweat lodge when I enter labour. I will let time lose meaning and surrender to the animal impulses of my body--letting it cry out when it needs to and growl deep in the throat and belly. I will let myself be cradled by my husband and the midwives, and doula who will attend me. I will remember that I am safe so that I can ride out the waves of birth without getting lost entirely. I see suddenly the the sweat lodge was a gift that I didn’t see the full value of at the time. It was a perfect preparation for birth given to me in days when I never expected to have a child. How strange that I can travel backwards now and see new aspects of the experience and new ways to apply it. I have already been both the mother and the child: The labouring woman clawing the earth in wild torment and the new baby crawling from the womb into the wide wide world under the slowly gyrating sky. May this experience give me strength and courage in the months to come and at the moment of birth.

"It doesn't get easier, it just gets different"

2010-12-11T08:26:00.000-08:00

As part of my doula service, I provide two prenatal visits, attend my clients' births, then make a postpartum visit to debrief and hug, but that's only the tip of the iceberg.

I encourage my clients to call or email me frequently...for years (yes, I mean that). I'm often on the phone for a few hours each day, answering clients' questions, brainstorming, or providing support and encouragement. I encourage my clients to call me whenever a question arises during pregnancy or postpartum, which is SO much more helpful than asking them to store it up for visits. We're able to work through each concern in the moment.

Please don't be shy about calling! It makes everything smoother in the long run!

Recently, I checked in with a former client to see how things were going (three years after she gave birth to twins). "Any words of wisdom?" I asked.

"It doesn't get easier, it just gets different," she said.

I've been a mum for 27 years, and I've cared for over 900 families as a doula...but with those few words, she reminded me of the daily reality of mothering little ones.

Change comes in an ever widening circle. Change comes daily with a newborn, then weekly...then monthly...then yearly, as she grows. The physical and emotional challenges of raising children are dynamic. "Someone keeps moving the goal posts!" said one client. "Did they cover this prenatal class!? I can't remember anything anymore!"

Who knew that flexibility, creativity and spontaneity (along with a whole whack of family and community support) were the keys to successful parenting? In the beginning, we thought we just had to learn the basic rules of "How to Parent" and everything would be smooth sailing! Boy, were we wrong! It's all about rolling with the changes...

But you don't have to reinvent the wheel. You are not alone! Someone else is going through the same thing...right now...

So, give me a call. Whatever you're dealing with...I've probably chatted with another client about something similar, just yesterday. And maybe, you might just want to connect with her. Together, we can support each other through the daily changes and challenges of mothering.

For example...One day this week I was standing in the rain on Granville Street, discussing a woman's overabundant milk supply, then an hour later I received a call in the IGA about another baby gagging and spluttering on his mum's gushing breast milk.

Then, the next day, I was sitting in my parked car talking with another client about how to increase her low milk supply, just before receiving a call from a different client to ask about donor milk.

Various solutions, including the "Eats on Feets" Facebook group (community milk-sharing), the local Donor Milk Bank, and my favourite lactation consultant, popped into my mind. Personal connections were made...and they were off!

Yesterday, a mum called looking for some support dealing with the changes that happen around six weeks. She had found her rhythm a few weeks earlier. Feeds had been going well, sleep had become more predictable. Then...wham! the six week growth spurt had begun. Her baby had become more alert and started to sleep less. She was having to feed more to increase her milk supply. The goal posts had moved!

We talked...I made tea while we talked...and we talked some more...

I'd better call her again on Monday to check in, and encourage her to go to her local community mum's group.

Every time a client calls me with a mothering question, it increases my ability to support the next woman. Each woman teaches me something completely new. I encourage her to share her experiences at the local mum's group or La Leche League meeting. We each strengthen the chain of women helping women. We support each other through the daily changes.

I won't tell you what to do when you call. None of this parenting stuff is black and white. I'll just help you add to your mothering tool chest, share recent research, brainstorm.

But, above all, I'll just do my very best to listen.

I'll do my best to share the wisdom that I've learned from my years as a mum (oh, gosh...and now a grandma, too!) and as a doula, and learned from all my other clients.

Yes, there will be times when I won't have the experience to address your particular problem. But, at the very least, I'll know someone...maybe a professional...or maybe even another mum...who will be able to give you the tools to help yourself.

And then, I'll remind you that each day will be a mix of joy and tears and laughter. That's mothering. It's always changing, it's always challenging. It's never boring.

My client was right..."It doesn't get easier. It just gets different."

Jacquie Munro - Vancouver Doula

What have I been doing all this time?

2010-12-10T17:27:00.000-08:00

Well, it's been 8 months! I think I must have been rather busy, to have left my blog for this long!

In addition to my doula work, "loving the grandsons" was added to my list of passions. With twins, there's a lot of room for family involvement, so we've all been chipping in daily to help our daughter and son-in-law and their brood. My memory of this past summer is long long walks by the seashore with my husband, carrying the boys in slings, allowing their parents a break at home...to sleep or eat, or just plain enjoy the peace and quiet.

It's been eight months filled with love and joy (we're not the sleepless ones).

Is there any downside? I tend to forget things more easily now, with so many things happening every day, but my iCal alerts keep me on task. So, clients...please call me before or after your prenatal visits for a chat if I haven't called you already. And when you call me, you might find that I whisper when I answer (sleeping babies!), and I might screen some prospective clients' calls if I'm rocking a tired boy while another stands holding my leg (I just can't reach my phone). Please accept my apologies in advance. BUT...the upside is that I now have a renewed and updated understanding of breastfeeding issues, sleep issues, introduction of solids, safety issues, attachment parenting...and a multitude of other topics. It's like I'm living a daily refresher course in how to support my clients through their pregnancies and postpartum experiences. You will benefit!

I'm now taking on fewer clients per month (4-5 at the most), so that I'm (hopefully) able to provide the best care to all. So, you'll need to call me early in pregnancy to book a spot. With this growing family, I'm learning to multitask all over again - and love it!

So, please don't hesitate to call or email! I'm here...just covered in babies from time to time....

Jacquie - Vancouver Doula

Dear Jacquie...

2010-05-20T10:20:00.000-07:00

Dear Jacquie,

We've not met, but I just wanted to thank you for my daughter's birth. I live in Edinburgh, although I'm from Victoria, B.C, and I stumbled across your blog about a year ago. My son (who's now 2) was born in hospital: my flat wasn't big enough to fit a birth pool and 2 midwives, and I hoped I could have a water birth in hospital instead. In the end, I was induced due to blood pressure and got a very controlled, restricted labour: I was on my back, monitored, for the whole thing.

When I became pregnant last spring, your blog was the final inspiration I needed to plan a home birth. You and Ina May were my encouragement through 4 days of slow contractions. In the end, though, my beautiful daughter came racing into the world, one hand over her head, into an empty bathtub. (The midwife had arrived 17 minutes before and let the water out of the bath to check me over...never happened! The birthing pool was filled and waiting in the next room but into the empty bathtub she came.) I had a wonderful, wonderful birth with no one monitoring, examining, or worrying me and the difference in my two birth stories still amazes me.

I'm attaching a photo of me and Rosa with my midwife team, an hour after the birth (the one in blue was the midwife, the one in white was a student on her first week - I was her first birth!, and the one behind was the second midwife who arrived 20 minutes too late).

I have loved reading your blog, and I really can't thank you enough for the inspiration you gave me.

All the best,

R (Edinburgh)

My Words

2010-04-09T11:21:00.000-07:00

Wide open

Your face is soft

Your shoulders are heavy

You are safe

Your baby is safe

This is your power

You are strong

Feel your cervix melt like butter

Your muscles open

Your baby tucks chin on chest

You are wide open

Soft

Slow breathing

Your hands are soft

You are safe

You are with all the women in labour

The women are with you

You are doing this

Breathe in strength

Breathe out worry

Breathe in power

This is your power

Wide open

Soft

Melting

Safe

- Jacquie Munro, Vancouver Doula - Slow Birth

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

2010-03-30T21:50:00.000-07:00

As you sleep, Finn, I stroke the world onto your forehead

cheeks

chin

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...

incomplete.

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

humming

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...

"Tundra..."

...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

Silence, s'il vous plait...

2010-03-25T12:07:00.000-07:00

No words

as we open ourselves to birth

Close your eyes

breathe

and feel the whispers of women

past

present

future

No words

Jacquie Munro - Vancouver Doula, Slow Birth

Slow Food in labour

2010-03-24T13:51:00.000-07:00

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

Outside of time/The whisper of water unites us

2010-03-17T20:31:00.000-07:00

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

Slow Birth Preparation

2010-03-03T12:58:00.000-08:00

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,

Breathe,

Then see if you still need prenatal classes.

Jacquie Munro - Vancouver Doula, Slow Birth

Slow Rainbow

2010-02-18T10:25:00.000-08:00

I've been on a journey of slowness during the past few months. Reflection, recovery, rebirth. Every free moment has been filled with cycling, running, long walks. I needed to be incredibly fit to face the births this winter. I was fit and well, but I just couldn't write.

I needed to be totally private this winter, in order to grieve for my dad, help my mum, support my family, and have the strength to help other families walk through their searing life struggles or challenging pregnancies and labours.

We're told that life never gives us more than we can bear. After 23 years of being a doula, and recently dealing with loss at a personal level, I think the gods thought I finally had enough experience to support a large number of clients dancing with great challenges - a client whose husband has been battling inoperable cancer, another whose baby is still in NICU, another whose mum has recently died, and so many clients whose pregnancies ended far too early.

I just couldn't write. These women's stories were too fragile to write about immediately.

Don't think that it's only been a winter of unusual loss. We've just seen a slow rainbow of birth experiences. In between the losses, there have been groups, or should I call them "clumps", of babies speeding through the gate like downhill skiiers. I've expected some of these babies to pump their fists into the air and scream, "Yeahhhhhh!" One was born so quickly into her mothers arms, born at home 25 minutes after her mum called me to say, "I think the baby might come today." Born with mum kneeling alone in her bathtub, husband careening around the corner - "A baby!" When I arrived, mum was nestling her baby in her arms in bed, laughing.

And then there were the amazingly triumphant VBACs. Three women this winter whose first babies had been born by cesarean. The emotional challenges in the last few days were hard to bear for one woman - "Oh, they say that you have an 80% chance of it working, but it's really only 30%." (Booking clerk) "Decide whether you're having your cesarean within 5 minutes." But with strong support, all women successfully pushed out their second babies "the old-fashioned way" (OB quote). What joy! These births will truly change lives.

And there have been so many women who have accepted the unexpected with such grace. They have been so calm. The woman who had to take an ambulance ride at 10cm when her baby pooped in the water...the woman who had to move down from the sweet Cedar rooms to the higher risk area at hospital when her baby's heartrate demanded action...the woman who had to make a decision to have a cesarean because her baby's knees were in the pelvis. These women listened to their babies and made their decisions with slow grace.

I've been able to live in the moment with these women and those they love, helping them to honour their bodies, honour their babies, and cross over to being parents...no matter what. The joys have been so great. Isn't it always the way when you are walking beside sorrow.

Just as one client vowed to "smash" cancer, these clients have all been strong, powerful, determined, and amazing.

And now maybe I'm ready to tell you more about them...Spring is here!

- Jacquie Munro, Vancouver Doula, Slow Birth

Pauline's Words

2009-10-27T15:59:00.000-07:00

We had a beautiful nurse for the birth yesterday.

Pauline, originally from Togo, is a mother of five, and a grandmother of two. Her last child was born on her own bed, birthed into her own hands. She birthed this baby on her own, with joy.

Our time with Pauline was magical. She spoke to us like she was taking us on a spiritual journey. She spoke low and slow, rolling her R's. Her words were like poetry...or a prayer...

As she was speaking, I copied her words onto paper...hear her...

The woman's body is so unique

It is well made.

Birth

the body knows this story

I don't write this story

That's how it is.

I will hold you in my heart all the time

I speak to your baby in my tongue

Your baby speaks my language

That's how it is.

Baby Zoe came into this world with grace, full of life. That's how it is.

- Jacquie Munro, Vancouver Doula, Slow Birth

Slowly...While Waiting for Baby...

2009-10-25T15:32:00.000-07:00

My daughter just asked me why I haven't been posting to my blog for some time. Well, like my mum, who just can't seem to read an entire book since dad died, I seem to be having trouble writing. Oh, I could write and write about all the amazing encounters that I've had with my father's spirit, especially in France (that time in Shakespeare and Company in Paris was extraordinary!)... But, write about birth? There's been a block...

So, I thought that I'd best just sit down and start writing while I'm waiting for another baby to come - a baby girl. Her mum and dad were supposed to be moving today, and were feeling quite stressed about it...so baby girl decided she would make things easy for them. She's coming early and now mum and dad get to cancel the movers! Babies can make magic happen!

I was at another birth this morning. A shiny birth... "Oh, this is fast!" "Good baby," says mum. "Great vocabulary!" says dad. "Can you say vocabulary?" "Vocabulary!" says mum after arriving at the hospital at 7cm, already feeling the first signs of wanting to push... Marcello came quickly, so that his mum wouldn't have to miss a meal. "Good baby!"

Then there were the other first babies this week... Two were both born on the same day (no overlaps!) How does this happen? First babies...under 12 hours? Yes, it happens. Marvelous denial of prelabour, I think! One woman called me to say she was already 2-3cm at her weekly checkup, but was still planning to complete her day's errands. She knew she could trust her body to tell her when it was serious about labour. But, things quickly changed, and I drove over to her house soon afterwards. Ten hours later...after dancing and lunging in the unlimited hot shower...out spun her over-eight-pound beauty!

Soon after, another baby decided to come at 37 weeks. Mum worked hard to deny the early contractions - "It must be pre-pre-labour!" She made it almost through the night, lying on her side, really not enjoying this at all! But she did it! And I did back circles, whispered calm words, while dad ran about, gathering everything possible. "Nuts!" I heard him cry. I thought it was an exclamation. But, he'd been toasting nuts for snacking... So great! We managed to make it through rush hour traffic - construction traffic - back-lane detours - phew! "Smooth and slow. Smooth and slow." I chanted. Fully dilated on arrival. "He's an angel!" said the mum over and over and over again when baby arrived. Dad stayed awake to watch him sleep all day...

And last weekend...a 2-3 day epic birth made me lose my ability to think in complete sentences. This birth taught us so much about surrendering to baby's cues, always trusting mum's instincts. This birth was so joyful...not that the others weren't joyful. But, there was ample time during this long birth for mum to contemplate the utter joy of labouring slowly. She truly had the time to think deeply about what she needed to learn in order to be the best mother for her baby. She decided to decide - and her baby came beautifully into the world by cesarean. What a triumph in so many ways!

You might think that only the long birth was a Slow Birth. But, I consider all these births to be "Slow Births." Don't be confused by the word "slow." It doesn't have much to do with time. It has more to do with giving each birth the time and attention that it deserves. It means not rushing through the experience. It might naturally be fast. It might naturally be slow. But it just needs to be what your body and the baby intend for it to be. And while it is happening...we are all listening to the body's lessons. We become connected.

Slow Birth is not hurried, not forced. It is calm, intuitive, patient, receptive. Slow Birth is about seeing the big picture and trusting each body's own rhythm. Fast or slow...

Now...I'm off to another Slow Birth...

- Jacquie Munro, Vancouver Doula, Slow Birth

Slow return from madonnas, pilgrims, sunshine, walking...

2009-09-12T08:55:00.000-07:00

Six weeks in England, Scotland, and France...walking miles to ruined castles, riding bikes through Paris, climbing Munros, hiking through hidden valleys, reading good books, exploring pilgrim's paths and spiral staircases, swimming in the sparkling Mediterranean...then returning to our own cottage to create wonderful thoughtful meals (and eat those French pastries!)...now that was slow travel at its best!

The families in France gave us such joy. New fathers with babies in buddha wraps, toddler in hand...laughing. Families standing by the trunk of the car, then pulling out (Mary Poppins style) tables, chairs, cookers, and setting up a full dining space in a field. Two hours later, seeing the same family, children still sitting with their parents at the table in the field, chattering together, laughing, eating, sharing...

Seeing madonnas, mothers, babies everywhere - sculptures, watercolours, Renaissance oils, tapestries, Iron Age figurines...

I am home, but I will be sifting through all these experiences for a long time...you'll be hearing about it in coming posts...

Now... I'm recharged, and ready for babies and mums and birthing...

Call me!

- Jacquie Munro, Vancouver Doula, Slow Birth

Slow Travel to the Goyt Valley, Schiehallion, Dordogne, Mediterranean, Mont Ventoux, Paris...

2009-07-28T14:49:00.000-07:00

On Friday, we're off for six weeks of slow travel in England, Scotland, and France...and I won't be back attending births until mid-September (try calling me on September 14th!)

I'm leaving all current clients in the capable hands of my brilliant backup doulas, who will be providing expert chats and doula support while I'm away.

For any potential clients looking to hire me while I'm away, I will still answer your email requests...but very slooowwly. We're staying in remote places - a hillside cottage, a farm, a former monastery, a restored convent, and a former weaver's stone cottage...very few of which have wifi! This is my only chance to be "off-call" during the year, so thanks for understanding my need to cherish my privacy during this time. So, please just send me an email to vancouverdoula@gmail.com and be very, very patient. I think the majority of my former clients would say it will be worth the wait!

Just so you know...I am fully booked for September, October, and November. I have one or two remaining spots for December and January...and am open to new clients for February and March and beyond!

Cheers!

Jacquie - Vancouver Doula, Slow Birth

Slow Birth...Slow Medicine

2009-07-20T12:35:00.000-07:00

It's been a long time since I wrote a new post...but so much has happened. The greatest joys and the greatest sorrows.

I took this photo while sitting and crying in a bathroom stall at the hospital, while my dad was in Emergency with a subdural hematoma caused by Acute Myeloid Leukemia, just ten days before his death. So much to take in...so little time. The positive graffiti really helped me.

We sprung my dad from the hospital after a few days, with the support of his doctors - he really wanted to be home in his artist's studio. With 24/7 nursing care from the Palliative Home Service (angels all, those who practice Slow Medicine!) we helped dad make the transition to whatever plane of existence is on the other side.

