Outside of time/The whisper of water unites us

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

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

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

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

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

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

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

Outside of time/

The whisper of water unites us

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

"8:12!!!" someone cries.

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

Jacquie Munro - Vancouver Doula, Slow Birth

An adagio hits a day of speed at full force

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

Slow Denial

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

Slow Birth > Mt Kilimanjaro

"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

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

The Birth Paradox

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

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

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

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

Let's call it the Birth Paradox.

- Jacquie Munro, Vancouver Doula

That's it! Time's up!

Love this sign! What a laugh!

But it does make me think about the very real anxiety that surrounds birth...and time.

When I initially ask clients what they wish for, the most common answer is, "A fast birth."

However, after we've been working together for a number of months, most clients realize that each labour takes as long as it needs - no more, no less. Each woman's task in labour is to accept its flow, allowing it to unfold as it should. Time and space start to recede, endorphins increase, tension starts to release, and then labour works well.

To put a time limit on any labour harms its natural rhythm. Birth is a psychosexual process. And, just like lovemaking, it withers when it is pressured by time.

Ultimately, once you understand the nature of birth and its relationship with time, you settle into a pace that fits you and your baby on this particular day. It may be fast. It may be slow. But, it should never be rushed or ruled by the clock.

So, don't be pressured by that sign...

- Jacquie Munro, Vancouver Doula

Madonna

This evocative Madonna collage will always remind me of the couple (both artists) who recently gave it to me as a gift after their daughter's birth. A treasure. It hangs in my room, and will also remind me of all the births I have attended - the layering of experience, the significance of cherished objects, the importance of history, the value of memories, the power of nature.

I see an old family portrait, a pomegranate, the impermanent dandelions, the water lily, the doll I had as a child, that special bike, that beautiful floor fragment, a cupola with light streaming through to the ground. We each see those things in the collage that hold meaning for us.

Labour is like this. Fragments, layers, images - all confusing, deeply challenging, yet breathtakingly beautiful. Our births are not "the pain." Our births are not physical. Ultimately, they are not of the body, they are of the mind. They are personal, they are dependent upon perception, they are ours. We birth as we live.

Birth is not "paint by numbers." Each birth is like a collage - totally different for each woman, each birth.

Five births since Christmas - each teaching us all new lessons to draw upon. I will look at the collage and name a part for each woman.

- With love and thanks to Tanis and David
www.silentalbum.com

Crossing the Portal, the Old School Way

I stood still in Pottery Barn the other week, in front of a phone that looked just like the lovely heavy black phone that we had when I was little. You know, the one with the rotary dial that, when you needed to dial 9-1-1, took such a long time for that 9 to rotate. No wonder they didn't stick with the British emergency code of 9-9-9. The emergency would have been over before the dialing was done.

So, still standing there, lost in space and time, I started to think about my low-tech childhood in the '60s and '70s, how I skipped to Kerrisdale elementary school in my skirt and walked through old door marked "Girls", and how my parents decided that it was totally unnecessary to have all the new high-tech things that were in the stores - how we shared a party line, had no answering machine, no voicemail, no calculators, no computers, no videos or DVDs, no recording devices, dishwasher or washer/dryer. We just had one little black and white TV with rabbit ears, a clothes line, and a hand cranked mangle to make life easier. (I laughed when I heard the editor of Canadian House and Home say just last week that her laundry room would not be complete without her most luxurious appliance - the mangle. Well, this one's electric, and it presses sheets, but hey...) It was truly an "Old School" childhood, and time was our ally.

So, I really noticed those multi-coloured cut-out letters stuck on the window at BC Women's Hospital the other day - "I DO IT OLD SCHOOL - ASK ME HOW". I kept thinking about those words as I helped a client through an almost 48-hour unmedicated, uncomplicated birth. After 31 hours at home, we went to the hospital to birth "old school" style. The tools at hand were our hands and eyes and ears and wisdom (other than my client and her husband, "We" also included nurse "Wendy" aka Michelle, and the Family Practice Group 2 docs Ron and Sheena, who all have the guts to go "old school"). Time, on this day, was our ally, for we needed a lot of it to accomplish the goal. The high-tech equipment didn't seem to know how to behave with us. The blood pressure cuff kept pumping itself up even when no one was there, and that brand-fangled-new monitor didn't work as well as the doptone, so it was turned off.

