Chance or Choice?

A Note From Carri:

I loved this post! There is so much more to a birth story than the stats of how long you were in labor and how big your baby was. I am a woman that had fast labors, but there were back stories to them as well, and it does make a difference. We all have to make choices throughout our pregnancies and labor, and it is how we navigate through them that makes the difference between chance or choice.

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Posted on April 21, 2011 by birthsmart

Many people believe that birth is very uncontrollable and the kind of labor you have is “luck of the draw”. And while that is true in a sense, I also KNOW that there are specific practices that can reduce a woman’s risk of various complications happening (like good nutrition, exercise, or not hiring the Dr. with the 70% c-section rate . . .). Birth is an experience of a lifetime and has emotional and physical challenges no matter how the birth story unfolds, but in my work, I am constantly reminded that women have more power than they realize to create the birth experience they desire. Three women I have recently helped to support illustrate this concept well.

To read the rest of this wonderful post click here.

MELISSA JOAN HART ON MYBESTBIRTH

Posted by Kim
Email received from Business of Being Born Facebook Group

Next week, we continue our celebrity webisode series with TV and film actress Melissa Joan Hart. We loved our interview with Melissa Joan because her two birth experiences mirror so many women that we hear from across the country.

Her first child was induced without any medical reason: “I was ready to just get my baby out and get my life going because I had been thinking about it for so long,” she said. What followed was a difficult labor that lasted 24 hours. It took several attempts before the epidural was administered correctly. Melissa’s doctor used a vacuum to assist. “There were three hours of pushing with my doctor saying, ‘One more push and you’re going for a C-section.’ I did whatever the doctors and nurses wanted me to do.” Melissa believes that her first son, Mason, just wasn’t ready to be born at the time she was induced. “I think he would have stayed in there another two weeks. I was mentally ready to have the baby, and because it was my first, I wanted to be done with it and have that experience,” she said.

When Melissa was pregnant with her second child, she wanted to do things differently. At a friend’s recommendation, Melissa enrolled in hypnobirthing classes where she learned relaxation and visualization techniques. “What I took away from hypnobirthing was the idea that you don’t have to be a good patient. You don’t have to do what the doctors and nurses tell you to do. They want to make it pain-free for you, and as easy as possible for them and for you. And they want to make you comfortable. But in hypnobirthing they teach you that birth is not a medical experience, and you have every right to bring the baby into the world however you want to, unless there’s an emergency.”

To hear how Melissa Joan’s second birth turned out, tune into mybestbirth.com next week! Melissa Joan’s story is being sponsored by our good friends at Milkalicious.

Birth Story - Griffin's Birth

Posted by Kim:

Below is the story of my second son, Griffin's, birth as written in my birth journal. Enjoy

2/11/05

Written by Mommy:

Well today is the big day! Hopefully our second little guy will be born on Uncle Will's Birthday! We scheduled our labor to be induced today because Griffin is growing at a healthy rate (possibly 3 lbs more than Connor's birth weight) and also this way our friends knew when to expect Connor to come over and play. It is a little bit difficult not to have family in the area.

** The decision to induce Griffin's birth is something I have regretted since. Convenience is not a good enough excuse, but I also remember being very tired of being pregnant. I only wish I had held out for my labor to start naturally, but I can't change that now. It is what it is. **

We weren't sure if you would be born today. At 5am we received a phone call from the birthplace saying that they were full with birthing mothers and we might not be able to come in, but call back at 8am to check. I could barely wait! At 7:58am I called and the girl who answered said we probably won't be coming in (why didn't I see this as a sign?). Then after waiting on hold for what seemed like 30 minutes, but was probably 3, she said "Can you com in at 8:30am?" I was so surprised it must be the closest feeling I have ever had to the surprise of natural childbirth. So we quickly got ready, packed Connor's bag, and umped in the car. Dad dropped me off at the hospital and said "OK call me when you're ready to have a baby. I'll be back to pick you up." Ha Ha, who is the funny guy? Dad then took Connor over to Aunt Kathy's house to play.