I say "plane of existence" because that's a quote that my son made when he was about four years old. He sat in the back seat of our car, and chattered on about life and death. "Why do people get so sad when others die? They just go to another plane of existence. It's the same place that I was before I was born. And you didn't cry about me before I came, did you?"

So, my dad sailed away on a journey to another world...the world where babies come from...

And since dad died, I've mostly attended home births...Slow Births. Interesting. Dad's home death was peaceful, sad, happy, tearful, full of laughter, mystery, questions. It felt like I was at a long home birth. How fitting that the majority of births that I've attended in the past six weeks have been pretty much the same. All the babies came into the world as they should, with grace.

We help them come in...slowly...

We help them go out...slowly...

With dignity, with love and light.

- Jacquie Munro, Vancouver Doula, Slow Birth

How NOT to tear...

2009-05-12T11:05:00.001-07:00

Just make a sign like this (the red crepe paper heart will take a long time to make!) and put it up above the head of the bed in the birthing room...and everyone will make darn sure that you don't tear!!!

Then, the nurses will put it up in their staff room to make sure that they never forget and pass it on to all the other wonderful women who pass through their doors...

Thanks to Lisa for her strength, determination, and love of glue-stick and crepe paper! (more on her amazing birth later...)

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

My dysfunctional love of statistics

2009-04-29T14:08:00.000-07:00

I loved statistics so much in university. Honestly! I'm still such a geek, that I love to look at my client's stats...not at regular times of the year (like December 31st), mind you. I like to do it when the spirit moves me (the happy convergence of left and right brain.) Or might it be tax-procrastination time?

So, here's this past 12 month's basic statistics...

Of 62 clients, 43 (69%) had spontaneous vaginal births without any major pain medications (epidural or narcotics), 10 (16%) had spontaneous vaginal births WITH an epidural, 2 (3%) clients had assisted births (1 vacuum, 1 forceps), and 7 (11%) clients had cesareans (2 breech, 1 face presentation, 3 dystocia, 1 fetal distress). Take some time to think about that. Only 5 clients (8%) had unplanned cesareans. What's the average in BC?

The majority of hospital births were at BC Women's (46, 74%), followed by St. Pauls (9, 14.5%), Lion's Gate (2, 3%) and Royal Columbian (1, 2%). Five clients planned for a home birth. Of those, 4 were successful (one had to transfer to hospital for meconium at 10cm, but happily birthed then went back home). There was also 1 unplanned home birth (luckily, she had fast-moving midwives!) So, only 6.5% of births were at home. Okay...I need more home births!

As for who was caring for my clients, family doctors top the list with 37 (61%), followed by midwives at 16 (25%), and OBs (9, 14%). The BC Women's FPMS birth docs cared for a whopping 37% of my clients. Thanks to all who did such a great job of making slow births happen!

A lot of people think my clients stats must be so good because they are having second or third babies. Well, almost three-quarters (46, 74%) of my clients were having their first baby. Only 16 (26%) clients were having their second or third baby, and 12 (19%) of those were returning clients. Of the four new clients who were "multips," one had a home VBAC, one had a home water birth, another had a home birth after a traumatic first birth experience in another country, and one was over age 50!

You might also say that my clients have great births because they must all be very young and highly motivated. But, most are over age 35, many are over age 40, and most would have been fine with an epidural or cesarean if it was medically necessary.

But, after many months of working together, these women were all motivated to have a slow birth...to listen to and trust their bodies...to allow for the natural rhythm of birth. And, with good support, and a great team (who can sometimes collaborate silently, with only eyes and hands to communicate)...it just worked!

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

In which a push mower acts as sweet music...

2009-04-27T13:16:00.000-07:00

On Saturday afternoon, I was dropped off at a client's Co-op on the Downtown East Side. As I walked to their door, a nurse from the local InSite walked by and smiled at me, a man with a grocery cart full of his belongings rattled down the lane, and a siren began to wail.

Once I was inside the door, though, another series of sounds took over...the cry of a woman in labour with her first baby, the shouting and shrieking of children as they played in the Co-op playground out back, the unexpected rhythmic whirr of a push mower acting as sweet green music. I had entered a hidden oasis only a block from Hastings and Main. It was cool, calm and wonderful.

She laughed and asked if I could hear her from outside...

We added the sound of the fan to the mix, and helped her to move, rock, sway, stomp, go on tip-toes, shower. She became calm when I talked her through contractions. She was kind and gracious in labour, only snapping once as her husband came into the bedroom to ask if I'd like some lunch, while holding said food in his hand... "Out!" Yes, labour increases a woman's sense of smell!

With the sounds of children and the lawnmower and the woman and the fan blending together, all sense of time disappeared. We were outside of time. As the contractions became stronger, she became more and more calm, toning low and soft. She melted open.

One last time into the shower with the fan blowing steam out of the bathroom and cooling the air. Water spilled onto the floor. We heard her growling. We smiled. Her husband put his head down for one last moment of quiet.

Then we headed through the streets in my car, as she dozed in the back seat, head leaning on a homemade quilt which covered the birth ball. One contraction, two contractions. That's all she had in twenty minutes. She was in that quiet slow space before pushing...

Then, a hint of a sound like she wanted to push as we arrived at the hospital. 9+ centimetres!

And she rode upstairs and pushed and pushed and moved and worked, and never gave up, and then...more than 3 hours later...beautiful pink Josephine (named after her grandfather) arrived, head askew, looking up at her mum...born completely posterior!!! She called out in her sweet voice and cried to let everyone know that she had arrived.

What a day of sweet music!

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

Slow Birth call to action

2009-04-24T16:28:00.000-07:00

My goodness!

Dr. Lauren A. Plante, a US obstetrician, has written a wonderful article (a MUST read!) in response to the increasing industrialization of childbirth (wasn't Canada's own Dr. Andrew Kotaska one of the first to argue against "industrial birth"?) Dr. Plante asserts that on-demand cesareans do not represent the height of women's autonomy, but are, in fact, the opposite. She calls for true autonomy for women - the right to choose from a spectrum of choices.

At the end of the article, she links the Slow Movement to childbirth, and almost challenges women to start a grassroots birth revolution. This is the first academic article that I've found that mentions Slow Childbirth. Wahoo!

The Slow Birth movement is organically growing! Read the excerpt below, then click the link for the full article...think about how you can be part of the transformation...

Come on - bring forth the change!

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

Plante, L.A. Mommy, What Did You Do in the Industrial Revolution? Meditations on the Rising Cesarean Rate. The International Journal of Feminist Approaches to Bioethics. Spring 2009;2(1):140-147.

Excerpt:
"As a reaction to industrial agriculture and food marketing, the Slow Food and locavore movements have recently been born. If de-escalation of our food production practices is healthier or more humane, why is intensification of our child production practices better than sustainable childbirth? I’m waiting for the birth of the revolution, or at least, the revolution of birth. Will women who are interested in Slow Food or cage-free eggs find their way to a Slow Childbirth movement? Imagine: educated upper-middle-class women who buy songbird-certified organic coffee and worry about their carbon footprint, just saying no to the quick-fix cesarean culture. If they’re not part of the problem, maybe they can be part of the solution. But the impetus must come from women themselves. Do we really believe that industrial obstetrics is the best model for ourselves and our children? We must clearly understand that real autonomy does not mean cesarean on request, but instead a spectrum of birth options that honor women’s authentic choices. Real autonomy also means, to borrow a sentiment from Gandhi, that women should bring forth the change they wish to see in the world."

The Green Generation

2009-04-22T11:18:00.000-07:00

It's Earth Day today! And it's Isola's and Milo's birthdays, too! They are just two of my client's babies who are part of the "Green Generation." My hope is that they will grow up with the smallest carbon footprints possible. I think they're pretty special one year olds, so they might be able to do it and be worthy of the title.

Now is the time.

So, am I, as a doula, "green?" I try to work with clients who live within a small area. I can walk home from both birthing hospitals. In labour, I help clients in their own homes, usually arriving on foot or on a bike. I help clients stay out of the hospital system for as long as possible, while remaining connected to their caregivers by phone. My clients rarely need IVs, epidurals, drugs, or any major assistance. My clients often go home as soon as possible (or birth at home with midwives). The majority of my clients are able to breastfeed successfully, and don't need to buy bottles or formula. Most of my clients use cloth diapers (well...at least during the daytime!) They also need less future counseling as a result of their positive experiences.

Think of the cost savings, the environmental savings! That's what I call a "green birth!"

We might wash some of those savings down the drain with the amount of hot water that my clients use in labour...(but SHHH don't tell anyone!)

That's probably a small price to pay for the long-term joy that an amazing birth brings to a family.

And I discovered today that there's a residual "green" impact. Today, Isola's mum called me up on her daughter's birthday, and we both started to cry as she thanked me for all the help that I gave her during her pregnancy and birth. Think of the long-term ramifications of a "green birth" on her and her daughter, and her family!

This mother will always tell her daughter stories of her joyful undisturbed birth, and this little girl will probably have a "green birth" in her future. She's truly part of the "Green Generation."

So, Happy Earth Day! Wear some green!

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

Bike the Blossoms

2009-04-16T20:49:00.000-07:00

"Abandon your fast life for another day of s l o w ..."

Whether you're pregnant or not (hey, I rode my bike until I was 8 months pregnant!) come and join other Slow Vancouverites at the Bike the Blossoms 23k ride sponsored by Slow Food Vancouver this Saturday, April 18th. It's only $10 each, and you'll be supporting the s l o w movement.

This self-guided tour is fun for the whole family! Enjoy a leisurely ride along boulevards of spring cherry blossoms, traveling through a diversity of neighbourhoods from the eastside to the westside, stopping at local community centres to meet local farmers, to sample local foods and refuel at slow food designated eateries, restaurants and cafes along the way.

Slow Birth will be there! Come join us!

(Apr. 19 - Well, that was fun! I saw lots of families with babies in various carriers riding through the city streets, but didn't spy any noticeably pregnant riders. And the weather stayed sunny and warm! The next day, at the Sun Run, I saw a LOT of pregnant participants - yahoo!)

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

Slow Stories

2009-04-16T13:04:00.000-07:00

I started to take notes during each birth after November 1, 1993. I know that because Kieran was born on that day. Kieran was a warrior baby. In fact, he was born face first. He never gave up with that chin-up attitude (and probably still hasn't to this day!)

The midwife did one final vaginal exam just before he was born. "Is that a bum?" she asked, just a little confused for a moment. "No, it couldn't be...you're hearing the heartbeat in the right place. It must be a mouth," I said. "It's the baby's lips!" she called out. So, Kieran was born, after a crazy challenging labour, with his mum on her high bed, holding up her silk dress (dad had grabbed a dress for her to wear, and I think it was one that she'd recently worn to a wedding).

Days later, when we tried to have "tea and debrief", Keiran's mum, my doula partner and friend, cried, as she tried to piece together our collective memories of what happened at the birth. Her first labour had been so smooth that we had expected a quick second labour. This days-long hard labour had been so relentless, with intense back pain, that we had all lost track of time.

She told me that she had keenly felt the loss when I had left her head and gone to help the midwife during those critical moments when we didn't know whether the baby was head down or breech. A woman needs another woman at her ear, whispering, "You are safe." I wasn't there for her as a doula in the end. I had become the second attendant.

We had no birth notes from those days of long hard labour - no framework from which to hang the memory. She was lost.

She asked me if I could write notes for all the women who would come in the future, so that no woman would ever have to wonder "What happened?"

So, now, I write as honest and true a story as I can write. I can only write what I observe, being on the outside of each woman's experience. I try to make sure that my handwriting is slow and calm. I watch my writing become larger and messier as the baby's birth moment approaches. Water drops on the page. A drop of blood smears. This is the external story of a birth.

I ask that each woman and her partner take some time to record their own experience, before I give them my birth notes as a gift. Each written account is part of the memory of the birth day. But, it's the woman's internal story which is paramount. Who cares that my notes say that she was in the bath for 5 hours. She believes that she laboured in the water through the night. She believes she was surrounded by candles (when candles are not allowed in the hospital) and peacock fans (when it was really a cardboard tray). She believes that she was rowing for a gold medal, not panting for hours. Her reality is the truth of the birth.

But my notes do provide something that she may never remember - her first words as her baby emerges. And now, most women don't cry because of a lost story, they cry with joy, when they read the words that they said to their newborn:

"I'm so glad to meet you!"

"That might have been the best thing I've done in my life!"

"You are so beautiful!"

"She sounds like a sheep!"

"Holy cow! It's a baby! Look! It's a baby!"

"You're sure a lot louder than I thought you'd be!"

Kieran's mum is moving back to the west coast very soon, so we'll have another "tea and debrief" very soon. And she'll probably tell me that my memory is faulty after all these years, that she actually wore her silk dress when her baby Zoe was born. And I'll tell her that, at the very least, my memory is clear about her strength in labour. The sound memories are clear, too. The garbage truck, the children outside. And I'll say I'm sorry that I left her head during Kieran's birth, and that I think of her every time I whisper, "You are safe," to each woman as she gives birth...

And then, we'll tell more slow stories of our lives...

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

Life Cycle

2009-04-14T09:23:00.001-07:00

Something as simple as a bike can save lives!

It only costs about $70 to purchase an International Planned Parenthood Federation Good Gift Bicycle for a midwife in a developing country.

If a midwife in a developing country owns a bike, she's able to visit more villages. Unfortunately, too many midwives lack cycle mobility, so, considering the local current price of a bicycle and its life-improving qualities for far-flung villagers, you couldn't deliver a better gift.

For us, riding a bike to visits is truly a luxury. But to midwives and other health care workers around the world, it's a necessity. Please think about making a donation!

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

Slow Bike "Rounds"

2009-04-14T08:48:00.001-07:00

I fulfilled a childhood dream yesterday. As a child, I always wanted to be one of those women who rides her bike to visit mums and babies.

I must have heard about it from my mum and her friends, talking about their pregnancies in the north of England in the 1950's and early 1960's. The image of the local village midwife, riding to visits on her bike, just stuck with me. It seemed slow, perfect, just the way someone should visit you when you have a new baby.

That (and reducing our carbon footprint) was why we moved back into town. But, it's only since I've had my shiny new yellow road racer that I've felt brave enough to do my client visits by bike.

So, when I realized that my son had my car, and I had to do a few visits in Yaletown, I bit the bullet, and headed out over the windy bridge. There's nothing more satisfying than going to visits in the busy downtown core and not having to worry about traffic, red lights, or parking. I even managed a whirl on the False Creek bikeway. Between visits, I stopped at a little French bistro, sat in the sun at a cafe table, and ate my lunch while answering the inevitable (but fun!) phone calls from two postpartum mums.

Thanks to my clients who didn't mind seeing me dressed just a little less professionally...what? my blue dragonfly jersey isn't totally business-like? Thanks also to my clients who didn't laugh at my helmet-head.

I rode home from my lovely visits with a parting gift of chocolates dangling from my handlebars, 30km/h (over the speed limit!) on the last bit of the bridge, past the Planetarium, under the bridge, past the Granville Island tourists, and up the hill to my home. Fabulous! Then the phone rang again. I put the kettle on and chatted some more. A pretty amazing realization of a childhood dream.

So, be forewarned...I'll probably be coming to see you on my bike very soon - glowing, shiny and smiling!

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

Warrior Birth

2009-04-08T09:51:00.000-07:00

"Next time I'm just booking a cesarean."
"My first birth was so traumatic - I want drugs the moment I start labour."
"I can't walk through the door of a hospital again."
"I think we'd better adopt our second child."

To all the women who say these words...
Please know that it wasn't your fault.
It wasn't your faulty body.
It wasn't your faulty mind.
It wasn't that you lacked will power.
It just wasn't a normal labour.
No guilt or blame.
It just wasn't a normal labour.

If you were surrounded by loving, caring people.
If you did the best you could, but the birth still shook you to your core.
If it was long and hard and unfathomable and didn't feel right...
there is usually a simple explanation.
Something just wasn't quite right.
It didn't have to be something big.
It could have been a sweet pair of hands by the baby's face,
or a head tilted to one side,
or facing out a hip,
or looking upwards.
Just bad luck on a big day.

This is the baby who didn't get the memo
about optimal positioning for birth.

Picture the baby who will come out simply and easily.
She's tucking her head down on her chest,
facing mum's bum,
has her hands in her pockets,
and is going to win the Olympic gold medal for the skeleton competition in 2030.
She's aerodynamic, flexible, adaptable,
and able to negotiate all turns with the grace of a pro.

She's lucky
born in the bathtub,
with her mum laughing.

Don't be hard on those babies who didn't get the memo,
those babies whose mums made those scary comments after the first birth.
These babies will never follow the crowd.
They'll be fiery and challenging, but totally brilliant (that's my girl!)
They're the ones who create great architecture, great music.
They are born with these passions tucked deep inside.
(Or maybe that's just me trying to put a positive spin on a difficult labour.)

The posterior/transverse/deflexed/asynclitic/compound presentation baby
tries to negotiate the birth canal
like a pine tree on the edge of a wind-swept cliff edge.
Bent, twisted.
He faces the hip, or faces forward, chin up, whatever the consequence.
This is not a birth for the faint of heart.
This is a warrior's birth.

So, when a woman calls to tell me about her first birth,
that long, epic first birth,
the one that she never thought would end,
and says that she can't ever do it again...

I ask her to thank her first baby for all the work that he or she has done.
We must not worry him or blame her.
First births are unrelenting in their demands,
because that is what is needed for us to be the best mothers to our children.
I remind her of her strength, her courage, her power as a mother.

She must have been a warrior to make it through
and out the other side.
She needs to know that it can be different,
oh, so different the next time.
I, too, have made it through that kind of a birth
then danced in the shower with my second.

She is not alone.

And, like Katie, she may choose to have her next baby at home, with the fan on, in the summer.

And, like Jasmine, she may not actually believe she's in labour until it's almost too late for a car ride, and then pant and blow through the tunnel to the hospital, and have the baby quickly on the other side.

And, like Lisa, she may find herself doing the "buzzard lope" around the house, and only get on a bed for the last few minutes of a beautiful labour.

And, like Trish, she may choose to have a vaginal birth after cesarean on her living room floor, while the trees blow outside.

