It’s raining baby girls...and a boy!

Six little girls and one little boy in ten days...

It all started with a funny phone call which woke me up... “Hey, Jacquie, it’s Mel! I’m at the hospital!”

“Mel?” (I have a Mel who's due in a month...) Wake up, Jacquie...This is another Mel...She’s friends with another client, and must have driven her to hospital. “Right! How is she? What’s happening?”

So began the 10 days of fun (no overlaps.)

Girl’s night at St. Paul’s. Eight women waiting for a baby girl. Magic, laughter, acceptance, hugs, and love...and a “face-off with a skunk” thrown in for a bit of drama. My daughter was there, too, to witness this birth, to add a greater measure of awe to the night. Hip shakes...”I want to rock!” “I want to push!” ...then, “Hi, Sugar!” “You smell like graham crackers.” “You’re beautiful!” This was a birth of simplicity and joy. It was such a gift to be a witness on this night...

Then, another girls night...but this was a challenging lesson of acceptance and love for an unborn baby. The water breaks before its time, the baby finds stress in labour, decisions need to be made, plans need reviewing...and a tiny girl is born. Deep love is borne out of adversity. Friends come out of the woodwork, and reaffirm that people can be good. So good.

The third birth started the next day...with a cough. You know, coughs really help open that cervix! Tissues placed strategically around the house...roaming through the rooms, climbing stairs, dancing, showering, telling stories of ducks and friendship, listening to the renovations in the basement. Just a normal day. Then the excitement begins...

I tell my clients that birth is not a linear process. The numbers mean nothing. You can get stuck at 9 cm for 7 hours, or you can go from 1-10 cm in an hour. What we need to watch is the rhythm, the momentum of the labour. If I’ve been with a client all day, I just KNOW by watching the labour escalate how long it will be... So, it was getting strong. We went to the hospital. “No, you’re only 1.5cm dilated. You’ll need to go home for a while.” It didn’t make any sense to me - I could feel that the baby was coming. The power of the contractions was palpable - I could almost feel the buttery quality of the cervix. She knew her baby was coming. “We’re out of here,” says dad, protectively. Back home, she spends 10 crazy minutes in the shower. Then.. “We have to go back to the hospital!” We pant together in the car, I “hear” the baby slide deeper and deeper. We arrive and roll into the birthing room - baby is born within 15 minutes. “We had a girl!!!” The nurse that asked them to leave earlier, apologizes...

Okay! So, what did we learn here? Trust the mum!

The next day, only three days before a booked cesarean...labour starts. Yahoo! What a joy! Music and showers, music and showers. And a labour that really takes off once mum kisses her son before his nap. “Love you!” calls Oscar as he slides down the stairs to his bed. A quick trip to the doctor’s office, surprising the other patients - a contraction here on the wall, another by the stairs... 3-4 cm...”Okay, okay, okay...” Then back home for pears and a lovely long bath...and sleep, and quiet calm contractions. Off to the hospital to settle in... “Ahhhh...” so quiet in the room. The water breaks, crystal clear. The room is dark. Hot blankets wrap her body...hands stroke the legs in rhythm. U2 plays “It’s a Beautiful Day.” She stands...and has her baby. “Oh, you’re going to love your brother!” “That might have been the best thing I’ve done in my life!” VBAC works!

Four stories told. Three more stories to tell. But, take time to digest how normal, logical, yet magical birth can be... before I continue...

White Lightning at Christmas

Dear Celia –

“I am a wonderful mother!” you cried while you were in labour. I wondered why this thought surfaced in the middle of a contraction. I didn’t disagree with your statement, but these contractions were like white lightning, your labour’s power vast. This triumphant cry hung in the air...

Ah…it became clear once the rest of the statement was spoken. “ - or else I would have just booked the cesarean weeks ago!”

The tangle of grief, guilt, willpower and pain was almost palpable in this tiny room at the hospital. I was at your back, stroking, squeezing, pressing – trying to help your baby negotiate through your pelvis on this Christmas Eve, and willing your cervix to open this time. Seven years ago, it had been so similar, and your son Andrew had been finally lifted from your body after a long hard labour. And now here was a deja-vu moment - I was bringing all my knowledge, all the strength of my hands, to bear, without much effect. Your cervix was still closed, the contractions raging like you were about to give birth. Here we were, your witnesses, your helpers, at your second son’s birth. At your side was your baby’s godmother, able to lend support without even having seen a birth, keeping her jet-lagged body awake in solidarity. Your dear husband was sitting close by, his lips tight from his own back spasms. I could see his own pain rise off his body like a desert heat.

No room at the inn on this day before Christmas. Why does this always happen?