So, things were kept as simple as possible. On and on...dancing in the shower, rockin' an rollin' on the ball, just one contraction at a time, one breath at a time, listening to lovely music. To get rid of a puffy cervix at 9cm, we used the Trendelenburg position on the bed (no epidural necessary) and lots of encouragement. We used hip squeezes, hip shakes, swirling and spiralling hips, visualization, trance-inducing techniques, foot rubs, endorphin sleep and dreams, squatting, kneeling, walking, tears, hands, eyes, and love....liberally. And this amazing labouring woman drew on the strength of all her life, with the aid of a few sherpas, and did what all women have the power to do, climb the highest mountain ever - birthed her baby with arms outstretched to touch his body.

And when that baby came, it was pure joy. No exhaustion, just sparkling laughter and smiles and "I'm as high as a kite!" (love those endorphins) and an eager, wide-awake little boy who came out with his meaty fist stretched to the sky. Ahaa! The culprit - just one little hand had slowed things down. We knew it! But, with time, this little man and his mum had worked it out.

When the pediatrician came later to say "Hi", she actually bowed down before the woman, saying "I am not worthy." And the doctors agreed that, if any drugs had been used, it probably would have been a cesarean. And the nurses outside were in awe, knowing that there's an initiative in the hospital to reduce the intervention and cesarean rates by encouraging low tech/high touch birthing, and wishing that they could have seen how it was done.

I am in awe of the couple at the centre of the whirlwind, this vortex of birth. I thank them for trusting in birth, for trusting in the body, for trusting their baby, for trusting me to calm their spirit and their wild eyes, when I'd say, "It's fine, it's normal, you are safe, you can do it," or "She's safe, she has the strength to do this."

On this day, I think all three crossed the portal, the old school way.

- Jacquie Munro, Vancouver Doula

Kaleidoscope

"For we live with those retrievals from childhood that coalesce and echo throughout our lives, the way shattered pieces of glass in a kaleidoscope reappear in new forms and are songlike in their refrains and rhymes, making up a single monologue. We live permanently in the recurrence of our own stories, whatever story we tell." - from Divisadero by Michael Ondaatje

Shattering reflective pieces of a kaleidoscope tumble in my mind's eye. These are a million moments of experience, random sounds from births - a cry, a laugh, tumbling beside facts, data, then mingling with sparkling words from literature, history, and art. Our experience of life is beautiful and complex and always changing.

And yet, our lives are a monologue of recurring spirals of experience and emotion...constantly returning yet pushing forward. Our stories may keep recurring, but they shift and change with each new telling.

In my work as a doula, I must take my own experiences in birth and share them as stories that I gift to each client to become part of her personal monologue - a few stories for each woman to guide her forward on her own spiraling quest. Some stories are shared more often than others. Other stories are packed away in a shining lined box in my memory, to be shared infrequently. These are the potent stories tucked away for those especially challenging births.

This past week has been all about storytelling...stories of patience. Two women labouring, one woman in waiting... One woman's journey to birth took five days of incredible patience, interspersed with all the stories I could tell.

I told her the story of the woman who went through two days of oxytocin, only to bolt from the hospital, be found on the path to Oak Street, return, and give birth within half an hour. I told the story of the woman who went through a whole day of IV oxytocin before she signed all the release forms needed, and went home. Her labour began naturally a week later and only took four hours. I told the story of the woman who waited 10 days after her water broke before having the baby. I told stories of patience, of trust. I told stories from my kaleidoscope to support her own wishes. She asked for more stories. And when her baby came beautifully, in a sudden blinding flash of speed, I took her story...