And, like Shelley, she may not believe that her second birth could actually be easy until the last minute, and give birth standing up in the hospital bath-tub, then order baby back ribs for dinner.

She is not alone.
She can do this,
no matter what happens

This is her story.

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

Food, glorious food!

2009-04-07T08:43:00.000-07:00

Women often ask me if they can eat once they're in labour.

"The books say I shouldn't, but I'm such a hummingbird eater, that I'll keel over if I don't keep eating!"

"Oh, please listen to your body, and it will let you know what you should eat, and when you should eat," I answer.

Think of the fuel that your body needs to do this amazing work! It needs fuel and fluids to function properly. Can you imagine doing a marathon, triathlon, or long-distance bike race without any nourishment? You'd be the one saying, "I bonked so early, it was embarrassing!"

But hospitals are slow to change their policies. Some local hospitals provide lunch trays to women in labour, but others discourage food intake, "in case she needs general anesthetic." A client's husband (an anesthesiologist) recently reminded everyone that he provides general anesthesia to accident victims who've probably just eaten their dinner, and everything is fine. And, he asked, just how many times do labouring women require general anesthetic in labour? Probably not enough to make it necessary to starve all the other women.

I remember being at a midwifery conference 19 long years ago. A young British midwife had dared to study food intake in labour. She found that there were far more complications among women who didn't eat in labour. She also found that most women naturally throw up at around 5-6cm., and that it's better to throw up something than nothing - way less acidic! All the midwives stood and gave her a round of applause, and declared that this would put an end to giving women only ice chips in labour.

But, 19 years later, that paper, and all the subsequent research, hasn't totally filtered down to the community level. And, "don't eat in labour" is still in so many of the childbirth books!

The hundreds of stories that I could tell about eating in labour...

But, here's just four memorable ones...

The British woman who made me sit there while she finished making a full roast beef and yorkshire pudding dinner. When it was ready, she sat down, took a mouthful, took a break to huff and puff, then ate another mouthful, took a break to pant... She kept going until her plate was empty. Then, and only then, were we allowed to take her to the hospital.

The woman who lived on the top floor of an old house behind the Park Theatre. She grabbed a tupperware container full of scones, to eat in the car on the way to the hospital. The container was empty by the time we arrived at the hospital. Her water broke as she walked through the doorway. She was deaf, so she would laughingly ignore anyone who tried to tell her what she could or could not eat.

The woman in Yaletown who asked her husband to cook her "an omelette." Well, he made a 3 egg omelette thick with peppers, mushrooms, onions, and sausages. Unbelievable! She walloped it off! (Sorry, to translate - "walloped it off" means "ate it really fast!")

The Burnaby woman with a black belt in Tae Kwon Do who had her husband run to the market to buy her papayas. She ate two. (Little did she know that her natural urge had led her to eat a fruit which can increase the power of uterine contractions.)

These women all arrived at the hospital late in labour, and had their babies in short order.

Food, glorious food!

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

An adagio hits a day of speed at full force

2009-04-05T11:01:00.000-07:00

I've noticed that I can manage most things as long as I move slowly through the day.

Within a few weeks, my children and parents will all be living within an easy bike ride.

I can walk or ride my bike to visit most of my clients. (Yes, you can expect helmet head when the weather is good!)

I can walk home from both BC Women's and St Paul's after births (there's nothing like breathing in the crisp early morning air as I walk over the Burrard Street bridge at 6am.)

The huge physical and emotional effort required to be intensely focused on a labouring woman and her family for hours and hours (sometimes days) is only possible when I live slowly, with intention, and gain strength by moving through the world using only the power of my legs.

Last week, I was reminded of how I used to live with the continual drain of moving at high speed. (How did I spend 17 years doing the 60km daily return commute from Tsawwassen?) So, there I was, driving along the highway to visit my best friend in Crescent Beach (I can only manage this 90km drive about once a month, now that we live a Slow Life). My iPhone alerted me to three email messages, two clients called to talk about miscarriage (on speaker), another called to let me know that she was in early labour, my mum called to say that my dad's blood test showed that his leukemia was gaining an upper hand and a blood transfusion would be needed soon, and a postpartum mum called to talk about her baby's latch.

And behind all of that, like a sound of a cellist playing Albinoni's Adagio in the background - pulsing, throbbing - was the vision of a client's beautiful 8-month-old daughter who had just lost her battle with an unknown lung disease. She is the first child ever lost to a client in 21 years.

The sad music of her mother's face.

I could have handled it all, if I'd been riding my bike, drawing on the strength of my body, the pumping of my heart, feeling connected with the world. But, somehow, it just all seemed too much, driving at 110km/h. 120 km/h. The adagio had hit this day of speed at full force.

I needed to be slow. I needed physical and emotional nourishment. I needed to be home. I needed to sleep long and deep. I needed to help a new mum and her baby that afternoon. I needed to visit a joyful pregnant woman. I needed to cry. I needed to hug. I needed to dig in the garden with my dad. I needed to help a baby come into the world. I needed to ride down a hill and breathe.

And, once I was back home, I was able to do all that, and more. I regained my footing, and I was able to be there, focused and strong, for everyone, and for myself. Slowly.

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

"The light is round like a ring and we move within its movement."

2009-04-04T22:36:00.000-07:00

Inside the light
your soul circles
winding down until it dies out,
growing like the ringing of a bell.

And between dying and being born again
there is so little room, nor is the frontier
so harsh.

The light is round like a ring
and we move within its movement.

from Not Everything is Now by Pablo Neruda

How do I write about the hidden realities of pregnancy? How do I write about the "opposite of birth"? How do I write about that unknown space between life and death?

In this blog I focus on the joy of working with pregnant women, attending their amazing Slow Births, and helping them through their postpartum journeys. But there are other journeys that some must travel. I hear their stories. Now, it's time to start telling some of these stories.

Because so many clients stay in touch with me after their first birth, I'm often one of the first people to hear about the second pregnancy: "I'm signing you up right away this time!" I've even had some phone calls from the bathroom! "Guess what?!"

But, since it's estimated that up to 20% (or more?) of all pregnancies may actually result in miscarriage, I also receive a number of phone calls each month from those same women - as they experience early pregnancy loss. They call me from bathrooms, from cars, from bedrooms.

"I started spotting this afternoon. What does it mean?"
"I just felt such a strong sense of dread that I went to the ultrasound knowing that something was wrong."
"I thought I was 14 weeks, but it stopped growing at 8 weeks."
"They say it was an empty sac, an anembryonic pregnancy. They say it was never a baby."
"I wasn't feeling sick any more, and I just knew."
"I think I'm having a Slow Miscarriage."
"I took the misoprostol and NOTHING HAPPENED. Can't believe it."
"Tennis ball sized things (blood clots) were coming out. I collapsed."
"I'm really struggling."
"It all happened the way it was supposed to. It was sad and awful. But it was even more empowering and incredible than those more negative things."
"I don't really know how to move beyond this sadness."
"We will try again, soon, I hope."

Eight clients have traveled this journey of loss in the past month. One woman is going through her second loss since last October, when she lost twins. Some have gone for a D&C instantly. Some have waited for weeks for everything to happen naturally. One travelled to Ontario and miscarried in her mother's home. No one had a miscarriage that was what she expected. Each story is completely different.

Sometimes, a woman and her partner must travel this journey alone, because the pregnancy loss can happen so early that she's not even seen her doctor or midwife. She doesn't know where to go, what to do. The Early Pregnancy Loss Clinic at BC Women's Hospital offers medical care, support and guidance, and Family Physicians and Counselors can help with the changing emotions that follow miscarriage. But, often, my clients call me because they know I've been through this experience personally, and have gained wisdom from the stories gathered from other women. Each woman knows that I will focus on her alone and listen as she tells her story, listen when she gets angry, and listen when words just won't work any more.

We hold our stories up to the light. We tell our stories to each other. We won't forget.

To start, this is my story. I never had a hard time physically with miscarriage. Both times, everything came away quickly, deeply, with me sitting in a red bath at home. Thankfully, I never bled too much nor too long. The physical aspect did not scare me. It felt right, complete, connected. I healed gently.

But, the first time I miscarried, in March 1986, all I could think was - Where did the lost spirit go? What was the spirit's purpose? Would it ever come back again? Was this its only time here as a physical being? I couldn't get the image of the lost spirit out of my head. I needed some meaning. And I was lost.

My husband couldn't help me. He wanted to help, but his loss was different, more theoretical. I needed stories told by women. I asked women for their stories of pregnancy loss, and heard nothing. It was still a time of whispers - "I hear she lost her baby, poor thing." Only my mother told me her stories of loss, why there were five empty years between my brother and me, and why I had a mental snapshot of her being carried out of our bathroom by large men (another pregnancy loss after a car accident when I was two). Only after I'd heard all her stories was I able to integrate my experience and find understanding.

When I miscarried a second time, in March 1988, while I was still breastfeeding my second baby, I was relieved. Yes, relieved. I admit it. I was so thankful that I wouldn't have to give up precious time with my son, precious time with my daughter. Did this lost spirit come and go just to help me decide that I only wanted two children? I really didn't feel any sense of loss. I looked at guilt and chose not to let it in. The miscarriage felt necessary, right, complete, connected.

Those losses eventually merged with the intense joy of being alive, being able to look up at the sun shining through the trees, knowing that everything is connected. We are all connected.

Now, all these years later, in March 2009, eight women called to tell me their stories of loss. Just like all the women who have come before them, they continue to tell me their stories, so we don't forget. We hold each other up to the light with our stories.

Each telling and retelling makes life feel more real, more exquisitely beautiful for its fragility.

The light is round like a ring
and we move within its movement.

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

Moleskine (or remedies for Slow Pregnancy)

2009-03-29T08:26:00.000-07:00

It's interesting what the body does to us in the last weeks of pregnancy. Even the most active woman feels the slow pull in her mind and body, urging her to wind things down. Slow Pregnancy has struck!

Sure, you still feel motivated to go for long walks (more slowly) and swim (more leisurely paced) or even join a group on a Thursday evening (and do yoga), but your mind and body are slowly, slowly pulling inward, demanding attention.

In the past week, women have called to ask if they're losing their minds, asking what just happened to their memories, their attention span, their drive?

"Remind me what week you're at?" And the answer is always somewhere in the 30's.

The body does a wonderful job of making you focus on the internal work of pregnancy, whether you like it or not, in the third trimester. At 20 weeks, the thought of working right through to the end of pregnancy seems like a great idea. The pragmatic approach will save precious sick days or maternity leave time. But as week 32 approaches, the mind starts to turn its attention away from work projects, away from deadlines, away from stress and pressure, and there's a sneaking suspicion that, just perhaps, work isn't quite so important any more...

That's when I get the phone call. "My boss is on my back about the deadline, but I just can't be bothered. I can't even remember what I'm supposed to do next! There's this pile on my desk. And I'm the project manager! I'm looking at my calendar, and nothing makes sense. What's wrong with me? I just keep bursting into tears!" Nothing wrong here, it's just the last trimester, and big work is happening inside. It's time to listen to the body, and start slowing down.

It's quite amazing how the body manages to quietly work its magic. If there's too much stress in a woman's life, and the voluntary slow-down doesn't happen, eventually there will be a physical manifestation that will force her to slow down, leave work, or change to part-time or working at home. It could be a rise in blood pressure, or some body part "out of whack" requiring daily physiotherapy. The body has its ways of demanding attention. It always manages to get each of us to slow down. Slow down.

One engineer, working in an otherwise all-male office, developed high blood pressure and memory loss that scared her in her last trimester. This normally "together" woman burst into tears at her midwife's office, unable to even call her boss to say that she was going to have to stop working. Her midwife offered to call her boss for her. The woman was so thankful, but felt so guilty and overwhelmed that she wasn't able to even make a phone call. "Stress, combined with low hemoglobin and high blood pressure? at 34 weeks?...it'll do it every time. Don't take on any guilt, you hear?" (In those days, Outlander was my prescription for her to read. Today, the equivalent would probably be Twilight. Trashy, easy to read, and great at lowering blood pressure if combined with your feet up on a good comfy sofa.)

And what about the memory loss? Studies have shown that, yes, you do lose some brain cells when you're pregnant. But, here's the amazing thing - mothering increases the neural pathways in our brains, making us unbelievably capable of doing a million things at a time. You just need to give it time. Let it happen slowly. Brains don't change overnight.

So, please be gentle on yourself, pack away the guilt, let the memory slide, slow down to Fiji time, allow the body and mind to complete the inner work of pregnancy. Be just a little bit less conscientious at work, a little less driven in the gym, a little more giving to yourself. Ask for support from those you love, from your friends, from your caregivers, or find professionals who can help you, physically or emotionally (your local hospital or health unit are ready and willing to help in whatever way possible, for free.) Read more junky novels, watch the clouds pass by, sit on a log and watch the waves...

Soon enough, you'll be able to multitask and work out, but AFTER the baby is born. There's plenty of time to be sucked into the rat-race of 21st century life, so please resist the urge to speed up for as long as possible once you have your gorgeous baby. Yes, please be slow and easy on yourselves. We are beautiful imperfect creatures who deserve hours of self-deprecating laughter each day.

P.S. I think I forgot to say something about those lost brain cells! Right...now I remember...you probably won't be able to remember a long list of things any more. But, that's okay. There's an easy way to overcome your memory loss. Just slip a little Moleskine lined journal into your purse so you can write down all your "notes to self", or ask for an iPhone with iCal as a group shower gift (I need BOTH because my brain is positively happy mush) and you'll be right back on track for the rest of your life. Right?

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

There's always room for more babies!

2009-03-27T13:54:00.000-07:00

Please email me to see if I have any openings for April, May, June or July. It never hurts to ask! Some babies have come quite early (amazingly!), so I have some emerging space available. Right, lots of room on that comfy sofa!

We'll be off to slow travel through Europe, while eating slow food, from the beginning of August until the first week of September. While I'm away, my backup doula will be available to field any questions or concerns...and even attend any early births!

I'm fully available for new clients with due dates after September 8th. Please remember that I ALWAYS have room if it's your second (third or fourth!) baby, or if you're a returning client.

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

Dare to be different

2009-03-25T08:47:00.001-07:00

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). "Soft...you are safe...your shoulders are loose...your muscles are melting...your bottom is loose...baby 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!

Okay...to 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

Slow Escape

2009-03-18T16:49:00.000-07:00

One thing that I love about working in the 'birth business' is that I don't have a structured schedule. Mine is more like a feast or famine schedule - no babies for two weeks, then BAM! four babies in three days. It certainly makes for an entertaining life.

Babies come whenever they like, and they always seem to come in a clump. Yes, a clump. "Group" would be the wrong word. A group feels orderly, predictable. But a clump - well, that sounds like just the right word for how babies arrive in the world. They seem to get a signal that NOW! is the time, and they all come in a clump, all jumbled together, jostling for position.

I attended five births the other week - five glorious, slow births. These babies didn't watch the clock (neither did their mums and dads and caregivers), and certainly didn't concern themselves about my lack of sleep. These babies came in their own time - one gently in the water, one with her mum's feet firmly planted on the ground, and a few with grand flourishes. But, they all came at their own pace - slowly, deliberately, safely. These babies taught us patience, and more than a few hard lessons.

So, when this recent clump had all arrived, I jumped at a chance to go with my husband on an impromptu visit to a small island close to our home. I didn't have any babies due for a week or two, so I could breathe easy, and run away.

We walked onto the ferry as the sun set, and, fifty minutes later, walked off the ramp into the darkness, carrying our backpacks. We didn't know exactly where the local Inn was, but the clerk had said, "You'll find it." We followed a woman who was pulling a suitcase on wheels, jittering over the rough road, hoping that she was going to the Inn. We might have been following her to her cabin, but we didn't mind. We were living slowly.

Sure enough, she drew us through wrought-iron gates to the Galiano Inn, complete with cedar shakes, tall tree posts, and, through the door to a vaulted space with a stone fireplace. We had arrived.

The next morning, we woke up to see the sun rise over Mount Baker, watched the large ferries plough through Active Pass, and laced up our boots for the day's walk. We had left our car, and our bikes, at home, opting for an even slower pace around the island. After breakfast, we walked to the Bluffs, explored the cedar forests, waved at llamas, watched the eagles soar, checked out the local organic food store, and, 15 miles later, returned to the Inn for a good soak and a read (about the Camino de Santiago de Compostela.)

The next day dawned with sunlight streaming across the harbour. Most of the other people staying at the Inn would be spending their day in the spa having hot stone massages and facials. But, that's not our style. So, we told the clerk that we'd be hiking to Montague Harbour. She had a quick intake of breath, "Oh, there's some wicked hills! You're walking? Really?" Being a mapmaker's daughter, and daring enough to interpret those lines on the map, I took a guess and said, "Let's head clockwise. I bet there'll be less hills that way." (Boy, was I gambling!)

Am I glad we didn't go the other way!!!

As it was, the hills were still a challenge. But, we just kept in mind that we were on foot, and not grinding our way up those hills on our bikes (or on the Santiago de Compostela pilgrimage!) We had time to stop, think, listen to the wind in the trees, watch the misty rain fall, feel it on our faces, wrap our scarves more tightly, gaze at the sandstone cliffs and the erratics at their feet. It took two hours to hike to the harbour, where we ate caraway cheese and stone fennel crackers on the shell beach. We didn't meet any other pilgrims on our trail, just a lone cyclist on a 40 degree hill, pretending to be Lance Armstrong on Mont Ventoux.

After four hours on the hike, we could feel each muscle working to keep us going. No pain, just good hard work. Our legs seemed to work independently, keeping pace with each other. We held hands at times. We tucked out hands in our pockets when we needed. Then we saw the rain heading our way. It came as a mist bank, white and blanketing the hills. We knew there was a pot of tea close by, at the Market Cafe, and reached the cafe just as the downpour started. A roaring fire, four throbbing legs, two cups of tea, and chocolate. Slow hike rewards!

An hour passed, and the rain softened. We ran across the street to the locals' trail to Sturdies Bay, only two kilometres away. This was our third passage of this trail, so we felt like we knew its secrets already, knew where the fern grove was, where the boggy sections were, where the people were gathering firewood, where we needed to take small steps to easily climb the steep sections. We felt like we belonged.

