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

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)

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!

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

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

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

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)

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

"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

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

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"

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

"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

"It's a GIRL!!!"

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

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

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

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

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!

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!

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?

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

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

Mikajo Yagi (1924-)

On Keeping Tidy

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

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...

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

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

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