...and gave it as a gift to the next woman...her friend, who went into labour a few days later. "She had her baby already? But she was due after me!" "Yes," and it was a triumph of patience. So this next woman took her friend’s story, gained strength from it, and pieced together her own story full of water and wind and patience. Water, wind, patience...those are the three things that kept her moving forward through labour. And her baby slid out beautifully, while her two feet were planted firmly on the ground. She was amazed at her own strength.

And I continue to tell stories to the woman who remains, in waiting, eleven days past her due date - climbing stairs, playing with her son, patient. Through her actions, she shares her stories with me.

To be a witness, a keeper of these stories, and to watch them form into a kaleidoscope of lives and lessons...that is one of my greatest joys in life.

…now…off to a birth…and another story for the kaleidoscope… - Jacquie Munro, Vancouver Doula

L'Arbre et Le Fruit

Here's a little excerpt from an article by Dr. Michel Odent, noted French obstetrician.

"According to traditional wisdom in rural France, a baby in the womb should be compared to fruit on the tree. Not all the fruit on the same tree is ripe at the same time. A fruit that has been picked before it is ripe will never be fit to eat and will quickly go bad. It is the same with a baby. In other words, we must accept that some babies need a much longer time than others before they are ready to be born. If you have some apple trees in your garden, you will listen to your common sense and choose an individualized and selective approach: you will not pick all the apples on the same day."

A recent client was concerned that she would be induced, as she had been in her first pregnancy. I had the confidence to tell her that her physician would not induce labour, even if she reached 42 weeks, as long as she and the baby were well. I could say that with confidence because I have been working closely with this particular group of family doctors for almost 20 years. This gave her peace, and she was able to relax. Soon after, she went into labour on her own, well after the typical "10 day limit" imposed in most North American hospitals. All was well. She could hardly believe the wonderful difference from her previous, induced, labour.

I live in a bubble, working as I do with midwives and family doctors who respect the current research, dare to challenge hospital protocols, and fully respect their clients' rights. I am fortunate to work in collaboration with caregivers who dare to wait, who only induce women if it is truly medically indicated (even if it causes a fuss with other staff!) In reality, this means I rarely see a woman face induction.

I am glad that I only work with caregivers who follow the best care practices. We work in concert with each woman and her body. Labours start on their own, women dance and move freely, women are continuously supported, women do not face regular interventions, women give birth standing, kneeling, or wherever they choose, and the women reach to pull the babies to their breasts. (Left brain dominant? Click here.)

In birth, we are not the keepers of the power, each woman's body is. Yes, we have to do our homework and ensure that everything we do is supported by the best evidence. But, after a while, the 21st century knowledge is only a backdrop to the ancient truth of birth.

So, if a woman's body is the tree, then the apple will fall, as it should, whenever it is ready, and will rest on soft safe ground. And the orchard keepers will be sitting, as they should, with their hands beneath them, in the shade of the tree. - Jacquie Munro, Vancouver Doula

Lessons from a Happy Flying Baby (Advanced Level)

Did I tell you that I think that labour lasts as long as you need to learn all the lessons required for this particular child? There’s perhaps a little extra time added to work through some particularly tricky past life experiences. The baby’s personality has a lot to do with this...

One of the family doctors I know, said that all three of her boys had labours to fit their personalities. One came flying so fast that his cord broke. And that’s how he goes through life - flying headlong into things (both physically and emotionally). Another son takes his time, considers all his options, then considers them some more. As a result, his labour took a long, long time.

My daughter is strong, powerful, never wanting to follow the crowd. When I was in labour, her head was trying to forge a new, totally different path - out my hip. Later, her high school math teacher said that she would pound away at a problem for a long time, only to later discover that if she just turned the equation around, the answer was there - and simple. That sounded just like her labour, since she eventually tilted her head, and came easily.

It’s interesting, but my clients who have the quickest births often have the hardest time adjusting to parenthood. They often tell me that they just can’t figure out their baby. In a 15-minute labour, there’s not much time to learn the lessons that you need to parent this child.