At the end of the trail, and around the corner, we treated ourselves to a visit to the local bookstore. It's one of those places that has reviews glued to the shelves - "John's pick", "Jennie's favourite". I bought "French Toast: eating and laughing your way around France." My husband bought "The Wisdom of Donkeys: finding tranquility in a chaotic world." Two slow life books.

Later that night, after we'd left the island by ferry, and arrived home, fully refreshed, the stragglers of the baby clump decided to arrive. Two babies came over the next three days, one after the other. We'd only been home for five minutes when the first phone call came. "Jacquie, I think the baby's coming!"

I smiled, changed out of my hiking boots, put on my birth gear, and headed out into the night. I loved our Slow Escape, but I also love Slow Birth (and those unpredictable clumps of babies!)

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

Slow Denial

2009-03-18T14:37:00.000-07:00

I promise my clients that I will always tell them the truth about what's happening during pregnancy and labour...but I must admit that I do downplay things during prelabour. Now, this is only to help the clients to make it through the crazy unexpected early stuff that really, REALLY, isn't labour.

This is the denial phase of labour.

Too often, people have the TV image of labour - your water breaks, off you go to hospital, get the drugs, and the baby is born on the bed (surrounded by gowned and gloved anonymous people). This may be what 90% of births are like...but they're not the kind of births that my clients have. They dare to be different. They live in denial. This is Slow Birth at its best.

Grandmas-to-be call and inadvertently pressure their children, "Why aren't you at the hospital yet?" Friends call and say, "I had my baby last month, and it was hell. Just go in now and get the drugs!" Labour will never progress with all those phone calls coming in. So, please, unplug the phone. Or, at the very least, record a new voicemail message that says, "No, we haven't had the baby yet, and we'll record the great news as soon as we meet our baby!" Then, turn off the ringer...and live in denial. (Oh, and you can strap on your TENS machine at this time, if you like!)

Denial works! One woman had her mum over for lunch when she was in early labour, and didn't even tell her. Then she headed out to rent a DVD, and planned to watch it that evening...and didn't even believe it when I showed up and said, "Now - you're really in labour. You'll have your baby in the car if we don't hurry!" (She had her baby a couple of hours later.) Denial worked so well for her (too well!) that we didn't have to play that game when she had her second baby.

A wonderful client had her baby last night (Tuesday night). Her "denial phase" started on Monday night. She called to say she was having mild cramps at 8:15pm. Now, I had a feeling that this might morph into labour, but I wanted her to be able to have a good night's sleep. So, I said that this could become labour, but it also could just be part of the normal changes that occur in the last few weeks of pregnancy. "Deny it, have a lovely bath, then climb into bed," I said. "This might stop, and the baby might not come for another week." She answered, "I do denial well! Sounds good to me!"

The next morning, she called to say that she'd done a great job of denying the contractions through the night, and managed to sleep quite well. Yes, the contractions had come every 10-15-20 minutes, but she pretended that this was totally normal, and she didn't waste any emotional energy on the contractions. By morning, she was feeling good, sounding bright and energized. Denial had given her a good night's sleep.

To make sure that she didn't have to do another night in labour, I suggested a good long bath after lunch. Her husband turned on music, and she had relaxed in the tub and chatted and laughed with her husband and sister. They made a great memory. They were living outside of time. "The bath was a turning point," said her husband. They didn't have to deny the labour any longer. After the bath, the contractions were 5 minutes apart and getting stronger and longer.

Are you noticing that this is a Slow Birth story? By playing the "denial game", they didn't focus on time, and allowed the body to rest and do its thing at its own pace. They were connecting as a family, and rediscovering that it's okay to trust the body's rhythm.

After the bath...after becoming so relaxed and soft, her labour began with strength and power. It wasn't long before we all headed to the hospital. The denial phase had lasted about 18 hours. We didn't count that as part of her labour. We started the official labour clock at 2pm. She started her labour happy, rested, emotionally strong, thanks to denial.

For the remaining 9 hours there was no need for denial. She could just inhabit her labour and let it advance slowly, at its own place. She danced, bathed, lunged, yoga'd, bounced the ball, stomped her feet, and sang. She only had one medical assessment during all that time. No one declared her "fully dilated", no one offered drugs, no one made her get on the bed...she just WAS in labour, without time, without judgement.

And her baby came with joy, her two feet planted on the ground. She was lovingly supported by one proud and amazed man, and four smiling women. Yes, she stood to have her baby, and clutched this little girl, called Lily, to her chest, laughing, "I don't believe it!"

Slow Denial had worked its magic!

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

Prodromal Girls (or how to have the perfect Slow Birth)

2009-03-03T16:45:00.000-08:00

Prodromal labour was the name of the game this week. Four babies were born, who each gave their mums long prodromal labours (and some long active labours, too.) None of the births were "easy" this week. But they were all amazing and beautiful and triumphant.

What's prodromal labour? It's Slow Birth at its ironic finest. It's that part of birth that isn't really labour yet (patience, patience). It's the body trying to deal with something without making it too challenging for the mum. But, the body doesn't realize that the mum has a brain (a very intelligent and 21st century brain) that continually tries to figure out what's happening...why is this taking so long?...why am I not having a 2 hour labour?...when will it pick up?...why?...how?...when? All those questions are exhausting. Prodromal labour demands that we honour the needs and rhythms of the body, and shut down the thinking brain. Prodromal labour forces the reptile brain to kick in. My job is to remind the mum that she must trust her body and baby...they both have their reasons for taking their time.

To us mere mortals, long prodromal labours can be challenging and undecipherable. However, to the four babies this week, the slow progress made perfect sense. They tried to give us their messages, and we did our best to interpret them. We promise to remember the lessons we have learned this week, and listen even more closely to the babies in future!

So, what was going on for these babies?

Baby #1: "Ooops...Who knew you couldn't come out forehead first? No one left directions for me! I thought it was a creative option! (They had to back me up and take me out, OR-style. Mum and dad didn't fuss about the change in plans, because I'm just too darned gorgeous!)"

Baby #2: "Hey, mum, I had my hand smushed against my face! And that cord kept getting in my way! I'm glad you gave me time! (I had fun being born in the water, it really helped make more room for me, and I made sure I slid out without tearing my mum, and, and, my hair was washed as I came out!)"

Baby #3: "Okay, if you only knew that I was 9lb14oz, you guys would have given me a break and been okay with the hours that it took me to figure out the best way to slide into the world! (Those people catching me all thought my shoulders would get stuck, but nope, I just needed to take my time so I wouldn't hurt my mum.) "

Baby #4: "Now, you have to understand what it was like in there. I had to twist my head this way, tilt it to the side a bit, just like that, then I thought, maybe, just maybe, I could mold my head into a banana and slide out mum's hip. (Oh, I forgot to say "Thanks" to the obstetrician who used her tiny fingers to turn my head into the right position. It was a breeze after that!)"

Now...we're waiting for Baby #5, who has yet to arrive. This baby may or may not be very overdue...who really knows for sure? We'll just have to wait and see...

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

Slow Birth Breech

2009-02-20T16:30:00.000-08:00

"Can we stop on the way and pick up a Big Mac?" asked the woman.

"Sure," said the man, as he turned into the drive-thru...

I was standing at the hospital entrance, wondering what was taking them so long. M was my very first client, and she was in labour. Her baby was frank breech (that's bum first). It was 1988.

M's family doctor was driving her to the hospital because they couldn't reach her husband at work. (Remember, this was life before cell phones and voicemail.) Charles, the doctor, worked out of a little home office in a small beach community, only minutes from her home. They were friends. She told me that he used to be a specialist in rural BC, hence his ability to roll with whatever came his way.

So, back to the scene. The doctor's car pulled up to the Emergency entrance, and out tumbled my client with a half-eaten hamburger in her hand. He parked the car and followed us into admitting.

(Okay...wait just there! Do you think this scene would EVER happen today? It was laughable then, but not completely absurd.)

We arrived at the maternity ward, and settled in. We could see the beach and the sparkling ocean from the window. There was a rocking chair in the corner, beside a full-length antique mirror. There were no monitors or equipment in the room. The nurses would set up in the hallway and only roll in the carts just before the baby was born. There was no disturbance.

"These contractions are nowhere NEAR as bad as our rowing sets!" M had been on the Canadian national women's rowing team. "Our training sessions were brutal!" (Perception is everything in birth.) I stroked her and she moved her baby down.

Now, I don't remember how long it was before her baby was born, but I do know that I was still breastfeeding my one-year-old son, and I didn't miss a feed!

There was no fear in the room, no increased anxiety because her baby was breech. The birth was allowed to happen in its own time. It was graceful and slow. The doctor just lifted up the baby's body as it was born, and out popped the head.

It

was

that

simple.

Now, you have to remember that the family doctor used to be a medical jack-of-all -trades in Northern B.C. He knew what to do at a breech birth. He knew that he had to trust the woman's need for food in labour - it would give her strength. He trusted birth.

Think about it! That was the very first birth that I attended as a doula. It was the first of so many Slow Birth lessons.

Over the next decade or so, I attended many breech births without worry. I knew I could trust the caregivers to be skilled at any and all maneuvers required. Dr. Woolley told me that he loved breech births. "At least you have something to grab on to!" Dr. Bagdan told me that breech births are often much less painful - "It's a soft bum, you know," and I remember seeing him catch two breech babies gloveless, just because they'd always come so fast (those two mums were breech themselves!) I also remember Dr. Thomas sitting on his hands and saying, "Jacquie, the key to breech births is to watch the flow of the labour. If the labour continues to progress without a hitch, then it will be fine. But, if the mother senses a block, then we'll do a cesarean when she gives the word." I saw him catch so many breech babies, and only one woman had a cesarean after she said, "It's not going to come." This was Slow Birth. It honoured the rhythm and messages of the body.

I don't know when that breech wisdom died, but after we lost Drs. Woolley and Pendleton, and Dr. Thomas retired, and the breech trial stopped vaginal breech births in their tracks, that was the end of it.

Sure, there were a couple of brave doctors (Go, Henry!) who would agree to attempt a vaginal breech birth, but that would be only if they were on-call on the day that a woman went into labour. Timing was everything - if the "breech" doctor was away, the baby would be born by cesarean.

A few years ago, my daughter asked what her options would be, if she was pregnant and her baby was breech..."Well, I'd have to drive you to Ina May Gaskin's "Farm" in Tennessee, or fly you up to Yellowknife to see Dr. Kotaska." (Recently, I told a doctor that, and she laughed, and said, "Yes, I'd do the same!")

So, you can imagine that I was thrilled to discover that BC Women's is hoping to start a Breech Clinic, which would ensure continuity of message, informed choice, and 24/7 vaginal breech capabilities. What a wonderful way to reduce cesarean rates! I hope the clinic opens soon.

I only wish that some of the new doctors could see how it used to be done - slowly, simply, and with such infinite trust in the body. Breech birth - the Slow Birth way.

Here's hoping that we can reclaim the old wisdom.

(Update April 3/09: Any woman in the BC Lower Mainland whose baby is breech, and wishes to explore the option of a vaginal birth, and whose current physician does not offer vaginal breech births, can now be admitted to BC Women's for care by a "participating" obstetrician. Thanks to all those involved for this fantastic policy change!)

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

We are not our bodies

2009-02-18T14:48:00.000-08:00

We are not our bodies.

As one who lives with birth,
I am at peace sitting at the doorway between life and death,
sitting beside each woman as she discovers the infinite.

At each birth, I must acknowledge that the doorway is open.
I honour it, thinking,
"This may be the day,"
and I am at peace.

I still remember being
in the last few lightning flash moments of labour
with my son,
thinking, with clarity,
"Death is a viable option here.
Perhaps the midwives will consider that."
But they didn't hear my thoughts, and my son
was born
onto my leg, and peed
all over me.
Our laughter seemed to make his wet skin shimmer.

I have been in a room, filled with Sufi women
mourning the loss of a baby
reciting the chapter of Mary
and hearing their chanting
knowing that the root of the word "rahim" means womb
being lifted up by their sounds
that rise and fall like the ocean
that recreate the sound of the beginning of time
the divine feminine
the womb

I wanted that day to last forever.

To our western minds,
how can a day of mourning be so breathtakingly
beautiful?

To our western minds,
how can we accept the knife-edge of pain and ecstacy
that exists in birth?

We are not our bodies.

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

Slow Biking on Valentine's Day

2009-02-15T10:11:00.000-08:00

I know this may seem off-topic, but I wanted to write about yesterday's outing (no births!). The sun was shining, it was Valentine's Day, and I'd just gone with my husband to buy presents for each other at MEC (no, not chocolates or flowers). We found a new red windjammer for me, just like the one I had when I was little, and black leg warmers (woohoo!) for my husband. Then, we headed out on our first long ride of the new year.

We talked about Slow Birth ideas, chapter topics, debriefed from recent births, and had a long ride around False Creek, through Gastown, around Stanley Park, then back to Granville Island for lunch at the best seafood shack ever, Go Fish! (for a counter-balancing calorie intake), then rode back up the hill to our loft.

What struck us were the number of people enjoying a slow day out in the sunshine (remember, it's February and freezing cold). The memories that stand out are:

Dragon Boats in False Creek filled with men and women wearing multi-coloured puffy down coats, focused on the perfect unison stroke,
a man on rollerblades near the 2010 Olympic Village, pushing his son in a stroller, with a tricycle balanced on top, followed by mum on a bike,
an old man riding his unicycle down a hill, holding a coffee cup in his hands, for warmth,
three homeless men, in three different parts of the city, on bikes loaded with recyclable bottles, all wearing bike helmets,
a group paddling their outriggers near Science World, shouting and laughing,
a man wearing a baseball glove, pitching his ball into a brick wall in the heart of the Downtown Eastside, watching to make sure he doesn't get in our way as we ride,
a family on tandem bikes, with flowers in a pannier,
5 groups of oddly-dressed people, running fast, carrying compasses (must be orienteering for team-building),
serious rowers gliding through the water at Coal Harbour,
a teenage goth carrying flowers down a back lane,
a woman quietly, happily, digging in the soil, creating a garden beside her solitary old house in the centre of town, amid the noise and cars,
four colourful pseudo-pelotons spotted around the city, dominating the bike lanes at a "slow" 40km/h,
the look on a new mum's face, just after her baby threw up all over her after a feed,
a mum carrying her newborn in a hug-a-bub, walking up the ramp after buying fish from a boat,
people working on their guerrilla community gardens, wiping dirt off their foreheads as they chat,
families, pregnant couples, babies, walking, riding, talking English, Spanish, Farsi, French, German, Japanese, laughing.

But the most amazing thing is that we connected with each one of these people on our bike ride. Our eyes connected, we smiled as we passed, we called "Hello!", we waved...

The connections are what count as we travel through our lives, and I think we're all doing a pretty good job of it in our little corner of the world...

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

"I'd like to order one epidural in the parking lot, please"

2009-02-13T12:42:00.000-08:00

During our initial phone call, many first-time mums nervously laugh, 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, or result in a greater likelihood of heavy bleeding. If your body naturally gives you a fast birth, that's just fine. But, I wouldn't willingly force a normal labour to move faster than it should. And, for those wanting to order "one epidural, please" in the parking lot...with a fast birth, there's just no time.

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.

Slow birth works, just like slow food. Plain and simple. Just a glorious mix of natural ingredients, without any additives -and so very, very good.

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

Slow Birth > Mt Kilimanjaro

2009-02-13T11:21:00.000-08:00

"Jacquie!" says the voice in the night. "I'm in pain."

It was 1:38am and I had a feeling this wasn't going to be her time. "How often do you feel what you're feeling?" I asked. "About every 10 or 20 minutes. But it really hurts!"

These night-time prelabour calls come often and, just like a baby needs to be calmed before going back to sleep, I just need to offer calming words to each woman, then sleep will come to her soon (after a good long bath). I remind her that the process of having a baby takes weeks, and this is just part of the body's way of preparing. The hormones work even better if she's soft and warm and sleepy...so into a bath, then back to bed. Sleep.

Days later, the real labour call came at 11:27pm at night - from her husband. "She was having a bath again, like the other night. But this time, she leapt out of the bath and started crying out!" Ah! It's her first baby, but when I hear a man's voice, I know I have to fly over. It's time.

Midnight - Contractions are 3 minutes apart and strong. She's moving, standing, sitting, breathing, swaying. She feels hot and cold. She loves when I shake her hips and the power slides down to the ground through her feet. "Jacquie! These aren't contractions! They're expansions!"

"I need to walk!" and she climbs the stairs as each expansion comes, marching back and forth through the house, hands on hips. She's amazing. "Hoo Hoo Hoo..." She runs.

In a Slow Birth, we trust the labour to tell us what to do. We're not looking at the clock (I don't even own a watch), we sense the increasing rhythm of the labour. The signs are always there - the blood (that's good), the clothes being stripped off (oh, so good), the nausea (it will go as soon as the stomach empties - quickly!), the shine on the tummy, the glowing face, the knees, and then...

"Pressure in my bum!"

We arrive at the hospital at 2am, after a safe drive through the empty streets, cool air fresh on her face. Almost 8cm, melting to 10cm. She's ready to push within half an hour.

Birth is sacred, and this birth is fresh and new, so the rest of the birth story belongs to this couple, crazy and hard and slow...and proud.

"Bonjour, bonjour!" I leave them three hours after the birth, curled around each other, the baby at the breast. "That was harder than Mt Kilimanjaro!"

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

Slow Birth is born

2009-02-08T22:17:00.000-08:00

Maybe I'm just a little slow...but I've finally decided that I have to act on my decision (2004) to start focus-writing on Slow Birth (think slow dancing, slow cooking, slow kisses, slow lane, take it slow, baby...) Don't you just take a big breath and sigh when you read those words?

I loved reading "In Praise of Slow" by Carl Honore, and discovering the Slow Food and Slow Travel movements as they emerged. We had always raised our children according to the "slow" philosophy. We talked, we listened to music, we read books together, and my husband and I kept our lives in pace with our children's development - we kept things slow, and the family flourished. When the slow movement began, it was nice to see that other people were discovering this way of living.

