"To sleep/Perchance to dream"

I love the drive from a client’s house to the hospital. I’m following my clients, watching the labouring woman’s hand reach up to the roof of the car during each contraction. For me, it’s an in-between time of quiet watchfulness, similar to that “out of time” feeling I remember while feeding a baby in the middle of the night.

Last night, we had a long drive from Surrey to Burnaby General. So, I turned on the radio to CBC Ideas and heard an amazing piece by Jeff Warren called "While You Were Out" about the changes in sleep patterns over the last three hundred years.

References to “first sleep” are present in Renaissance and pre-industrial writings. Only now are researchers discovering that our biological sleep pattern has two main cycles, “first sleep” and “second sleep,” with a two hour intermediary trance-like period, “the watch.”

After sunset, the family would head to the communal sleep space. There would be a quiet period of 1-2 hours rest in the dark, followed by “first sleep,” a deep rejuvenating state. This long wave sleep state would increase the levels of prolactin (ah, the breastfeeding hormone!) After 4-5 hours, people would enter an altered state of consciousness, induced by these high prolactin levels. Any breastfeeding mum knows the timeless trancelike effect produced by high prolactin levels - patient, waiting. In this period, people would traditionally pray, muse on the day’s events, or quietly make love, while listening to the natural sounds around them. Later, “second sleep” would come, full of REM sleep and dreams. They would all wake at sunrise.

This sounds so much like a typical night with a new baby. Hmmm... Rather than seeing the postpartum sleep pattern as unnatural, perhaps we should see this as our return to our natural biological state. Sleeping alone in a room devoid of sensory input seems to be an unnatural state for humans. Our North American need to mold our babies into beings who can sleep alone for long uninterrupted periods is, in fact, altering the delicate hormonal and chemical balance in our bodies.

So, have a quick read of the article, “The Cultural Biology of Sleep,” before delving into Carol Worthman’s research papers, which include “The Ecology of Human Sleep.” You may find some food for thought during “the watch.”

“In and out like a fiddler’s elbow”

I laughed when I heard this expression on CBC radio this morning. It’s supposed to mean that you’re really busy. Well - that was me this week. It had started out quietly...

And then...

Three births in two days. But the crazy thing is that I didn’t get more than four hours sleep in 64 hours. People said I looked alert and I felt fine the entire time.

I know that if I’d been at only one birth I would have fallen apart. But attending three births, each with their own special atmosphere, flavour, challenge and fun, seems to be what made the difference.

Challenging and fun it was!

It all began with another day of diversion at BC Women’s Hospital. Funny word “diversion.” The dictionary definition is “an activity that diverts, amuses or stimulates.” Hah! Yes, it is certainly stimulating when the hospital is on diversion. In hospital-speak, diversion is when the hospital cannot accommodate a patient. That’s just fine when it’s a general hospital. You just wait. But labouring women can’t just wait. You get sent, or “diverted” to another hospital. On Wednesday, my client was sent to Royal Columbian Hospital. The next patient after her was sent to Ridge Meadows...the next to Victoria. It’s too upsetting to think about those other women.

Luckily, once my client arrived at RCH, she was given the top birthing room. She dubbed this “The Las Vegas Suite” because of the oversized bathtub smack in the middle of the room. Details aside, this was an amazing birth. She showed such strength and power, trusted me when I said “You are safe,” and pushed out a glorious 9lb 11oz baby boy.

When I returned home on Thursday at dinner time, I didn’t go straight to bed. I wanted to enjoy the evening. How silly of me... I was out again by 11pm, heading for a home birth. I was relaxed. I knew there would be no emotional struggle against the system, no worrying if there was room at the inn. We just had to honour the flow of labour.

Well, there was one moment of anxiety when my client worried that the baby might be born before her older child woke up. No need to worry, though - we had tucked her and the new babe into bed, cleaned up the house, and driven away before her daughter ran into the room. What a morning of discovery for the family!

Then, when I’d only been asleep for two hours...

The pager vibrated off my bedside table. A client needed an emergency induction. The self-described “pessimistic” obstetrician held out little hope for a vaginal birth. But, after only 9 hours of active labour, and “optimistic” heroics supplied by the family practice doctors, my client greeted her gift of a lifetime - a wide-eyed son. Not a small feat for a 43 year old single mum who had hardly dared to dream about this day.

I drove home at midnight. The nurses called out to me as I left the building, “Drive slowly!” “Be careful!” “Keep the windows down!” “Sing loudly!”

I thank them all for their care.