So, be thankful if you have a long, gradual labour. There are many benefits to the lessons learned during this time - lessons that you will draw upon for a lifetime. You might even begin to understand that labour and birth is something that’s out of your hands, and that's okay. When things are slow, it's not "your fault." It might just be your baby speaking to you through your body...

So, listen. - Jacquie Munro, Vancouver Doula

Land Speed Records (baby style)

The three little girls born this week almost set land speed records. The total official labour time for all three was 5.5 hours. Wow! (One was a first birth!) Now, I'm counting the official labour time as starting once TWO progressive regular contractions are coming every 10 minutes. (That's 2/10 for short.) Now, the total time of the three labours from the "first sign" adds up to 14 hours.

So, we had "fair warning" for each. I made it to each birth...and we all made it to the hospital in time (my apologies to the drivers that we flashed on the highway!) We didn't spend much time at the hospital before each baby was born (45min, 2 hrs, 30 min.) And...the quotes from the mums and dads and babies were great... "It's amazing the second time around - that was a little easier!" "I can't believe it's over already!" "The whole thing was incredible - crazy!" "That wasn't as bad as I expected!" "Whaaa!"

Now, I wonder if these girls flew into the world because they knew they were joining their sisters? Between these three families, there are now 6 girls!

Welcome to Hannah, Sadie, and Ava! - Jacquie Munro, Vancouver Doula

"The only real valuable thing is intuition" - Albert Einstein

Oh...the remaining three babies...I never talked about them... Sorry! Here it is...

It's interesting how women often have a sense of how their labour will go, even weeks before the due date. Some women have dreams of a spider web (baby wrapped in cord) or a rock climber (cord again) or a square peg in a round hole (positioning problem.) Are these premonitions or self-fulfilling prophecies? I don't know. I like to think that the body is giving the woman a clue about what is currently happening, and that these dreams are reality-based, not fear-based.

The last three births in the marathon week mirrored their mothers' dreams and premonitions exactly. One had said that she wasn't concerned about the birth at all. Another had said that she had a hard time visualizing the baby coming out of her - there was some problem with that image. The third said she was feeling very patient.

Well, the first woman, a heptathlete, had the straight-forward first birth that she had envisioned - pacing around the house and hospital, squatting between her husband's legs for her baby's birth. Pure and simple. No muss no fuss. What joy!

The second woman laboured beautifully at home, made a smooth transition to the hospital, and sunk into the tub on Holly. Her labour had looked like it was accelerating normally, but whenever I talked about the baby sliding down, she'd jump in with..."No, don't say that." It was as if she knew it wasn't safe to imagine the baby descending. It turned out that the placenta had partially abrupted, and the baby needed to be born by cesarean to stay safe. I truly believe she had known there was something going on at an intuitive level. There's no better lesson to learn as we head into motherhood - that we can trust our instincts. Amazing.

During her pregnancy, the third woman had been so accepting of whatever labour might throw at her. She seemed so calm, trusting in her body. She had a long slow prelabour period, and surprised the doctor by showing up for a prenatal visit...at 7cm! Even though it took a further 10 hours before the baby was born, she remained patient throughout. She took in everything that I said, her husband said, her nurse said, her doctor said...trusted her body, did what she needed to do for her baby, and it all worked! Here's her account:

"Your confidence and coaching really worked for me - I kept remembering you saying that it's all in the mind and that it's safe to go further. Every tip you gave me, whether it was working through a contraction or a push, made so much sense. I could actually imagine myself climbing up the rope when you told me to do so.

My first birth experience has been so positive and amazing, and I should really credit you for it. It's just like having a personal trainer run with you through your first marathon. And I can now speak from firsthand experience that birth itself is not unlike running a marathon. I remembered how the crowds cheering on the sidelines, the bands playing, and the water stations, all gave me boosts of energy. You supplied the bands, the cheering crowds, and the sips of hydrating water when I needed them. Somehow giving birth to Allison seemed a whole lot easier than the marathon ... probably because I had my own support team for the entire journey! Thanks so much!"