Every week, I still make my slow-cooked soup, just like my mother. I treasure my red Staub Cocotte and joyfully watch my family eat my lemon-braised chicken (then love to hear my brother talk on the phone about trying to replicate the tastes in his own home in Oregon). We eat local produce (carrying our bags to Granville Island market or riding to outdoor summer markets) and try to do our best to honour the 100-mile diet (though, we're gentle with ourselves when we fail).

Now that our children are all grown up, we live in the centre of it all, live small (in a loft), ride our bikes, and walk every day (I love walking to client visits, or walking through leafy Shaughnessy on my way home from a birth). When we're on holiday, we don't try to "bag the sights". We take our holidays slow. This summer, we'll be hiking the Scottish hills, riding our bikes across the Provencal countryside, and sleeping in stone-built cottages for a week at a time - exploring new places at a snail's pace. We'll carry our reusable bags from shop to shop in Montmartre (thanks to Clotilde for telling us where to go) and take our baguettes and veggies home to our flat, then bike ride through Paris using Velib.

So, it's only natural that I would try to help my clients (okay...you're seeing my bias here) to have a Slow Birth. Slow Birth honours each woman's hormonal rhythm, allowing for the ebb and flow of labour. If there's a plateau in labour, Slow Birth means listening to the wisdom of the body, and letting the body take its own time. In Slow Birth, the clocks are all turned around. If we rush the body, we often do it harm. Slow Birth is like lovemaking...it just doesn't like to be rushed...and interference can stop it completely.

Slow Birth doesn't mean that the birth has to take a long time. Birth should stand outside of time. It may be fast. It may be slow. But birth should be allowed to take the time it needs.

Slow Birth - reclaiming the natural rhythm of pregnancy, birth, and parenting. Watch for the launch of slowbirth.com....coming soon...but slowly...

And in the meantime, take some time to check out my debut blog on SlowPlanet!

- Jacquie Munro, Vancouver Doula...and SlowBirth...and SlowPlanet

"It's a GIRL!!!"

2009-02-05T18:05:00.000-08:00

That exclamation is becoming more and more rare. I miss hearing it at every birth, now that so many docs have in-office ultrasounds and clients bring their families to pay-per-view 3-D and 4-D ultrasound "Discover the Sex" parties. These days, the baby's birth is often pretty quiet...no exclamations of "It's a BOY! or It's a GIRL!" any more.

For me, waiting until the baby is born to discover the baby's sex is one surprise that I truly enjoy. It's the best surprise in the world - more people should try it!

At the most recent birth - what a rush - we were ALL convinced that it would be a boy. But the parents hadn't wanted to find out the sex in advance. After two boys, I don't think mum, dad, doc, or doula couldn't even entertain the thought of this baby being a girl. There would have been too much expectation. They just believed they were having another boy, and that was that...

So, when baby came flying into the world after a whirlwind labour (yes, mum was chattering with us about boy names only half an hour earlier, and we were only in the birthing room for, what? nine, ten minutes? before the birth). I really did a double-take when I checked between baby's legs. "No penis...where's the penis?" said my mind. Dad had already seen that it was a girl, and whispered it into mum's ear.

"I can't believe it!" she cried. She laughed. "I'm in shock!"

No longer can she see herself as the "mother of boys". No longer can she call, "Boys!!!" when dinner's ready. Her own perception of herself changed with the realization that she had carried a girl for 9 months. In a moment, this new member of the family had changed the future.

We all looked in awe at this pink, bonnie girl, who tipped the scale at over 8.5lbs...and has a bottom lip that is already familiar with a pout that you can ride a bike on!

Yes, for sure..."It's a girl!" What a wonderful surprise!

(2/12/09 - Tee! Hee! She bought a PINK hug-a-bub for her baby girl, Paloma. So cool!)

- Jacquie Munro, Vancouver Doula

The Birth Paradox

2009-01-31T14:22:00.000-08:00

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

2009-01-30T17:48:00.000-08:00

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

2009-01-29T15:34:00.000-08:00

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

2009-01-26T12:19:00.000-08:00

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!

2009-01-25T20:22:00.001-08:00

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!

2009-01-25T17:02:00.000-08:00

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?

2009-01-14T14:47:00.000-08:00

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

2009-01-14T14:43:00.000-08:00

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

Mikajo Yagi (1924-)

On Keeping Tidy

2009-01-08T15:47:00.000-08:00

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

2009-01-05T12:47:00.001-08:00

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...

2009-01-03T13:15:00.001-08:00

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

Birth with Two Snowmen

2008-12-22T07:44:00.000-08:00

Birth is never what we expect. Even though we may say we don't have expectations...we do.

So, when I arrive at the hospital around 6am with a client who is 7cm and stretchy to full dilation...there's a part of me that expects her to be happy and nursing her baby by lunchtime. Admit it, Jacquie...after almost 800 births as a doula...you do have certain expectations.

Yes, I must admit, I do have some expectations. But, so do you. If someone told you the birth story later..."she had her beautiful baby girl at dinner time"...you might say, "I expect that she had an epidural (isn't that something that usually slows the labour?)" But, no, she had no epidural, no pain meds at all. Things just slowed down to 1 or 2 contractions every ten minutes for most of the day. She even managed to sleep.

What made things slow down? Probably not just one thing. Perhaps it was a combination of our collective expectation (totally subconscious), head position (asynclitic/deflexed), and/or compound presentation (hand or cord in the way?) Or maybe it was, as some cultures believe, the will of the baby. She might have just wanted to be born at dinner time..."I don't like breakfast!"

So, though I'm sure we all had the expectation of a quick and uncomplicated birth, that just wasn't this mum and dad and baby's story. This birth was our reminder to respect the need for infinite patience, and to respect each baby's journey, each family's journey together.

How else would we all have had such a special day to watch the snow quietly, honour the passage of time, and see their family gather, build two snowmen, and shed great tears of joy when the baby finally arrived. I don't think the day would have been quite so wonderful otherwise.

- Jacquie Munro, Vancouver Doula

The Recovery Effect

2008-12-11T21:05:00.000-08:00

It's really odd. Whenever I'm recovering from an illness, all the births come easily and quickly. So, what's with that? In the first couple of weeks after I returned to work after my Uterine Fibroid Embolization, I laughingly said to clients that I could only manage a 6-hour labour. It was a joke! But, they all obliged.

No, I don't really think it's a fluke, because it's happened before. When I was recovering from pneumonia one year, all births in the recovery month were speedy, and I seemed to spend less than 6 hours with each. No kidding! (And, no, it wasn't that I showed up late and left early.)

It seems to be the same effect that occurs on a day when there's a nursing shortage(due to fabulous weather?) at the hospital. If I'm told by the assessment nurse that there are only beds for women who arrive "ready to push", then my client miraculously speeds to full dilation in no time at all.

The mind is a powerful and wonderful thing...

My only worry is...now that I'm totally well and feeling great...will my clients have long births again?

Hmmm...a dilemma...

Anyway, here's a snapshot of the births that I've attended recently...

Eli - Ah, the beautiful boy who wanted to get here extra early. "What? They want to send you to Prince George to have the baby? I'll fix this!" And we fixed it. Phew! Now THAT was a whirwind birth...17 minutes from "I think the baby's coming", was it?

Eva - How can I be even more emphatic in future when I tell clients to get in the car (during what they think is early labour) and head to the hospital? "Yes, I know your first birth was long...but you had forceps! There's a wide open freeway available for this baby, and she's going to use it!" We met at 69th and Oak...and panted and breathed all the way to the hospital. I'm so happy that we have cell phones to alert the doctors and nurses that we're INCOMING! "We did it!" cries mum.

Noah - Another second baby who followed the "slow slow easy...BOOM!" entry to the world, thanks to a doctor who knows how to spin babies. I love these posterior babies with strong personalities. They certainly know how to make a grand entrance when they decide to come (4-10cm in 20 minutes)!

Ella - A first baby who wanted to pretend that she was a second baby... Ella made her mum dance and sway, then make a dash to the backseat of my car (funny memory of the concierge trying to focus on reading his paper while she laboured in the lobby). Zip up to Cedar at BC Women's...and voila! Ella came so quickly that it surprised pretty much everyone. The sun shone through the skylight...amazing.

Lauren - Wow...another first baby who wanted to earn the speed record (4-10cm in less than 2 hours, when you'd expect 6 hours). I just love mum's words as she started to push..."It wasn't that bad." ...and dad noticing that the baby sounded like a "baby pterodactyl". Just wonderful!

Oscar - He came so quickly for a first baby...unexpectedly born in the hospital, but home before bedtime. His mum laboured with grace, and his dad touched his head, a sacred act, just minutes before he was born. Sweet pea!

Amaan - A dark night...driving through the rainy streets...a long walk up a hill to the hospital entrance (stop, hug, pant, breathe)...then gentle care as the baby comes quickly. "I did it! I felt it all!" Welcome little one.
What a triumph!

What a joy and a gift to be able to be a witness these miracles.

- Jacquie Munro, Vancouver Doula

Good as New

2008-10-20T17:54:00.000-07:00

Touch wood...I'm feeling as good as new and ready to work!

I'm not allowed to lift anything (like a post-cesarean mum) for a while yet...but I generally don't plan on lifting pregnant mums. That's a job for the dad!

So, please don't hesitate to call me!

"Oh, is this the fibroid?"

2008-10-11T12:05:00.000-07:00

Well, well...take a look at the quote above. Picture the scene. Lovely, caring and chatty admitting clerk walks me up to the ward (with my dear husband). Since it's 6:30am, there are no nurses to be found. A nurse comes out of a room and wanders down the hall (was she sleeping in there, I wonder?)

The clerk says, "I have a new patient for you," and the nurse replies, without looking at me..."Oh, is this the fibroid?"

The clerk pointedly answers, "Her name is Jacqueline Munro, and she's here to have an embolization this morning."

Rather than making me upset, this dehumanizing language almost almost made me snort with laughter. Three thoughts instantly came to mind: 1. Sarah Palin (queen of the stupid comment). 2. If only I was a cartoonist, then I could have done this comment justice. 3. Who teaches these young nurses anyway? Empowering and respectful language is paramount, girls!

Thankfully, shift change comes quickly, and my pregnant (of course!) day nurse K was lovely!

Thoughts and questions about my hospital experience...

1. Everyone should have a doula...for anything done in hospital. At least the doula would make everyone introduce themselves!
2. Catheters without an epidural are not fun...not exactly painful...but very unpleasant.
3. Why are patients blamed for the nurse's inability to successfully insert an IV on the first try? "You mustn't have been drinking enough water." (Nope...I'm floating in the stuff!)
4. Nice art work in the recovery area at UBC...very nice... (Okay...I must be drugged) The Fellow says I have more fibroids than she could count (I love being unique).
5. Why did the anesthetist play Bob Dylan's Blowing in the Wind? And why do the nurses and resident think that it's Willie Nelson (They're TOO TOO young to be working on my body!)
6. Why did everyone start talking about Halloween while I was being given a cocktail of conscious sedation drugs?
7. I want to thank the porter for singing me lullabies while in the elevator.
8. I'm not accustomed to having a heartrate of 44 (Is this the effect of fentanyl or morphine? Yikes!) The talk of atropine doesn't thrill me.
9. The bed was quite comfy.
10. Wherever I go...even when I'm totally drugged...people tell me their birth stories in great detail, and want to know if I approve of their doctor/midwife/OB/hospital choice. I just want to sleep!
11. Who added those sickening bumps to 16th Avenue?
12. Why don't I remember seeing the specialist whose name is on all my prescriptions? Was he hiding or did the fentanyl make me forget?

One client said she's happy that I'm going through all this...at least I'll have the hospital experience fresh in my mind. Well, I can tell you that I can now relate to having narcotics (I stopped taking them asap), that I understand the agony of post-surgical gas pains and nausea (someone needs to warn you about this BEFORE the cesarean), that I know the feeling of a digestive system that isn't quite ready to start working again (also - thoroughly unpleasant), and that I now feel like I'm 10 weeks pregnant (and waiting for the morning sickness to go away).

But, I can also say I'm in awe of the fact that my hemorrhaging stopped as soon as I was in recovery. I'm happy about that...but still waiting for the other shoe to drop.

Each day, a little bit better. Those healthy wishes from friends, family, clients and blog readers really do help. Thanks!

p.s. The photo is of a fibroid knitted by a medical student...

- Jacquie Munro, Vancouver Doula

I'm off to see the wizard...

2008-10-07T16:16:00.001-07:00

I'm off to see the uterine fibroid wizard at UBC Hospital first thing in the morning. "No food after midnight, etc., etc." This is all new territory for me. My only previous major hospital stays have been for my children's births. Though I'm going in for a different reason, the focus is still on the same body part...the uterus. Everything I do seems to revolve around this amazing muscle. I hope it cooperates tomorrow. I should be up and running in a few weeks...

Wish me luck!

Lady in Waiting

2008-10-02T13:34:00.000-07:00

If you’re having a hospital birth, perhaps one of the most challenging parts of labour is the transition from your home to the hospital. Many couples worry about the car ride to the hospital, but it’s amazing to see how most women manage the ride with surprising grace. If the car ride is timed so that it coincides with the trance induced by high levels of endorphins (well past the mid-point of labour), then the whole journey can be manageable.

To illustrate - I vividly remember one client’s ride to BC Women’s from UBC. It was around 4am. She threw a coat over her naked body, somehow managed to run to her car down a long apartment hallway (between contractions), then crawl onto the back seat of her minivan, exposing her bottom to an old man in a trilby hat, who was coincidently walking his little Scotty dog past us at that moment (you should have seen his face!) Bouncing along in the car, this normally private woman laughed and laughed. “That was FUN!” Yes, the trip was uncomfortable, with her husband trying to negotiate hundreds of potholes, but the absurd nature of the trip far outweighed the pain it may have caused.

The stories that result from the car ride can be epic, from the woman riding to the hospital with her head popping out of the sunroof of a Mini, to a recent dad’s call to BCAA: “I locked the keys in my car with the engine running at the Emergency entrance to the hospital!” If you’re lucky, you’ll notice the absurdity in the moment, and laugh.

Now, it’s the hospital assessment room that can be a possible source of stress. If you’re lucky enough to have a midwife who has already completed the assessment at home prior to hospital arrival (which happened last week with one client), you might manage to bypass the assessment room altogether - yahoo! - and go straight to your birthing room. This causes a lot of excitement and very little stress.

The next possibility is that the family doctor will meet you at the front door and do the assessment personally. The continuity of care provided in this scenario is wonderful, and the time spent in the assessment room can be relatively short, provided the hospital can quickly assign you a nurse. There’s also the added bonus of having an additional advocate present to help negotiate the hospital protocols. If I’m lucky, I can coordinate this...but it’s really hit and miss.

If the family doctor is busy with another birth, or en-route, or your primary caregiver is an obstetrician or resident, then we have to hope that the assessment room is not too busy, that all the other women in the assessment room don’t require high levels of care, that the staffing levels aren’t low on this day, and that there’s more than one nurse available to care for the 5 beds in this area. Fingers crossed that the assessment room stay won’t drag into multiple hours, which can easily happen. (I always try to call first, so at least I can alert my clients to the possible delay.)

There are a lot of variables that can increase a woman’s stay in the assessment room. The assessment room nurses (who are amazing, highly qualified, and caring people) do everything in their power to take into account BOTH the triage process and each labouring woman’s needs. There’s a lot of paperwork to be done, protocols to follow, personalities to placate... The assessment room nurse needs 8 arms, two heads, and more than a little wit and understanding, to make it through each shift.

It may appear to clients (husbands especially, since the labouring woman is generally just focused on each contraction) that the nurses are sitting at the desk doing nothing. Often, the people sitting at the nurses desk are not the assessment room nurses, but interns, residents, other doctors, or even a clerk. The supervising nurse in assessment must juggle all her patients to ensure that the woman with the highest care needs can proceed to the next “level”. Granted, the nurse might not be able to explain what she is doing for each woman during the process, but that’s what I try to cover with clients in between contractions. “Yes, it might look like you’re being ignored, but you’re NOT. She’s left the room to negotiate with labour and delivery to have a nurse transfered up to Cedar to be with you, so you don’t have to wait until a Cedar nurse returns from her 45-minute break, etc. etc.” It’s my job to fill in the gaps in information. But, if I need to breathe through the contractions with the woman in labour, the dad will have to wait a bit for my briefing.

Even a 45-minute stay in an assessment bed may seem like an eternity, but it’s about as fast as the system and safety will allow (unless you’re ready to push...then you get to fast forward!) For example, the nurse needs to read a woman’s chart thoroughly to determine her risk status, her drug allergies, her particular needs, and contact her caregiver (and wait for a response). If a nurse is forced to cut corners, a woman could inadvertently be given a contraindicated medication (i.e. fentanyl being given to a woman with an drug allergies), or miss important medical information. I am able to highlight certain important points when I speak personally with the nurse, but she must confirm this by reading through the notes, and then doing a thorough history and assessment herself.

The setting certainly doesn’t make a labouring woman feel safe or calm. The beds are narrow, the space is noisy... But, I ask all clients to imagine that we’re still home, to keep their eyes closed, to focus on a calming hand, the soft pillow, their partner’s voice, my voice. Often I have to talk the woman through each and every contraction, so that she remains calm between each contraction. Yes, she might roar during contractions, but that’s her way of coping. It’s the in-between times that tell us how she’s doing. If she’s able to breathe calmly between contractions, or even say, “Wow! That was intense!” or “I didn’t like THAT one!” then she’s fine. (I try to wangle assessment bed 5...the one with a DOOR!)

As a doula, the assessment room experience is certainly challenging. It takes years of experience to negotiate the process gracefully and diplomatically. Most problems can be prevented creatively. Petty staffing wars can be averted by anticipating them in advance, and steering clear of potentially tense situations (trust me, I’ve seen it happen recently.) Protecting the woman in labour is paramount.

Sounds like it’s better just to stay home until you’re ready to push (which is what one doctor laughingly suggested recently).

Hmmm...at least you have a doula with you who knows the staff and your caregiver, and can provide the best possible “concierge service” around...