I’m sorry, Celia, that your own doctor wasn’t available. We didn’t have the bat-phone to contact him. I’m sorry that the head nurse, caught in the middle of it all with only 14 nurses on shift, couldn’t get you a room. I’m sorry that the OB Resident and anesthetist were held up in the OR, helping another woman. I’m sorry that I had to keep telling you to wait – to wait - for anything stronger than the nitrous oxide gas. But I’m glad I could be honest with you, and stay by your side.

You amaze me, Celia. When we talked on Christmas Day, one day after giving birth, you said you were thankful that you hadn’t been given the cesarean in the morning. You were thankful that we got you an epidural, gave you time to think clearly, to sift through your baby’s internal messages, your body’s strong messages, before finally having an emergency cesarean in the afternoon. You said you were thankful that you had those seven years between your children…thankful that you now finally know how hard your body was trying to tell you that something was wrong in the past few weeks, in the past years. You said you were glad to be able to understand that things really do happen for a reason, and that your questions of the past years have finally been answered.

I have always had infinite faith in women’s bodies. You have strengthened my faith.

I am so glad that I was there for you, to witness your children’s births. Because I was at Andrew’s birth, I knew how strong you were. Despite what you might jokingly say, I knew that you wouldn’t call for pain medications unless your body was telling you to “take action!” I was so glad that I had seen the precursor signs to uterine rupture before. I thank the other women I have worked with, Barb especially, who have walked through this potentially life-threatening doorway before. Barb had been so calm in the bath, at 9 centimetres, when she had said, so quietly, “Jacquie, there’s an emergency,” and I had known exactly what was happening. Even months later, she said she’d never been scared, never doubted that we would honour her body’s cues, and her inner knowing. She knew she could trust the women at the hospital to care for her, to do the surgery well, to look after her body and her baby. I am in awe of this deep trust, and so thankful that it can exist in 2006.

So, when your body found a miraculous way to make the pain break through the strong epidural, I knew that we all had to “take action” and move swiftly. Thank-you, Celia, for breathing slowly and deeply for your baby through it all, for letting go of expectations, for telling everyone exactly what you needed at each minute, for trusting that everything has a purpose, for being a wonderful mother…

Thank you to all the staff for listening. Thank you to the Obstetrician for being gentle and respectful. Thank you to the OB Resident for her elegance under pressure. Thank you to our nurse for her calmness when she could have given in to fear. Thank you to the Pediatric Resident for holding baby Callum with reverence.

Celia, you have walked through the door between life and death, as all mothers must, and come out the other side. So many women these days are fearful of the feral nature of birth and mothering. You walked through to the other side with grace, in spite of the fear and pain.

At this Christmas time, I can’t think of a more fitting birth story. It wasn’t easy or smooth; it was raw, it was real. Celia, you taught us all about the infinite strength of the body, mind, and spirit. And, yes, Celia, you must be a wonderful mother!

With love to you and your family –

Jacquie

Grandmother’s advice: “"A cup of tea and a bran muffin, and off you go.”

Thoughts on birth... by Andrea
Don’t we overplay most major events in life? Don’t we overuse words like “excellent”, “amazing” and “excruciating”? Use “never” and “always” out of context?

So why, for certain major life events, like marriage, birth and death, does it seem that we underplay them? Marriage, modeled after some Disney version, is for another blog, on another day. So, for now, is death.

But birth is current for me, and Rosie’s arrival has me wondering why, apart from humorous musings of people like Carol Burnett (to paraphrase: ‘It’s like this: take your upper lip, pull it out as far as it will go, now lift it up and pull it over the back of your head.”), no one says anything, really, about it. Other moms smile a secret, knowing smile, now that you are part of the club. The nurses at the pre-natal classes show drawings, with the mom’s face getting progressively… well, squiggly. I have never felt “squiggly”, so this didn’t mean much to me. The baby books say things like “How you might be feeling: anxious, in pain, worried about the baby.”

But no one said:

You will go inside, deeper than ever before, and a fog will descend on the outside world.

Time, as you now think of it, will change. Contractions will last for eternity, yet the hours will go by like minutes.

At times, you will not just be in your body: you will be your body.

The word “excruciating” will, at last, mean something to you.

You will have to reach for strength in places where you have never looked for it. There is no way to practice this.

And no one said:

If you are lucky, there will be a moment where heaven opens up and pours its light down on your child. You might even hear a moment of angel music.

Memories of a birth...
From the first birth, by caesarian section, I only knew a bit about the contraction part. Before I went under the epidural that time, I got up to move and had one brief and, to me, terrifying glimpse of immense pressure. Wow, I remember thinking. If that’s what’s in store, I’m just as well to go for the anaesthetic.

And yet, after, as I reveled in my healthy boy, I had regrets. There was such a slim chance we’d get pregnant in the first place, and now I had missed the opportunity for this supposedly life-changing event of a “proper” birth. Had I wimped out too soon? Had I done something wrong?