So, these three women listened to their bodies and their babies, and had the births that were "just right" for them. This was a true testament to mother's wisdom...and a mother's intuition.
- Jacquie Munro, Vancouver Doula

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...

The tip of the iceberg

A nurse asked me the other day, “Do you just meet your clients at the hospital? Do you meet with them at all during the pregnancy?”

Kat’s pregnancy and birth sprang to mind instantly. A nurse herself, she knew the superstition about nurses’ labours - “you get everything that you don’t want.” So, she knew she’d have to work hard to set up the best environment for birthing her baby without much “fuss.” So, referred by a friend, she hired me one October when she was three months pregnant. She had a lovely family doctor who specialized in maternity care, and trusted Kat’s ability to give birth. Then she signed up for prenatal classes, prenatal yoga and fitness programs. Everything was in place.

After our initial interview over tea, we phoned regularly, and I made two long visits to her home, talking with her and her husband about their personal philosophy, their challenges over the years, and their hopes for the birth. I answered all their questions from, “How will he be able to finish his thesis with a baby in the house?” to “Why does everyone say I must have an epidural?”

Throughout the pregnancy there were challenges to discuss...not big enough to call her doctor, but enough that Kat needed my support. For example, early in her pregnancy, she went to an independent lab for an ultrasound. She had been shuffled in and out within 5 minutes. “Next!” She was back in the car before she knew it...in tears. We talked on the phone after that, for at least an hour. After our talk, she decided she would only go for testing at her own hospital, where there was a greater chance of continuity and consistency of care. She was glad that she could use me as her sounding board.

In our many phone calls, we talked about her fears... “What if it’s so fast that you don’t make it to our house?” and her thoughts on her own ability to deal with pain...”I’m a bit of a wuss.” We talked about her hopes and dreams, her expectations of motherhood, and her concerns about her husband making it through the labour if it was long ("He'll need to sleep!") She called whenever she had a cold, when her friends gave birth ("Why isn't it me?"), when the baby was moving too much or too little, when she needed help sleeping, whenever anything needed to be discussed.

I worked to help her see the big picture, to help her to let go of expectations, to help her listen to her body. As an oncology nurse, she found it was a struggle to let go of fears, but, with encouragement and her own strength and wisdom, she met the challenge.

In late March, another phone call: “Did I tell you that I want to avoid the baby being suctioned, to have everyone quiet at the birth, to avoid medications, to get lots of encouragement??? The last minute worries had surfaced, the fear of not having her wishes honoured was voiced. We had talked for 12 hours by this point, over the course of the pregnancy...and it was really starting to spill out now.

Then came the due date. Another phone call. Then came another two weeks. Daily phone calls to me. More doctor visits. Testing at the hospital. Our contact increased as the days passed. When she finally went into labour, she was comfortable with her “team,” and we had discussed almost every possible scenario in advance. Kat had decided that, in order to labour with minimal intervention, she would have to stay home as long as possible.

Two days later (all the time in labour)...

...we had baked, walked, made soup, taken photos, and watched two nights of playoff hockey. Her husband was finally asleep in the bedroom, and I was at my limit and ready to fall onto the futon beside me.

Kat was still pacing the living room. To say she was frustrated was an understatement. Her contractions had never quite “kicked into gear.” We had been in touch with the doctor and hospital at regular intervals, and had been told to stay home until things escalated. What was it going to take?

Finally, I said that we would have to go to the hospital for further support if nothing had changed within the hour. I suggested that she try one last bath, (and a firm talk with the baby!) while swishing her hips from side to side to loosen her body. I closed my eyes...

“Quick! Jacquie! My water broke!” The words tumbled into my dream. It was an hour later. Kat was standing beside me, dripping... I tried to wake up. The next contraction came, and it was STRONG! Finally! I worked hard to wake up her husband, and we drove Kat to the hospital.