- Jacquie Munro, Vancouver Doula

Ticking the "Home" box

2008-10-02T09:31:00.000-07:00

A former client recently emailed me, asking me to write a post about home birth. Was she searching for information for the ongoing debate with her husband? Even though it is the woman who must ultimately make the decision about her birth setting, it is imperative that her partner is included in the process of informed choice, and comes to understand and support her decision, without fear.

Since I'm known as the research-oriented and pragmatic doula, I'd better throw in some evidence. So, here are a few things I want you to consider:

1. When you are presented with two equally effective treatments, then "best practice" requires that you take into account the patients' preferences (that means HER).

2. The Province of British Columbia Ministry of Health fully funds care by registered midwives, both at home or hospital.

3. A 1986 World Health Organisation report concluded that “home is the most appropriate birth setting for most childbearing women. Women (and their attendants) choosing this option must be provided with necessary diagnostic, consultative, emergency and other services as required, regardless of place of birth.” See College of Midwives of British Columbia.

4. In 2002, the "Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia" was published in the Canadian Medical Association Journal. The results showed that "women who gave birth at home attended by a midwife had fewer procedures during labour compared with women who gave birth in hospital attended by a physician." "Comparison of home births with hospital births attended by a midwife showed very similar and equally significant differences." The final interpretation of the study was that "there was no increased maternal or neonatal risk associated with planned home birth under the care of a regulated midwife."

5. In September 2007, the UK National Institute for Health and Clinical Excellence issued clinical guidelines (The NICE Intrapartum Care Guidelines) on intrapartum care of healthy women and their babies during childbirth. Under ‘‘key priorities’’ it stated: ‘‘Women should be offered the choice of planning birth at home.’’ Information suggests that for ‘‘women who plan to give birth at home or in a midwife-led unit there is a higher likelihood of a normal birth, with less intervention’’.

After attending almost 800 births in my 21 years as a doula, I can now say that I'm most comfortable (and I feel most safe, actually) at a home birth, with a client who has come to this decision freely, who is autonomous, who is radiantly healthy, whose midwives (there are always two present) are trusted and respected by all of us, and who has a partner who fully supports her decision without fear. But that's me...now.

I can't squish a woman into that mold. I would never want or expect everyone to be "that woman". A woman must go on her own unique and challenging journey to trust birth that much. I trust each woman to make the decision regarding the best place FOR HER to give birth, and with whom to give birth. I support each woman without reservation, no matter what her choice. In order to give birth at home, a woman has to gradually grow into the person who can make that decision. I know I didn't reached the point where I would have chosen home birth until I was 31, after giving birth to two children, and after attending over 100 births (many at home). Until then, I simply didn't have enough information to make an informed choice about home birth myself, even though I HAD made the amazing, and life-changing, leap to midwifery care for my second birth!

So, to the couples who are spending evenings debating home birth (she wants it...he's not sure...grandma says "over my dead body"), please do your homework. The research is clear. The more difficult task is to deal with the images swirling in your heads - images born of myth, misinformation, and fear, fueled by society's expectations and the media's lopsided representation of birth. You need to talk to people (call me - my clients would love to share!) about their personal experiences of home birth, watch movies which include home births (like The Business of Being Born or Le Premier Cri), and understand that choosing home birth doesn't lock you into that option. It just means that you can now include another option in your choice of birth places - you can now tick the "home" box.

When asked where she was planning to have her baby, one family doctor with four children would always say, "Wherever it wants to come out!" (In the end, she had #1, #3 and #4 at home, and #2 at the hospital) Because...on the big day, if you've given the body and the baby both options (hospital AND home), their final choice is always loud and clear!

Now, if I could only let you into my head to see the images of the home births that I've attended...but that's for the next post...

- Jacquie Munro, Vancouver Doula

Lying in...

2008-09-29T10:57:00.000-07:00

Well, this month has continued to be full of lessons for me. I've been listening to my body and caring for it very well. I'm astonished at how much better I feel already. Though still anemic, I'm light years ahead of where I was in August. I can climb stairs and not pass out! My heart isn't racing if I walk to the bathroom! I realize now that I was living in a perpetual state of "pseudo-9-month-pregnant life"...you know, that period where you deliberate over moving the bed into the living room just so that you won't have to climb the stairs...or find that linking arms and sauntering is de rigeur (rather than your usual non-pregnant power walking).

I'm well enough to feel good about heading into hospital on October 8th. I'm not daunted by the post-procedure pain that I've been warned about ("You should be able to relate...it's like a couple of days of labour," said one doctor.) I'm not going to fight the suggested recovery time of a few weeks... I will listen to my body and honour its needs.

(p.s. The amazing painting is "Crawl Out" by Vancouver artist Madeleine Wood)

- Jacquie Munro, Vancouver Doula

Listening to your body

2008-09-11T12:50:00.000-07:00

Well, it's certainly been an interesting month...I now know how the VGH ER works when you really need it (yes, the triage system works well and I jumped to the front of the line!), how little an IV hurts when you REALLY need it, and how fast you can get appointment with specialists in the BC Medical system when you are considered URGENT. I also know the odd, prickly, clammy, scary feeling that comes from losing too much blood...very interesting (from a professional standpoint), but I don't need to experience it again.

The whole time, my mind stayed in doula mode..."Ah, that's what a good fast IV feels like"..."Interesting - even though you know there's no needle in there, you just don't feel like waving that IV arm around". I was happy to receive such respectful care from the VGH staff (who even turned around my bed to face the wall so I could gain more privacy during an exam, without me asking). And, in the middle of caring for me, one nurse chattering, "Wow! You attend births? I think cesareans should be the way of the future...I'd rather crack open a chest than watch a birth. You're so brave!" I laughed, even though I felt ready to pass out.

And I can still see the smiling face of the ER doctor as he came in and said, "I want you to know that the biopsy was negative for cancer." I almost laughed...I really (amazingly) hadn't considered that to be even a possibility. It was quite funny, honestly.

Interestingly...I presented with such CRAZY high blood pressure (I've NEVER even seen a client with HELLP syndrome have this high BP) that I got 3 nurses at once. Hmmm...probably not something to brag about. So...I'm not pleased with my body this month, and that's an odd thing for me.

I always tell clients that they can trust their body, that we just have to figure out what the body is trying to say. Well, I'm listening and waiting...

Perhaps everyone's right in saying, "Look, you have cared for others for 20 plus years. Now it's time for us to look after you."

So, thanks so much to my docs, Stephanie and Kristin, for telling me to take this month off, and expediting matters so successfully. Thanks to my clients who call to check in, or send text messages that make me laugh. Thanks to my husband (for taking time off work to care for me) and my family (my mum and dad even come and clean for me!)

And that postpartum tip about asking for help? It works! If you just tell people how you really are doing...they will step in and help. It's quite amazing. The struggle for new mums (and now me) is in the acceptance. I think I'm good at acceptance now.

So, to all my current clients due in the next few months...we'll just have to see how my appointment goes next week, and then I'll be giving you a call (surgery may await!) My daughter, Sarah, and I might be doing tag-team birthing for a while. But, I'm always here, ready to listen and help guide you through your pregnancy (this hasn't affected my mouth or ears!)

Okay, body...I'm listening...

The curse of the efficient woman

2008-08-07T16:58:00.000-07:00

I always encourage clients to send me a blog post after their birth. Here's a post that I asked dear Kate to write after she told me about one day in her "life as a new mum". I'll be writing more about her amazing home birth (and the string of amazing home births I've attended) recently....as soon as I've had some sleep...

"This is for all the women who are doing very well... you know the kind - maybe you are one. One whose families are wondering, why does she keep calling her doula every two days? Surely a doula is just necessary for the labour part. Maybe even your husband, who was over the moon at having a doula present at birth, is a little skeptical:

"You like calling Jacquie, don't you?"
"I do! And she says we can call as much as we like anyway!"
"I guess she hopes that it tapers off after awhile, even though she says she's ours forever."
"Well she doesn't expect it to taper off THIS quickly!"

My father's partner calls this "the curse of the efficient woman".

I admit it, I'm doing well. My labour was short (so short, we didn't make it to the hospital - hurray for homebirths!), my stitches have healed, my breasts don't hurt, and we get some sleep every night. My baby is gaining weight and generally seems happy. Now he is five weeks old, and I made it out to stroller fit yesterday. Today,with Sacha happily sleeping in his baby wrap, I cleaned the garlic we've grown in our garden and made a fresh batch of granola, all before noon - perhaps I am an efficient woman. But even we have 24 hour periods like the one I'm going to tell you about, when Sacha was just 3 weeks old...

Nana, my mother-in-law, was visiting, and we decided to head out to Langley to pick up some berries. While we were there, I figured I ought to have lunch with my baby sister, still just 19, who lives there with her mother (who is not my mother). Anyhow, my sister has a stepsister, also 19, who had a baby 4 days after mine. I have worked hard to avoid jealousy over the fact that my own baby sister has another nephew to adore just when I have provided one for her... So when, during lunch, my sister holds Sacha the entire time, but talks steadily the ENTIRE time about the OTHER baby, I do my best to smile and encourage. After all, a teenage mum needs support, and I should be glad my sister is helping out so much. When we were sitting in the restaurant after my sister leaves, Nana takes Sacha and says to him, "Well, Baby X sure is a perfect baby, isn't he?". I laugh, relieved that I'm not crazy. And after all, I am doing well... so I still have a sense of humour.

Later the same day, Sacha, Nana and I are on our way home... Unfortunately, we overshoot feeding time by about 15 minutes. The last bit of the drive home is a combination of wild, distraught screaming from Sacha, punctuated by eerie minutes of silence in which I become terrified that he has screamed himself out of air... But, we make it home and he gets fed. I laugh, relieved that I can so easily meet my baby's needs. I am doing well...

Midnight that night, disaster strikes. I have fed Sacha, and burped him. When I lay him down right after a feed, he gets the hiccups, starts to cry, and things go downhill from there. So I am in bed, slighltly propped up, with him on my chest. Have I mentioned my son is strong? Somehow, while I am semi-dozing, he pushes up, rolls to the side...and right off me onto the floor. I jump up with a shriek, pluck my beautiful baby off the hardwood floor, and lay him on the bed to examine... he hasn't even woken up... his eyes open as and he sees me above him, talking hysterically to his father about whether he is concussed, whether we need to take him in to the hospital. Meanwhile, Nana runs into our room having heard the fuss... there I am half naked sobbing "I d-d-d-d-ropped him on the fl-fl-fl-floor..." We all notice that my nursing pillow is on the floor right where he landed.. Everyone concludes that he landed on the pillow. And, well, babies get dropped (I got dropped 3 times on my head according to family lore). I laugh, relieved that Sacha is ok, there are no bumps and bruises. Nana goes back to bed. But I am officially NOT doing well...

"Aren't you mad at me?" I ask my husband, still sobbing.
"Of course not. You didn't mean to, and he's perfectly fine!! "
"But if you'd done it, I'd be FURIOUS!!"

I cry some more over my own double standards... Eventually, my husband suggests that I take the baby downstairs for a cuddle so I can work out all my guilt. I follow his advice, and an hour later I manage to put the baby in the bassinet and throw myself back into bed for a few hours of desperately needed sleep.

The next morning, I am feeling fragile. But having been reassured by my husband, mother, and mother in law that I am still a trustworthy mother, I venture out. With the baby, the dog, and Nana, we walk to the grocery store. We get groceries (stored nicely in the stroller, while baby snuggles in a sling). I have overshot feeding time again, and since I'm not about to subject any of us to a long bout of crying at this point, we stop at an off-leash park. The dog runs after sticks while I feed Sacha. Suddenly, my friendly, bouncy lab-cross who still looks like a puppy at nearly 3 years old, starts barking and running towards somebody across the playing field behind us. I jump up, babe in arms, shirt half off, receiving blankets flying, and see that Nellie is headed toward a mother and daughter across the field. Now, I know my dog is all bark and no bite. But, THEY don't. They see a large, black dog tearing towards them. Unfortunately, the mother seems to have no sense of how to react to a dog, and starts screaming. Not just a yelp - repeated, high pitched, terrified shrieking. The daughter follows suit, and just to add to the effect, they both start running in circles. Nellie thinks this could be a fabulous game, and keeps on charging towards them. They keep shrieking and running in circles. I start to wonder how this is going to end as I'm yelling "SHE'S FRIENDLY, JUST STOP SCREAMING. PLEASE!!!!!!!!! STOP SCREAMING!!!!!!!!!!!". I alternate this with yelling at Nellie to come back. After a few crazy seconds that felt like minutes, Nellie comes prancing back, very proud of her efforts, and the mother and daughter aren't shrieking, but the mother is yelling at me from across the field, accusing me of having a vicious dog off leash (in an off leash park, of course). By this point, I am shaking, the baby is crying, and Nana is trying to pull the pieces together. We put Sacha in the stroller with the groceries, get Nellie on her leash, and make a beeline out of the park (as fast as we can considering Nana has recently finished a course of chemo, and I still have stitches on the mend.) I laugh, glad that Nellie didn't reveal any new aggressive tendencies, but there is more than a little hysteria in my voice. I'm not convinced that I'm doing so well...

We make it home. I go to use the washroom and see that I have acquired a blotchy rash all over my neck and face. Nice touch. Nana suggests that it might be stress related, takes the baby, and sends me for a nap. An hour of solitary sleep and a tearful phone call with my own mother later, and I feel like I could possibly soon be doing well again.

So, for all of you who generally do well, and maybe don't feel like the roller coaster ride of early motherhood is quite as crazy-making for you - don't fall prey to the curse of the efficient woman -- let everyone know that you need just as much TLC, and make those phone calls to your doula!" - Kate, mum of Sacha James (and Nellie the dog)

"Silence is the perfectest herald of joy" - William Shakespeare

2008-07-25T14:38:00.000-07:00

I remember going to one of my first doula visits (with the woman who would eventually give up her law practice and become a doula) and talking with the couple about all the things we had to discuss before labour. My client's husband later confided to her that he was alarmed by how much I talked during the visit. "Oh!" I said. "He hasn't seen me at a birth. I'm so quiet. My eyes and hands speak, but not my voice." He was so relieved (I think I'd actually scared him at that visit)...and I went on to attend all three of their children's joyful births.

The reason I talk so much at our prenatal visits, is that there is so much to cover. My own children are in their twenties, and I have been discussing birth with them all their lives. I STILL haven't covered it all with them! Can you imagine trying to filter all the information to fit into two visits (and many phone calls) with clients? It really can't be done.

The best I can do is help my clients get a sense of the underlying philosophy of birth, to encourage them to trust their bodies, to help them to remain undisturbed while going through labour. I still talk and talk before labour begins. But, the volume goes down to a whisper once labour is upon us, just as the lights go down....because we have to be silent to hear the lessons that the coming baby has to share.

- Jacquie Munro, Vancouver Doula

Coming up for air...

2008-07-22T14:59:00.000-07:00

Okay, so I've officially decided that the full moon really MUST make babies come in groups!

In the past week there have been so many babies, with their due dates randomly spaced over a six week period. Thankfully, there were no overlaps. Well, there was one 8-minute gap between two clients (it took me 8 minutes to run down the hill from one completed birth at St Paul's hospital to the next client's house on Pacific!)

So, there were two undisturbed home births, two undisturbed hospital births, and two challenging births caused by sweet posterior babies (resulting in one cesarean and one vaginal birth). The largest baby (9lb 13oz) and the smallest baby (6lb 12oz) this week were both born vaginally with no meds. What a ride!

Here are some wonderful quotes from the women in labour:
"I'm not scared, it just hurts."
"Once a contraction's over, you feel like you're in paradise."
"That was good! Almost no pain!" (about contractions in the shower)
"You have no idea how hungry I am right now!" (said at 10cm)
"That was the best experience of my life!"
"When his head came out, there was all this liquid, and it almost healed me..."
"I never knew he'd be this beautiful."
"I never knew she'd be this beautiful."

Now, if everyone else could just keep their legs together for a couple of days... I have my daughter's engagement party to get sorted!

- Jacquie Munro, Vancouver Doula

Baby at the Breast

2008-07-07T15:59:00.001-07:00

Sorry...shamelessly proud mum here. My daughter Sarah painted this Warhol-esque breastfeeding baby (acrylic on canvas) as part of her final Breastfeeding Counselor project. Love it!

Now that we're on the topic of breastfeeding... A lot of women mistakenly believe that they will automatically receive incredible breastfeeding support at the hospital and during the initial weeks at home with the baby. Sadly, this is just a myth. Read about the resignations of local lactation consultant extraordinaire Renee Hefti, and then sign up for the breastfeeding courses that she offers in the community (604-733-6359).

Shameless promotion here - but it's truly necessary!

- Jacquie Munro, Vancouver Doula

Doula as "Obstetric Technique"

2008-06-16T08:46:00.000-07:00

Check out the MedWire News synopsis of a new study that was recently published in the journal Birth (2008: 35: 92-7)

Doula support reduces cesarean and epidural rates
by Lucy Piper 03 June 2008
Examining the perinatal effects of doula support for nulliparous middle-income women accompanied by a male partner during labor and delivery.

MedWire News: The continued presence of a doula during labor significantly reduces cesarean delivery rates and the need for epidural analgesia in middle- and upper-class U.S. women accompanied by their male partner or another family member, researchers report.

They suggest that maybe fathers should not be expected to fulfill the role of primary labor companion.

Susan McGrath and John Kennell from Case Western Reserve University, Cleveland, Ohio, USA, investigated the potential benefit during labor of an experienced doula to provide both emotional and instrumental support. A total of 420 women were randomly assigned to either have a doula present throughout labor in addition to their male partner or no such additional support.

Women who had the support of a doula had a significantly lower cesarean delivery rate than the control group, at 13.4 percent versus 25.0 percent. They were also less likely to need epidural analgesia, at 64.7 percent versus 76.0 percent, respectively.

Among women with induced labor, just 12.5 percent of women with a doula had a cesarean delivery, compared with 58.8 percent of those without a doula.

All women and their male partners who received the support of a doula rated their experience as positive.

"Continuous labor support by a doula is a risk-free obstetric technique that could benefit all laboring women and should be made available in all maternity units," the researchers conclude.