I was able to push these thoughts away and delight in my blessings. But when the miracle of pregnancy happened a second time, I felt that this – a non-anaesthetized delivery - would be part of the lesson. My life often seems to me to be a series of lessons missed, lessons repeated, and I felt this would be one. Or rather, I really, really wanted it to be one, and so it was.

So I dug through files and friends to find you again, Jacquie. My rational mind (what an Anishnabe friend would call “monkey mind”) said things like: You won’t need a doula this time. You’ve basically been through this before. You and Mike and some nurses can handle it. It will probably be another C-section anyway.

My instinct, which I am continually trying to listen to with more open ears, said, call Jacquie. So I did.

Several months later, as I entered the chute into labour about a week early, I found myself panicking, despite weeks of pre-natal yoga meditations and some conscious effort to prepare myself for the event this time around. Last time, I had avoided thinking about my fears, and the pain. This time, I try to welcome those thoughts, especially when Jacquie asks me, is there anything on your mind this time? Pain, I hear myself say. Yeah, she replies, it’s there. You just have to go through it.

But as the early contractions drew me into the cave, I had an initial fleeting panic. I’m not ready yet. I had other plans this week. This baby can’t really be coming now. And then the panic was replaced by the simple thought that, at any point, we could call Jacquie. So we did, and it was off to the hospital.

At first, I was as I say “in the cave”. You can stand up and move around in the cave, you can talk to other people. As dilation progressed – way, way too slowly for my liking – I was still able to respond to her suggestions. Gently rubbing my back; let’s shake those hips, dance that baby down; why not try the shower? In the moment, all movement seemed ridiculous to contemplate, and yet once encouraged, there was always new relief.

And there was her anticipation and reassurance. In the cave, you don’t try to stop your body, or, as my g.p.friends put it, ‘smooth muscle has the power of veto’. With every new turn, Jacquie is there. You’re safe. You’ll feel pain here, and here – it’s safe to feel that pain, go with that pain. (I had a yoga teacher once who tried to get us to meditate through itches, to get us not to lift a finger to scratch at a nose or cheek. “Go into the itch instead”, he would say. “Become the itch”.) So it is with the pain, except that I have no power to do anything but go into it, to become it, or to try to resist it, which doesn’t work. Let go, says Jacquie. Unclench your hands and see what happens. Not believing but trusting anyway, I let go my hands, which have been clinging to Mike’s, and feel myself drop. I’m dropping out of the cave. It’s time to push.

In the state of pushing, I am in a tunnel. I’m not just watching – I’m there. It’s brown in there, and as I push further and further I go through large, flat bubble-like things which are light brown. They are the pain. The tunnel, I now believe, is the birth canal.

The first time I push, I do so naively. The pain is quite something, and I’m just wondering how I’m going to manage it (assuming I’m not one of those moms who later says, almost blithely, well, it was intense, but he was out in 2 pushes), when I hear Jacquie again. She’s farther away now – no one can come into the tunnel with me, there isn’t room for one thing – but I hear her say: push through the pain; there is another side at the end – a place you can push off from. Some people say that it actually feels good there.

Again, I don’t really believe it, but since I’m going to have to push anyway, I go as far as I can. Descent, pain, pain, and – there it is! A push-off place! Now, the descent into the push is like wading through a gooey swamp, and at the end is dry land, terra firma, where I can gather my strength and really step off, back up towards the light, the room, breath, and water. It doesn’t exactly make me look forward to the pushes, but it gives me something to reach for, that will provide some relief and also sense that I am doing something, that we are going somewhere.

I wonder if I can put into words the incredible bonding I now feel to this woman, who can issue directions I don’t believe and have me follow them anyway, only to discover they are true. No, I don’t think I can put it into words.

I am pushing in series of 3-4 pushes per contraction. The tunnel looks the same each time, it feels the same each time and this is odd to me in the moment: why am I not feeling – or “seeing” - forwards progression? Why, indeed, is this kidlet seeming to move, and then slip back? I am tired and tiring faster still, I want to quit, I am not proud, I can’t do this, I feel free to tell anyone who will listen. And, there is Jacquie again, bringing Mike in with her – they are my pit stop crew as I come around the circuit and wait for the next contraction; they whiz around me getting water, moving blankets, getting cool cloths, and always, always, cheering me on, with an energy that only later strikes me as incredible, given that they do not have the adrenaline of labour, and have not had any sleep.