The baby was born!

Someone at the hospital said, “Well, that was easy for you guys! You just popped into the hospital and the baby was born!” We all yawned, then laughed.

So, to answer the nurse’s question, “No, I don’t just meet the couple at the hospital. We usually work together for many months during the pregnancy, and many hours in labour before you see us. It might look easy...but...”

It’s just the tip of the iceberg.

Searching the past for ritual

Over the years, I have been a witness to many birth rituals. Often, these are rituals drawn from different cultures. Those that spring to mind...

A Tibetan woman had a long labour, followed by a cesarean birth. Outside the operating room waited two beaming monks, their robes a bright contrast to the hospital walls. After the baby was born, the father asked that the first piece of cloth to touch the baby was a silk fuschia prayer shawl that had been blessed by the Dalai Lama. There, in the operating room, was one spark of colour. The birth shifted from medical to spiritual.

A Sikh woman laboured, standing by the bed in the hospital. While the nurse was ritually laying out the delivery cart, gloved and masked, the husband ritually laid out a prayer table. The altar of medicine looked out of place.

A Japanese woman reached down for her baby, pulled him up to her breast, and named him. "She must tell him his name as he comes to her breast," whispered her husband.

But there are also historical rituals to be considered...

At the Victoria and Albert Museum in London, a current exhibition titled, "At Home in Renaissance Italy," highlights the rhythms and rituals of Renaissance living. One highlight is a portrait of a noblewoman, wearing a marten's pelt with a jewelled head. This fashion accesory was believed to act as a guardian to women during pregnancy and childbirth. The marten was thought to conceive through the ear and give birth through the mouth. Much easier!

The women were also pampered after the birth, their food being carried to them on ritual birth trays, lavishly painted with protective images.

Pregnancy is a wonderful time to explore these cultural and historical rituals, and perhaps foster a stronger connection between peoples and times.

The Inner Journey of Pregnancy

During a client’s first pregnancy, I’m continually trying to think of the best way to help her prepare for this life-changing event. Over the months, we certainly talk on the phone about her physical changes. But her emotional changes, her expectations, values and priorities are of even greater importance.

Often, a woman’s inner wisdom is at odds with the societal standard, and my job is to help strengthen her confidence. I have to help her to trust her body’s ability to birth and shut out the voices shouting, “You really should have that test” “You’ve never done this before” “Everyone has a Diaper Genie” “Buy bottles in case breastfeeding doesn’t work.” The competing voices can almost drown out her “I can do this,” and weaken it to become “I’m naïve to think I can do this.”

To have an ideal first birth, a number of factors have to be firmly in place. A perfect example was recently outlined by a local midwife, who wrote “I know if I have a 28 year old woman who has not been sexually abused, who really wants to be pregnant and does so easily, is a successful artist working in a home studio, does no prenatal screening, eats healthily and exercises moderately and regularly, and plans a home birth with the support of her partner, that she is going to have a wonderful labour and birth.” This hypothetical woman would have a strong sense of self, a willingness to make choices outside the societal norms, and would make the job of the doula and midwife look easy.

How do we help the woman who is over 35, perhaps embarking on this pregnancy on her own, or becomes pregnant shortly after entering a new relationship, or is finally pregnant after enduring years of fertility treatments? What if the woman has been subjected to emotional or physical abuse in her life, has been marginalized in her life or job, or is still struggling to define her boundaries?

In the North American society of 2006, the nine months of pregnancy seem far too short to deal with all these issues. The woman often spends her pregnancy on an external journey of moving house or renovating, buying a new car, buying baby gear, fighting for maternity benefits, choosing and attending the right classes (prenatal, fitness, yoga, etc.), and preparing to entertain any number of visiting family during the postpartum period. Society places little priority on the inner journey of pregnancy.

Where is there time for introspection? Where is there time for long walks on the beach with wise women or a supportive partner? Where is there time to read novels that quietly address the emotional issues at hand? Where is there time to dance, to sing, to draw, to express the inner journey?