Fabulous study (Under "Do your Homework" in the sidebar, click on Birth: Issues in Perinatal Care or read the entire study via Recent Notable Journal Articles.) Who knew that continuous support by a doula would ever be called a "risk-free obstetric technique?" Only in the U.S., eh? The guys at Monty Python could have really used that in their birth scene in "The Meaning of Life"..."Oh, and we're forgetting the doula, that new risk-free obstetric technique! Put her next to the machine that goes "Ping!""

But, don't let that one phrase muddy the results of the study...they're great!
- Jacquie Munro, Vancouver Doula

Ten Questions

2008-06-15T20:23:00.001-07:00

I think there’s a purpose behind the nine long months of pregnancy. This time is vital for introspection, reflection, setting boundaries, and discovery. As I’ve said so many times before, birth is not a “body” act...it’s an act of the soul and the mind and the will.

Yes, I have a checklist of the things that I need to discuss with clients...and worksheets for them to fill out if they’re “paper people”. But, in order to serve my clients well, I need to go further, deeper. So, over the months, we talk on the phone discussing everything from diapers to spirituality. I often ask couples some unusual questions to help them uncover how their life experiences may affect them during the birth and postpartum. Usually, the deeper we go, the greater the understanding, resulting in a much more positive emotional experience for everyone.

If we skim the surface in our phone calls or visits...or if clients don’t share honestly with me...or give me only SOME of the pieces to the puzzle...then the house of cards may fall down, and a challenging birth and postpartum period may result. I can only work with the information that is given to me.

So, thank you to all my clients who take the time to build a bridge of earned trust. Thank you to those who hear me, to those who share openly and honestly with me, their partners, their families, and friends. Those who share without masks or guilt or shame should find that the process of pregnancy and birth will take them to a whole new level of living.

So, here are just 10 of the questions that I may ask over those nine months...some might appear unusual...but there’s a method to the madness...

What kind of an suitcase packer are you? Do you have games to see who can take the least amount of stuff in your MEC duffle? Or do you always end up paying for overweight luggage? (This question is not just about what you pack!)
How long does it take for you to make decisions - on your own, and as a couple? Did you take 10 years to decide to get married? Or do you often kick yourself for being too impulsive (like Dharma and Greg on TV)?
How much guilt do you take on in life? Do you think you’ll be able to be pragmatic and avoid “mother guilt”? (We have enough guilt in the world...)
Would you ever consider going on standby? Would you be okay with the wait? If three flights were cancelled, would you just “roll with it” or feel like you were being tortured by the wait? (One dad described waiting for labour as “Sitting at the gate, waiting for a standby flight to Auckland. You know New Zealand is beautiful, and you’ll love the trip, but you have a love/hate relationship with the flight - you might even get to the point where you want to jump out of the plane - but it’s all worth it!”)
As a couple, how do you think you would you do on “The Amazing Race”? Would you be the “bickering couple” or the “couple who accepts any challenge happily”? Would you spur each other on to better things, or do you think you’d give up? (One couple described themselves as the “bickering couple” who you know love each other incredibly - and win!)
When you’re on a big ride, or hike, or in competition, how to you respond before the endorphins kick in? What strategies have you come up with to cope with your known response? (I whine initially, but my husband encourages me, lets me go slow, then cheers when my endorphins kick in - the best supporter!)
What kind of family boundaries do you have? What family issues are swirling around you as a couple? Would you be able to say “We’re on a baby honeymoon...and we’ll see you in two weeks”? Or would your families’ actions become the talk of your small town? (One couple went “underground” for a week at week 2 postpartum, because they had been bombarded by family visits, and the new mother/baby connection had suffered as a result. Going “underground” helped them to claim their autonomy as a new family.)
What was your role in your family of origin? What was your partner’s role? How do you plan to reconcile the differences as you become parents yourselves? (One client realized that her actions as a first-born, and her husband’s actions as the “baby of the family” required discussion prior to the birth of their first baby...and looooong walks on the beach.)
What has been your greatest emotional challenge in life? How did you cope? How has it changed you? (One client said being thrown into the shark-infested waters of the Indian Ocean made her face her fears. Another said writing her bar exam taught her to take life “lightly”. Another said her battle with cancer at age 19 had changed her “from a lamb into a warrior”.)
What have I missed? Is there an elephant in the room? (Though I’m not the family physician or midwife, I do need to know, in advance of labour, if a client has a clinically diagnosed fear of giving birth. That happened in 1990...and it’s a long story... )

- Jacquie Munro, Vancouver Doula

Vancouver or Bust!

2008-05-27T08:53:00.000-07:00

One of my recent clients is a doula from Fort McMurray. She drove all the way to Vancouver to have her baby. I was honoured that she asked me to support her and her partner (and sister) through her labour. With her permission, I'd like to share a part of her email that she sent me after she had driven all the way home with the new baby (only a few days after the birth!)

"I really wanted to email you and say thank you once again for a terrific job and your incredible support. I drove to Vancouver with hopes for an amazing birth, and I couldn't have imagined it being any better, even though it was longer than I anticipated! I wrote down my birth story as you suggested, and literally just finished reading your notes. Like you said, it's so funny what a different perception you have when in labor. I love the quotes you wrote down, and I honestly thought you had arrived at my sister's place at 4am, not 4:45! You make the birth sound like it happened a heck of a lot faster than what I remember it feeling to be. What an incredible experience! Thank you for making it be so.

I can't remember if I explained this to you or not but bear with me if I already have. There are three things that you did which were crucial to my needing encouragement to carry forward. The first was the 2:30am phone call I made to you where I said I was considering going to the hospital to walk or have my waters broken and you said, "No, you're not. Go to sleep and let your baby and your body do what they need to do." I had read a birth story before driving out to BC, and this women spoke of a laboring tradition in Africa where a laboring Mom is guided to a log by village women who have not yet had children. This woman crosses the log by herself with no help and is welcomed on the other side by all the women who have children. At my sister's apartment I ventured out onto the log and at 2:30am I got stuck there. Your voice at 2:30am showed me the way across that log on my own again and you greeted me on the other side. It was amazing.

Secondly, was your word of "Safe". In my own time, mostly during a warm shower at home, I would envision myself in labor and I found myself singing a mantra of "It's okay, I'm safe here." I never explained this to you beforehand and you using that word during my contractions at the hospital renders me speechless at how effective it was in guiding me. My husband asked later if this was a word that you and I had chosen together and I said, "Not at all. She just knew."

Lastly, when it came time to get onto the bed and my contractions were extremely intense, you held onto my thighs firmly, almost as counterpressure, and it was incredible how more in control I felt during my contractions when you did this. It is definitely a tool I will carry forward when I begin doula work again. I know the hip squeeze is a welcomed favorite among my clients, but just that security of the firm hold you placed on my upper thighs was incredible. Truly.

So, thank you again so much for all that you have both helped with and taught me about. My gratitude for the opportunity to work with you goes beyond words, and should I choose to have a fourth baby in Vancouver, I sure hope I can work with you again."

...And I thank HER for letting me be a witness to her power on that day!

- Jacquie Munro, Vancouver Doula

Le Premier Cri

2008-05-21T23:27:00.001-07:00

Don't you love Paris? There, in the Opera Metro station is an ad for an amazing birth movie. Would you ever see that here? A birth movie in full theatrical release?

However you can view Le Premier Cri, find it, view it (I googled and found the complete movie in a free download...search hard!) Yes, it's in French, but please forget all the French that you know, and listen to the birth sounds, the music, not the words of the narrators.

The cinematography is breathtaking, the births are achingly beautiful. I found myself laughing out loud in joy at the woman in Mexico being carried to her car in a blanket and transported to the seashore just after giving birth. I wanted to be the woman moving beautifully through the South American jungle to the river - stripes on her belly. There is truth in this movie.

Find this movie - the search will be worth it...

(Note: I've been getting emails from people who can't find the movie...ask a teen...honestly...they'll have it for you before the end of the day...as long as it's legal in your area.)

Peasant Feet

2008-05-21T12:49:00.001-07:00

I usually get at least one or two phone calls a day from clients upset about the pregnancy comments and “war stories” that other women feel the need to share.

“I don’t want to hear it any more!” said a woman to me this morning.

Another client said she was literally trapped by a cousin at a family gathering...wedged in at the back of a table, locked in between a great-aunt and the story-telling cousin. “The baby’s head was SO BIG that they had to...(insert whatever horror story ending you like here).”

These comments, so freely given, can stick with you, and really hurt. Or they can turn what was a carefree pregnancy into a time of anxiety.

“Wow, you’re big!” or “Boy, you look small for your dates!” or “Make sure you get an epidural in the parking lot!” or “I’m just going to book a cesarean next time! You should, too!”

The endless combinations of horror stories and thoughtless comments are awe inspiring.

In our phone calls, I usually remind my client that it’s perfectly acceptable to say you’d rather not hear the stories...or just stick your fingers in your ears and go “LA LA LA LA!”
Protect yourself from these stories - using whatever means available!

Now, I’m not pregnant, but I was given a taste of how my clients feel just the other day. I was feeling pretty good. It was the long weekend, I’d been to a lovely birth overnight, I’d slept well, and knew that no babies would arrive on that day. As a treat I thought - I’ll look for some new sandals (I’m usually a no-nonsense “get in and get out” kind of shopper). I sat down with an array of pretty sandals to try on.

“What size?” asked the clerk. “Ten,” I answered.

She came back with a pile of boxes...then looked down at my feet. “Oh!” she exclaimed, “I should have had a look at your feet first! You have PEASANT FEET! Just like me! You won’t like those...you need something much, much wider.”

Then she proceeded to go to the back, returning with a clunky (ugly!) pair of servicable fish-net runners. Ugh! “Those are better for you.”

*sigh*

So, okay, people. Here’s a plea. Keep your comments to yourself. We’re happy to live in our own little worlds, with our own (perhaps misguided) ideas about our own bodies, our babies, our lives...whether we’re pregnant or not. We don’t need to hear your war stories, your “birth as rape” or “birth as prison” stories...or even how teenagers are going to ruin our lives. A positive outlook really doesn’t hurt anyone. I choose to think positively!

Personally, I like the fingers in the ears, “LA LA LA LA” approach. Now, I’m just going to shove my peasant feet into some nice flip flops...or, better yet, go barefoot to visit my next client.

- Jacquie Munro, Vancouver Doula

An Undisturbed Birth

2008-05-20T11:34:00.001-07:00

I've been talking a lot about "an undisturbed birth" lately.

The language that we use in labour is so potent. I'm uncomfortable with many descriptive terms surrounding birth, such as "I'd like a normal birth"...or "She had a natural birth" ...or "We did a pure birth." It sounds like all others are abnormal or unnatural or impure. Birth just should be.

So, it came to me, recently, when I realized that so many of my clients have what I describe as "she just went into labour and then had the baby" births...they had all been undisturbed in labour. My role is to keep her private space protected and undisturbed, to help her feel free to move undisturbed, to be the guardian of her cave. She remains hidden, unobserved, in a safe space.

Even if I'm with her, I cast my eyes down in respect, until I am addressed. Often, I am just a hand, or a whisper, or even a silent presence beyond the curtain. Her partner sits still, a great gift, close by.

The photo show it all. She is safe, alone in the shower. Her partner, and I, and her midwife, watch the rippling reflections on the floor, listen to the rhythmic pulsing of the shower, become transported, lost in time.

Our job is to help her remain undisturbed.

But...Oh, no! Here's the night nurse, who I usually adore. But she walks in at 7pm, saying loudly..."Och, it's HOT in here!" We all put our fingers to our lips...hope the woman dancing in the water doesn't hear... Later, the woman says her body tensed up at that moment, and she thought, "Oh, no, not a Scottish accent!" and it took a while for her to get back into her undisturbed rhythm (and she later came to love the accent).

An undisturbed birth is a challenge to achieve, but its effects are immeasurable.

- Jacquie Munro, Vancouver Doula

Do you need a doula? (or...I am your Sherpa)

2008-05-20T10:41:00.000-07:00

I was debriefing with a second-time client yesterday. She wanted to tell me how important it was that I was by her side at her second birth. “This time, lots of people said I didn’t need a doula - that you’re not a midwife...that the doctors and nurses would be there to help me. But I knew that you’d be there just for me - and I trust you. I knew you were there in my corner - always.”

Her husband thanked me for being there again - for helping to create such a positive experience. He put it all down to what he calls “the Jacquie magic”...the fact that everyone in the hospital treated them differently because they were with me.

It’s sad, but true. The hospital staff do treat patients differently depending on their caregivers. They’re human - they have their favourite doctors, nurses, and doulas. I really would love a world where everyone walking through hospital doors was treated equally. But, right now, it doesn’t happen...so if I can do anything to make my clients feel more autonomous, more respected...then I will. Petty “wars” can be waged between overworked and under-respected staff, and I do everything in my power to prevent my clients from being a witness to negative behaviour. Preventative magic helps.

It all starts prenatally. We cover every possible scenario in our talks over the phone, in person, via email. We discuss the woman’s hopes and fears, interspersed with stories of her life. We talk about how the couple works together, what their strengths and weaknesses are, how they face challenges separately and as a couple...even how they’d react if they were bumped from an important overseas flight. We discuss family dynamics, setting boundaries, postpartum planning. The prenatal preparation isn’t about following a prescribed path - its about finding how each woman’s life experience has uniquely prepared her for this particular birth. Whether she needs to do soprano vocal exercises in labour, or relive that amazing underwater night dive in Fiji, conquer the West Coast Trail’s ladders once again, or run the Paris marathon with each breath during labour - we will uncover her own history that will carry her through to birth. My job is to protect her from outside disturbance without her ever noticing (it’s kind of like trying to be the best server possible).

Luckily, since most clients are referred to me by their caregiver (and others), I know that there is a web of security and trust between us all. I may have known a woman’s midwife for 15 years (from the wonderful “community midwife” days)...or have been the family doctor’s own doula...or have known the doctor-on-call with the extremely dry wit (who my client has never even heard of) for 20 years. I know their style, their particular sense of humour, how they react when they’re tired, how they react when they’re sad, and most especially, how we can all work in concert to provide the very best care for my client. We often know each other well enough that very few words need to be spoken. This helps the woman to stay in her birth trance, without interference or complication.

At home in labour, after the client has spoken to the caregiver, I can offer additional information. The other night, in between contractions, I only had time to say...”Hi! Second baby, just vomited, some bloody show, some pressure, we’re coming in. Oh, and she’s GBS positive but doesn’t want antibiotics.” “Fine,” said the doctor, because he knew he could trust me that this baby was coming fast. I called the hospital and spoke with the assessment room nurse, who said - “Hi, Jacquie. We’re short four nurses because they called in “sick” on the long weekend, so no Cedar (the fancy rooms with windows) tonight. But we have a room for her.” When we reached the hospital, the nurse and I exchanged glances as soon as we walked through the door. “Hey Jac...pushy?” The couple didn’t really have to say anything - they could stay in “the zone”. We went straight into a birthing room - no stopping in the assessment room. She stayed standing by the bed. No “please lie down, put this gown on, etc. etc.” Her wishes were honoured without debate (the nurse and I had had the GBS-decision discussion a few weeks ago, so there was no need to belabour the fact on this night).

At the hospital, I know NEVER to show up at the end of a shift, when tempers are frayed - you will either be left to wait for the next shift, or be caught in the vortex of emotions borne out of 12 hard hours. If the vibe is weird in the assessment room (like it was a couple of weeks ago), I know the nurses well enough to whisper, “What’s up?”, and be trusted enough to be told the truth - that everyone’s on edge because an obstetrician wrote an incident report after a woman was sent to Cedar without allegedly fulfilling the criteria (long story). A war is brewing. We negotiate, and figure out a way (enlist the dad’s aid) to have my client go upstairs to Cedar without it causing a problem for the nurses in assessment (diplomacy in action). We’ve been through enough that we’ve built up a trusting relationship, and are able to work together collaboratively, seamlessly, so that my client doesn’t even suspect that we averted a petty war on the hospital floor.

I’ve worked with clients giving birth at home and in the hospital for over twenty years. I’ve quietly built bridges with midwives, physicians, and hospital staff. I’ve worked to earn the trust of each nurse and each unit clerk (these women have their finger on the pulse of the place). The amazing thing is, each new client reaps the rewards of the cumulative history of all these births, and all of the experience gained from those who have gone before her.

I’ve learned to chatter less and listen more, to teach by example, to foster trust in each woman and her baby, to soak up every lesson, to read voraciously, and to constantly tend the bridge of trust and diplomacy with all caregivers. Because I am autonomous, and not affiliated with any group or hospital (no affiliation = no baggage), I can focus on each individual client’s needs and wishes without prejudice.

I’d love there to be a day when I could trust that each and every woman in labour could be autonomous and free to give birth undisturbed, that her history would be one of complete trust in the body, that no doulas would be needed. But, that’s not possible in today’s society, within the current health care system. Each woman still has her labour, her own history, AND the system to negotiate.

Each woman in labour still needs a navigator (one midwife recently said that I have to add "Even with a midwife!"), or as I laughingly say at times, “Just think of me as your Sherpa,” as I carry the bags up the stairs. Each woman climbs her own mountain, while I quietly deal with the bureaucracy, the logistics, climbing up the stairs behind her, all the while chanting like Barack Obama...”yes you can, yes you can...”

- Jacquie Munro, Vancouver Doula

63 new mums

2008-05-10T09:09:00.000-07:00

Since last Mother’s Day, I’ve witnessed 63 women transformed into mothers. Pretty cool, eh?

So, to all the wee ones - give your mum a big wet kiss tomorrow!!!

(Sorry mums. It will probably be somewhere between 5am and 6am...but, babies never did have a great sense of timing...)

Okay...so here’s an excuse to buy new bedding

2008-05-09T14:56:00.000-07:00

When a single friend calls to say that she’s had “quite the night!” it can mean many things. But, when a client calls me post-baby...well, it means something completely different.

So, a client called to tell me that they’d had “quite the night!” She said that they had kept the night-time as low-key as possible. “Just like you said, Jacquie...lights out...no eye contact with the baby (Ed. note: If she sees you looking at her, then it’s party time!)...making sleep sounds during feedings...not waking a sleeping baby, diaper changing before the feed if needed, etc. etc.”

“Things were going quite well. Then, at 4am, I felt like one breast must have leaked all over the baby during the feed. In the dark, I used my hand and a cloth to wipe it up, then curled up with her and fell asleep.”