But even the pit stop crew can’t give me muscle power I don’t have. My legs and arms are starting to shake. I find myself mentally ready to push harder but physically, I am just giving out. Even my uterus must be getting tired – the contractions are coming less frequently now (how can that be? I wonder fleetingly) and seem less intense. And my will to descend again and again into the tunnel is waning. Unbidden, I am hearing the voices of women saying “just two pushes.. two pushes… two pushes”. I am starting to feel resentful – where are my two pushes? I’m working hard here! Where the heck is this baby? At one point I reach down to touch the head – I saw this in a pre-natal video, and always thought it must surely be one of the most inspiring things a mother-to-be can do. But as I touch it, all I can think is – great: now where’s the rest of her?

I am spent, but no one seems to be rushing to get me out of this. And now, without knowing where the energy comes from, I try to drown out the womens’ voices. I reach, and what I come up with is what the pre-natal yoga instructor said, as she had us pump our arms to banish our fears. We would pump, in and out, out and in, eyes closed, well past the muscle-burning point, and as we huffed and puffed and squinched our faces up, she would say, calmly, Keep going. You can do this. You will need all your strength and more. You can do this.

So I say, weakly, barely whispering: I can do this.

I can’t imagine anyone will hear me, but Jacquie does, she picks up the line and throws me an end and then pulls, hard: that’s right Andrea. You can do this. You can do this. I allow myself to be pulled along, and we go through some more contractions.

And at last, it is time for the baby to be born. The doctor will help, there will be an episiotomy: OK Andrea, one more push, and you’ve got a baby. Suddenly, the tunnel widens, I can sit up in it, and there is a doorway coming closer and closer. At the last minute, Jacquie calls into the tunnel “Andrea! Open your eyes NOW!

And I do, and there is the light of heaven and the moment of angel music, and my daughter, and my tears and laughter and joy all filling the room, as she, and I, emerge into the daylight, into the world.

Strength is not in her/but she enacts it as the wind fills a sail

Each and every birth I attend is a profound and unique gift. But sometimes, just sometimes, events conspire to make the day even more inspiring. Tuesday was exhausting, cathartic, and joyful for all of us. I can’t even put it into words. Even talking with my client just now, rare tears flowed when I shared some information about how the obstetrician had helped her. The obstetrician, with her private source of inspiration drawn from losses of her own, trusted my client’s need to do this her own way, and in her own time. The obstetrician agreed that if my client had been given an epidural, a repeat cesarean would surely have followed. We had all reached deeper than usual to support this woman fully through her life-changing day.

So here’s the basics on paper:
Previous cesarean for 10 lb baby
Arrived at hospital 6-7cm after 4 hours labour
Movement, shower, swaying, rocking, gas
Fully dilated after 7 hours at the hospital
No epidural, no forceps, no cesarean (to the staff's surprise!)
Just plain hard work, squatting, moving
Born after 3 hours pushing - an 8lb 5 oz girl!
"You have the most beautiful ears!" says the pediatrician to the baby

My experience was of a continuous flow between us, connecting us like a rope, a lifeline. Her husband would whisper encouraging words softly. With every single contraction I would say, “Breathe in strength...you can do this...breathe out...you are safe...deep breath in...blow it away...breathe in for baby...blow it away...deep breath in...you are safe...you can do this...” On and on, hour after hour, one contraction at a time. Resting in between: “Feel how amazing the rest is, your head is heavy, your face is smooth, your arms are heavy, your legs are heavy, your bottom is loose.” Hips shaking, pelvic rocking, foot massages, constantly moving... If I stopped talking, she would call, “Jacquie!” or “Talk!” I would hear her mouthing the words, “I can do this!”

The mum says she is changed by this experience. Here are some quotes from our talk this morning:
“I will be a different person after this”
“I was reaching to new levels of my own strength”
“One step at a time...like a rock climber...I was putting hooks into things...”
“When I was pushing, you said to push through the pain and I’d come out the other side - it worked!”
“You knew exactly what I wanted even before I knew what I wanted”
“With each contraction, it was like I’d jump over a crocodile laden swamp and would land safely on firm ground on the other side”
“How are you able to translate birth into all venues and all languages?”
“It’s like you are my fairy grandmother”

Many thanks, Andrea, for your inspiration. As your daughter’s birth has changed you, it has also changed those of us who helped you. Thank you for allowing us to bear witness to your strength.

“There’s snow! That means it’s winter, so the baby must be coming!”

...to paraphrase an excited older sibling (age 4) this morning...

So cool that her logic worked so well. Mummy and daddy have said for 9 months that the baby will come in the winter. It snows in the winter. Today it is snowing. Therefore, the baby must be coming today.

And the baby came. What a drive through snowy streets to the hospital! What joy to find that my client had already surpassed her last labour’s dilation! What a triumph for her to labour without intervention or medications (other than nitrous oxide gas - which doesn’t count, right?) and birth (with under an hour of pushing) a glorious 9lb 1oz baby girl!

This VBAC (vaginal birth after cesarean) was the talk of the hospital today. Congratulations!

- Jacquie Munro, Vancouver Doula