Perhaps the best preparation for birth is to use the nine months of pregnancy wisely. Relish this period, which bridges the gap between two dramatic stages in a woman’s life. Both literally and figuratively, take time to follow eastern philosophy and “breathe for the hollow organ.” Breathe in deeply, wait, be still, exhale, then wait for the body to take the next breath. Live in the moment. Listen to your body and get out of the fast lane of the 21st century.

This inner journey of pregnancy can be profound. If a woman listens to her inner wisdom, surrounds herself with strong women and men who will support her choices, honours her body’s need for stillness, and sees time as her ally, she may yet have the birth that she wishes. It can also change her entire outlook on life. And, ultimately, it can give her the confidence to raise children with grace, laughter and understanding.

Taking Stock (or living in a bubble)

It’s good to take stock of things every once in a while. Change happens so gradually that you often don’t notice until you stand back and observe the differences. Strangers are often the first to notice changes in our children. When did my daughter change from looking like her father, to looking like me? When did my son get taller than his sister who is almost four years older than him? Somehow I missed seeing the changes in the moment.

It’s the same regarding birth practices.

When I started working as a doula, shaves and enemas were still routine. Women were given IVs, and continuous monitoring was deemed necessary. Women still had to write militant-sounding birth plans in order to achieve their goals during birth. Informed consent and family-centred maternity care was a goal, not the norm.

Now, it’s only old books on library shelves (or U.S. television?) that perpetuate the myth that these practices still exist here in Vancouver.

Maybe I live in a bubble...but things have changed here in the hospitals over the past 20 years. Monitors aren’t routinely kept in birthing rooms. I rarely see IVs given without cause or consent, and the nurse is the first person to suggest “more juice so you don’t need an IV.” No one looks at me oddly when I shake my client’s hips or help her to squat. The doctor will do everything in his or her power to prevent a woman from tearing. The nurse and I can be so in harmony that we communicate with only our hands and eyes, and guide the labouring woman into the bath. The doctors and nurses now hire me for their births. No one seems to remember how to do an enema. The dad and family are welcomed with open arms. Pretty much everything that women used to include in birth plans are now accepted as normal practice (so we just don’t write them any more). Prenatal classes include more birth art than breathing. The nurse might put aside her paperwork, take photos lying down on the floor, and cry along with the family. The labouring woman and her family are truly at the centre of this new type of care.

Long gone are the scary matrons of old. Now, I know that the charge nurse will encourage my client to stay at home as long as possible. At the hospital, she will take my client’s blood pressure twice...then wait...calm her down...three times...until she gets a low enough reading to allow admittance to “the fancy rooms.” I know that if I don’t see our nurse for a while, she’s busy trying to advocate for my client. I know that if I get a hunch that something’s not quite right, the nurse will listen to me and take immediate action. Together, we have prevented many complications.

I’m lucky that most of the doctors and midwives that I work with have recommended me to my client. I know that I can call them at any time with concerns or questions. They also call and email me an equal amount. It’s such a seamless and collaborative process that I never noticed when it reached this level of cooperation. When did we grow up?

“Come out of the circle of time/And into the circle of love” - Rumi

In the past, it was the partner’s job, as coach, to time each contraction with a stopwatch. I still have my old list of “...8:27...8:39...8:45...8:54...”from my first labour in 1983. The fixation on time has continued. Now there’s even a program that you can download to your Blackberry which will graph your contractions!

In contrast, I encourage my clients to let go of actively timing contractions at the beginning of the labour process. I think timing contractions is almost too simplistic a gauge of how labour is progressing. It makes you focus on an external reality and lose touch with your inner rhythm, your inner knowledge. It can also make you fixate on how long things have been continuing which, in turn, can lead to frustration or impatience.