“Just after 6am, we all woke up, the sunshine streaming through the thin curtains, illuminating the bedroom scene...of poopy chaos!!!”

“My husband said if the room had been filmed in black and white, it could have passed as a scene of carnage!” she laughed, as she was telling me the story over the phone. “There was baby poop EVERYWHERE! It was smeared all over my face, my nightie, his hair, the baby’s hair...just everywhere! In our sleep, we’d rubbed it all over the sheets. too. I’d taken off her diaper, but not put another one on!!”

“We could have cried. But, we just sat there in bed, laughing. Because we remembered that you’d told us a similar story of another couple doing this...and using it as a good excuse to buy fancy sheets. So, we threw everything into the garbage (Editors note: I know, I know... this isn’t an eco-friendly story) and got into a bath together - all three of us. It was quite wonderful.”

Love it!

Phone calls to a doula

2008-05-07T16:08:00.000-07:00

To all pregnant clients...here’s a “head’s up”. Some time after the baby’s born...you will make this phone call. The wording and timing may vary, but the questions will be essentially the same.

“I’ve got this pile of books here. One says to get the baby on a schedule, another says to feed on demand. But what does “demand” mean? What if the baby comes off after 10 minutes. Is that a feed? When do I change the baby? Before, after, or in the middle of a feed? Am I wrong to want to grab my baby away from visitors? You know, they’ve come all this way, and brought presents, but I just want to hide...”

We’ll probably spend up to an hour on this particular phone call. We’ll laugh together...we might cry together...then you’ll hang up the phone floating on air. Why? Because you will have been reminded of your infinite strength, your inner wisdom, and your ability to trust your body and your baby.

My role during the postpartum period is to help you tap into the same basic instinct that took you so beautifully through labour. Let’s assume, like most of my clients, you birthed without any disturbance, and everything was straight-forward. So, there shouldn’t be any major challenges to overcome (i.e. no latch problems caused by narcotics or aggressive suctioning, etc.) So, I will just have to remind you of your power that you drew on in labour, and remind you to continue trusting your body.

And, with the baby on the outside, you will trust her to teach you wisely and gently. You will be still and calm and hold her close always, in order to hear what she needs to teach you.

Just know that you will find it pretty freaky when she give you a withering look at midnight, as you’re changing her. It’s a look that will seem to say, “Oh, no, you really don’t know what you’re doing.” But then the look will be gone, and she will roll with whatever you’re doing, or cry and tell you a few stories. But she won’t hold a grudge. She’ll be amazingly forgiving.

And you’ll soon discover that changing her before a feed will save a lot of clean up time...because if you jostle her and change her AFTER a feed, she might easily throw up all over you and her new jammies. Then, she’ll be wide awake...and need another feeding...and the doorbell will ring...(don’t answer!)

And you’ll soon discover that zips and buttons and snaps can make you feel TOTALLY incompetent, so you’ll just buy those bag nighties with the envelope neck. Pull up the nightie, change the diaper, pull the nightie down. All done!

And you’ll also discover that a newborn baby is kind of like a 15 year old boy. “Hey, mum, I’m just going out to grab a bite.” “But, you just ate an hour ago!” “Yeah, great dinner, mum. Thanks! But I need a pizza.” No, you didn’t do a bad job as a mum. He’s just growing like a weed! Same deal with a newborn. Cluster feeds, marathon feeds, feeding every hour....whatever happens, it’s normal. Trust the baby to know what she needs - she won’t overdo it. And miraculously, she’ll morph into a more predictable creature at some point after 6 weeks.

Thinking about dinner...I like to think of the breasts like...Side A is dinner...Side B is dessert. Sometimes you want dinner without dessert. Sometimes you want a break before you eat dessert. Sometimes you go straight from dinner to two helpings of chocolate mousse. Whatever happens, it’s normal. You know, just like those nights when you have dinner (great dinner, right?) then have dessert...then want popcorn at the movies...oh, and some nibs, and a big drink. Then the next day you might just want salad. Do you analyze it to death? Do you need to read a book to see if you’re normal? No, it is what it is.

And that’s what life is like with a new baby. If you just roll with it and trust your body and your baby to figure each other out, it will work out fine. If you need a few pep talk phone calls along the way...then you’ll be just like every other mum.

“So, oh...before you go...I have to remind you to...
...lock the door to visitors who just want to hold the baby (and not vacuum)...
...turn all the clocks around, especially at night...
...sing out loud...
...and be easy on yourself...”

- Jacquie Munro Vancouver Doula

i carry your heart with me

2008-05-07T14:40:00.000-07:00

If I had a newborn now, I would search for poetry to read aloud during each feeding, to calm us both and feed our souls.
- Jacquie Munro

i carry your heart with me(i carry it in
my heart)i am never without it(anywhere
i go you go,my dear; and whatever is done
by only me is your doing,my darling)

i fear
no fate(for you are my fate,my sweet)i want
no world(for beautiful you are my world,my true)
and it's you are whatever a moon has always meant
and whatever a sun will always sing is you

here is the deepest secret nobody knows
(here is the root of the root and the bud of the bud
and the sky of the sky of a tree called life;which grows
higher than the soul can hope or mind can hide)
and this is the wonder that's keeping the stars apart

i carry your heart(i carry it in my heart)

- ee cummings

Snapshots of Love

2008-05-05T16:42:00.000-07:00

A woman sings old remembered songs in a shower. The sound of her laughter echoes in the room and blends with the sound of the water.

“Hands!” A woman opens the shower door during a contraction, reaches out and holds onto her husband’s...and my...hands. When the contraction ends, the door closes and her eyes close.

Only a few hours away from birth, a woman takes time between contractions to place tin foil on the sofas and chairs; her power remains.

“I like it here” says a woman as her head burrows into the corner of the car’s backseat.

“Hips!” “Water back!” A woman moves autonomously in labour. She calls to us to take our places during each contraction...at the hips, at the back, and at her hand.

“Happy?” The lips turn into a smile, her eyes crinkle, the water runs over her body.

“Shhhhh” Her eyes gleam as she looks at her newborn, rooting for the breast.

All these snapshots are of women under the influence of the “love hormones” - oxytocin, endorphins and prolactin. As a doula, I continually witness the softness, the power, and the amazing transformational effects of these hormones, which are released when women are undisturbed.

So, with these snapshots of birth "as I witness it" in my head, I watched The Business of Being Born online last night. The enormity of the loss of normal birth, the rising infant mortality rate, and the rise in planned cesareans in the U.S. struck me like never before. Michel Odent’s warning about what we could potentially lose made me dream about births all night.

Are we, as a civilization, beginning to lose what makes us human?

I spent today speaking with clients, and googling more of what Dr. Odent has said on the subject. In the Scientification of Love, Dr. Michel Odent explores this question, looking at love “from a scientific angle, yet with great respect for the beautiful orchestration of normal physiology as it works to its best capacity when it is undisturbed. Love, we learn, is a strategy for human survival.”

As critical as our need is to protect the environment, I think our need to protect the integrity of normal birth may even be more fundamental.

6 babies in 2 weeks...

2008-04-05T09:16:00.000-07:00

Each of these 6 births has an essence that will remain with me always...

Azure's birth - Shower and more shower. Clary sage really works. Then a "hands off" birth. This wee baby slides out like toothpaste from a tube. Incredible. Mum reaches down to bring her daughter to her breast.

Nora's birth - Kisses on mum's forehead by her love. After a gentle labour, spent mostly in the water...this babe crawls to the breast just like in the WHO video, to the shock of the nurse, and smiles of the mother.

Sean's birth - Intuitive partner by her side, she makes each difficult decision with grace and patience. A challenging birth, but one where the baby's needs were honoured, and the body trusted to tell its own story.

Sasha's birth - A gentle spirit. A flashbulb memory from half way through...she's dancing in a dress from Bali...just beautiful...working to spiral her baby down...down... Her husband smiling, laughing.

Luke's birth - Women's hands anchoring her feet, she leans on the dresser, partner stroking her back...and ohhhh's her way through another contraction. Birth works.

Jessica's birth - Powerful, furious body power! Rocking back and forth, one foot in front of the other - she lives in a whirlwind of creative energy...with the cat reaching out a paw in a gesture of sympathy. The baby curls like a cat on her breast.

The Contraction Question

2008-03-31T09:19:00.000-07:00

“I don’t think I’m in labour yet. I feel it really low down, all in front. It’s not hurting ALL OVER.” said the doctor on the phone.

“ALL OVER?” I asked, sounding like a parrot.

“Yeah.”

“Um...if all is well, it shouldn’t.” I was just a little bit confounded. Here I was, talking on the phone with a physician who’s been attending births for years. She’s amazing with her patients, so intuitive. Now, in labour for the first time, she was just as confused as everyone else in labour.

“Um...” I decided to go over the "what do contractions feel like?" question. “Primarily, it should stay down very low, near the pubic bone, like menstrual cramps, getting gradually longer and stronger over time. It can give you that drag-your-bum-down feeling. You may feel a sensation of heat wash over you, just like you’ve opened a pizza oven. You may feel shivery on and off. You might feel nauseous. You might have it radiate to your lower back. Everyone experiences a variation on the theme. But, you definitely shouldn't have that “grab your tummy and crumple up in agony because it hurts all over pain” as seen on TV. That’s just drama for TV. Real labour is something that you already know on so many levels. And it’s not linear. It doesn’t just get exponentially worse like on TV. It ebbs and flows.”

“Yes, I remember you telling me that. But I didn’t believe you or all the other women. So,” she asked, “when we palpate the contractions of a woman in labour by feeling the top of her uterus, she doesn’t feel any excruiciating pain up there?

“Not in a normal labour. It’s only when there’s something wrong and the body needs to get the message across BIG TIME that you can feel pain in weird places. If everything's fine, you should just feel the contractions way down low...”

“So...uh...what I’ve been feeling all day might just be labour?”

“Probably. The start of labour is something that you will only figure out retrospectively. But, I can hear in your voice that you’re having contractions about every four minutes. You keep fading out. How about if I come over, and we can figure it out together...”

Well, to make a long story short, I went over to find that she WAS in active labour. Her lovely son was born only a few hours later.

Now, I don’t tell this story to poke fun at the doctor, but to show that, no matter who we are, we all have various ideas about how contractions may feel. We've been bombarded by descriptions all our lives. But these descriptions tell us more about the person who is doing the describing than about contractions themselves. Our perceptions are unique. So, whether we’re a family doctor with years of training and experience, or have read every book there is on pregnancy, or have listened closely to all our friends describe their experiences...our personal experience of contractions will be unique.

No matter what, even if this is your first labour, the contractions will be something that you recognize. They may not be what you expected, but they will be something that you "know" on a gut level. Hey, you're not going to get to age 30-something and then have the body throw you a complete curve ball, are you? Trust your body to let you know what it needs. As a doula, my role is to help you navigate your particular labour, no matter who you are, and what kind of labour you are "given". I try to help you shut down your 21st century brain, and accept the logic of the reptile brain.

And, wonderfully, that’s exactly what this doctor had done in her own labour...

I think one of the reasons she had such a smooth labour was because she didn’t NAME it “labour” until her body forced her to acknowledge it. She didn’t watch the clock. She didn’t waste emotional energy on waiting for labour to speed up, or to perform in any particular way. She just let it go, basically ignoring it, just like you would try to ignore cramps during a particularly nasty period. Who cares that she'd done all this because she was expecting something FAR worse than the reality.

I’m actually in awe of her way of getting through labour.

Maybe we should all try it.

Change

2008-03-31T08:04:00.001-07:00

Change. Is it always good?

In the next month or so, obstetricians at BC Women's will be changing their provision of care at the hospital. Rather than having three call-groups providing an in-hospital rotating OB consulting service (24 hour call, with each physician or midwife being able to choose one of the three available OBs, if a consultation is warranted, depending on the case at hand), there will be two obstetricians on hand (one primary and one secondary) at all times, each working 12-hour shifts, drawn from the combined pool of 20+ obstetricians that used to make up the three smaller OB groups at BC Women's Hospital.

When I heard about the change, I asked if caregivers would have a choice of obstetrician if they required a consult during labour. "No," said the head nurse, with a quizzical look. So, you'll just get who is available, not who might be the best "fit" (clinically and emotionally) for the client on that day. Even if an OB has been consulted during the pregnancy, if a family practitioner or midwife needs OB assistance in labour, they will be not be able to choose between the 2 OB's in hospital, but will only be able to consult the one who is designated for consultations. And remember, there will be one less OB in the hospital at any time. Hmmm...

I know that other hospitals have been using this one-OB-fits-all approach for years (e.g. St. Pauls - but they have a small pool of OBs, and a low-tech high-touch philosophy that seems to work well from the patient's perspective, and their nurses are given quite a lot of autonomy). At first glance, this change at BC Women's might appear to signal a departure from patient-centred care. But, apparently, improving patient safety was the primary motivating factor. So, it may be a good thing in the long run - the 12-hour shifts might result in more energetic OBs providing more focused patient care. But, the shorter work day (and the inability to chose the OB) could result a loss in continuity of care for the labouring woman. Could the positive working relationship between a family physician and a small OB call group be lost in this reorganization, causing further internal conflict? Who knows.

Will notice of this change be given to each woman prior to her decision regarding her primary caregiver for pregnancy, so she can make an informed decision about prenatal care? Now, this is a tricky question. Pre-conception information regarding "the caregiver decision" is already lacking in B.C., with many women making their decisions based on non-B.C. books or the internet. For example, many newly pregnant women don't know that B.C. midwives are covered by BC Medical (practicing in both home and hospital), or that the BC Women's "Birth Docs" are there for women whose family doctors don't provide obstetric care, or that, in B.C. (unlike the U.S.), obstetricians are not intended to be the primary caregivers of "low risk" women, but are consulted after a referral by a family doctor or midwife, if the pregnancy becomes "high risk".

As a doula, part of my role is to inform clients about their choices, their rights and responsibilities, and to help them to retain their autonomy. I'm also there to quietly remind them that birth is a normal life process. I do my best to provide my client with comprehensive information in a balanced and thoughtful manner, working in concert with their caregivers (many of whom I've known for 20 years). I certainly don't have all the answers to the questions that I've posed in this post, but a general wariness of change (I'm a Taurus, through and through) made me sit down to write this. Despite my feeling of unease, I'm going to have to sit on the fence with this one, and wait to see how it all works out.

To the obstetricians, it might look good on paper. But we'll just have to see how it works in reality....for the labouring women.

(Update June 11/08: The new system has been in effect for a while, and, while the obstetricians are well-rested and seem to have a new lease on life, I have witnessed some dangerous gaps in continuity of care when an OB is the primary caregiver of my client.)

(Update March 2009: Obstetricians are still voicing their concern about the 12-hour shift. Yes, they are well-rested and able to perform better in the OR, but some women have fallen through the cracks due to a lack of continuity of care. Some women may have three of four different OBs looking after them in labour, each with a different approach. No solution so far...)

Persian New Year and "Fire Bum"

2008-03-20T21:41:00.000-07:00

Last night was a perfect example of a final prep visit...with a bonus. When I walked into their living room I noticed some special items on top of a shelf, obviously placed with care. I could see potted hyacinths, coloured eggs, wheat sprouts, and more. The shining couple explained that it was Persian New Year, and that the altar held seven items that each symbolizes some aspect of rebirth and rejuvenation. I was honoured to be a guest in their home on this special day. It seemed fitting that we were talking about welcoming a new life into their home at the new year. Then, the cat jumped up and tried to eat the sprouts (to the cat it looked just like catnip, I guess...) So, ancient ritual and custom met the quirky reality of the animal world. That's kind of like how labour works...

On this second prenatal visit, always done in a client's home, I see the couple in their comfort zone. I also look for labour inspiration by seeing what's on their bookcase or what holds a place of honour in their home. After tea and a chat, we get active, and do a "birth rehearsal" through the rooms. Stick a glass to the wall and listen to my voice as we roam the house: "Oh! You can totally polish your hardwood floors with lavender wax in the last month - on hands and knees! That might help to keep things loose and, you never know, help to keep the baby in a good position. Oh, and that toilet is positioned perfectly so you can sit backwards on it in labour..." etc. etc... No, I'm not manic, just excited to show people how their body can move them through their own space in labour. It's quite fun for the couple, to see their home from this new perspective.

So, fast forward to later that evening. Here's the scene - I was demonstrating the "shaking the apples" move to them. "You don't just shake the hips, you rub fast, just like you're trying to make fire. You can feel the heat from the friction..." The dad took over and did it perfectly (I say perfectly, because she made little sounds of happiness.) "I'll call it Fire Bum," he says, smiling, and writes it down in a notebook. We all laugh! "Fire Bum!" A new name for this move is born.

We move through the apartment, with her trying out different positions (in this visit, we discover that she can lean on the kitchen counter AND slide her bum against the cool fridge at the same time - what a bonus in labour!)

I demonstrate the different power balance that happens when someone's standing above her, moving to her level, or kneeling at her feet. "Which feels better?" I ask. "Wow...what a difference...when you kneel at my feet it feels so good." She feels the power that will flow into her in labour as her partner holds her, their heads close together.

"But, watch the thumb wiggle," I laugh. I demonstrate and she shudders uncomfortably. "That's no good," she laughs. There is so much meaning in that thumb wiggle... So many times in labours around the world, there's a sweet man who places his hand on the labouring woman's leg (good so far), holds it there, pauses, then...starts to wiggle that thumb (yikes!!!) There's so much good intent in that wiggle - "I love you, I want you to be okay, it will be all right..." - but it just comes across to the woman (just on this one day) as fingernails on a blackboard. It sends the pain signals shimmering, expanding through her body. Yowzaa! A still firm hand, instead, acts like an anchor, sending powerful messages of safety and warmth through her body.

After two hours, all of their questions about the upcoming birth are covered, as well as trust, movement, honouring the body, non-verbal communication, back circles, mesmerizing back strokes (complete with waterfall images), rhythm and ritual (plus logistics - "Yes, you can really call me at any time, day or night!") They are ready.

So, I leave them at the door, a loving couple at the beginning of the New Year, so close to the birth of "a family".