Take me for example. There I was, waiting for my first labour to start. I was 10 days overdue. On paper, it looked like I had been in labour for a week. Contractions were every three minutes - sixty seconds long. I thought I was going through the longest labour on record. But I was still able to walk and talk through each “contraction.” I was really just having prelabour tightenings. But my fixation on timing had made me exhausted and mentally drained even before the true labour began. If I’d been able to talk with someone a few times a day during that last week, someone who understood the logic of the body and the rhythm of labour, I might have been able to rest more, and been more emotionally capable during the true labour.

Now, when I’m working as a doula, I try to help people deny the niggly prelabour stuff. If you think of the early symptoms like the start of a period then you may be able dismiss the first signs of labour (the “forget it” stage). Sure, we talk on the phone during this period, but you certainly don’t need to time anything. If you only attend to the active part of labour, where you can no longer deny it, it will feel like your labour is shorter. (Like a client this year who denied things so beautifully throughout the day that she asked me, "Do you really think I'm in labour?" when I arrived at her house. It was only 5 hours later that her first baby was born.)

Now, I watch the momentum of labour, the woman’s movement, her face. Is she flushed? Are her knees bent? Is she rising onto her tiptoes at the peak of a contraction? How much clothing can she stand to wear? What sounds is she making? All these things tell me how her labour is progressing. But I’m not the “keeper of the wisdom.” In prenatal visits, I share all these secrets with clients.

I just love it when I get a phone call from a dad..."Uh, she’s doing that thing you showed us on the chair. The contractions only started half an hour ago, but I think we should just meet you at the hospital." I can hear her low moans in the background. It’s so great to know that he “gets it,” and hasn’t had to rely on timing contractions to determine the fast progress of her labour.

If you truly MUST write down the contractions (for the baby book), do it. It can be a fun way to keep busy during early labour. But it’s only good at showing you exactly when active labour starts. When does that happen? Well, the moment a woman says, “Put that pen down and rub my back!” she has reached the start of active labour. Oh, and another great indicator of the beginning of active labour is to play a game of cards. I was at the hospital with a woman who was being induced. “When will I know that it’s REAL?” she asked. “Well, when you throw your cards at me,” I said. It was only another half hour later that she threw the cards down. “Now, I know what you mean,” she laughed, as she jumped out of the bed. Ahaa! She had entered active labour.

So, here’s a great way to access your instinctive side: Take off your watch, turn all the clocks around... and feel the rhythm of contractions. For example, you can lean on the kitchen counter for a contraction, then pick a walking circuit around the house. You might have to walk three circuits before another contraction comes. After an hour, you may only be able to complete two circuits before the contraction comes again. You will know “in your body” the rhythm of labour, and won’t need to focus on time any more. Once you are able to flow with the labour, this will encourage a trancelike state (ah, endorphin release!), and help you go deeper into labour. But, always remember to keep in touch with me and your midwife or doctor. Oh, and we’ll know that it’s time to go to the hospital when you can’t walk another circuit (I will certainly be with you by that time!)

Every labour is totally different. Some women follow the textbook and have contractions which increase in length, strength and frequency. Other women can have contractions which are fast and furious from the first contraction. On rare occasions, some women find that their contractions are “pokey” all the way through. Labour is not a linear process; it ebbs and flows as the body and your baby requires. I will help you navigate this rhythm. When I talk to you on the phone, I will be thinking about how many times you have to stop talking (i.e. have a contraction) within a 10-minute period. In early labour there might only be one contraction every 10 minutes. Generally, in active labour, 3-4 contractions will occur in each 10 minute period. But the sooner you can let go of time, let go of your “thinking brain,” the sooner you will experience the timeless rhythm of labour. You will be able to cope much better.

So, I encourage you to trust your body’s rhythm, drawing guidance from your chosen caregivers. Talk to your doctor or midwife in advance about phone contact in early labour. Remember, you’ll be talking with me on the phone A LOT in early labour, and I will come whenever you need me. My arrival isn’t based on time, but on your need for extra support. Or your partner’s need for support! Then...I’ll be there.