I went up to the birthplace and checked into room 2105. The first thing I do is change into the birthing skirt my friend Carri gave me as a present and a jog bra. Daddy arrived soon after and started shooting video right away. Now that he has become a video editor extraordinaire he looks at shooting video in a whole new light! My goal is to give birth to you by 6pm. We'll see how things go.

Written by Daddy:

Here's Daddy! Connor and I dropped Mommy off at 8:45am at LUH and told her to give us a call if she needed anything, its boys day out! Ha, not really. After dropping Mom off Connor went to visit Aunt Kathy for the day. Everyone was anxiously awaiting Connor's arrival for a day of cars and trains. I arrived at LUH at 9:15am to coach baby Griffin into the world. We're in room 2105 this year and we've got a much better view this time, we can see snow covered Long's Peak from our room. I started with casual photography and video to capture the scene. At 10:30am pitocin starts, the fun begins. So far so good, Dr Finnegan stopped by at 12:30pm, 3 to 4 cm dilated and he broke Mommy's bag of water at 12:45pm. While anxiously awaiting Griffin's arrival we listened to the Birth Day and U2 CDs we made and watched Old School. 2:30pm Epidural time. The epidural seems to have been slower to take effect, but by 3:15pm we seem to have a good block. Kim is about 7cm now. 4:10pm Dr Finnegan stops by and Kim is about 9cm dilated now.

Written by Mommy:

Our first nurse is Elaine and she is quite nice. She is from Alberta, Canada and we talked a lot about Toronto and how beautiful it is there. Elaine starts the pitocin around 10:30am and she said it will take about 3-5 minutes before my body will react to the iv. Unfortunately the contractions do not start as quickly as I had hoped, but there are a few.

Around 12:30pm Dr Finnegan stopped over and broke my bag of water. I am only dilated to about 3 1/2 or 4 cms, but he said this should really get my contractions going. Unfortunately this is not true, but I am definitely having more contractions than before. I work through the contractions while watching Old School. You can't help but laugh through the contractions.

Around 2:30pm I decide it is time to get up , use the bathroom and prepare for the epidural. For some reason I have to take a pepcid pill with an Alka Seltzer chaser. I don't remember doing that before, but then again, everything about your pregnancy, labor and birth has been totally different than Connor's. You are your own man. The Dr finally arrives after Elaine checks me and says that I am 7cm dilated. I am so surprised because the contractions at 7cms with you seem about 1/2 as bad as the contractions I had with Connor at 4cms, and they are in a totally different location. My contractions with you are at the top of my belly pushing you down. My goal is to deliver you by 6pm.

After getting the Epidural everything calms down. I am actually a little tired and feel like I could fall asleep. however, by 4:00pm I am completely dilated but you seem to be in a long sleep period and the contractions are not regular. Elaine is going to call Dr Finnegan and see what we should do. She thinks we should turn down the epidural and turn up the pitocin. So that is what we are going to do.

By 6pm the contractions are regular and I have regained a lot of feeling in my lower body because the Epidural has been turned off. At this time Elaine leaves and Suzy becomes our pushing coach. She and Daddy start to urge me on and hope that you will be born before Suzy has to leave at 7:00pm. For a while even Dr Finnegan was in the room to hold my leg. They kept telling me to push down and I thought that was what I was doing, but I guess not because you were not moving much.

Suzy leaves at 7:00pm and Joyce takes over and the pushing remains the same. Wither you are stuck or I am a terrible pusher. Unfortunately I think it is the latter of the two. Daddy is being so helpful because by now the Epidural has completely worn off and it is pretty painful. Because I don't seem to be pushing well I ask Joyce to get out the mirror so I can see what is going on myself. I figured if I could see your head maybe it would give me something to focus on. It seems to help a little, but by 8:00pm Dr Finnegan tells us we have a 1/2 hour until c-section. I almost lose it, but I am determined to push you out. I do not want a c-section. Daddy and Joyce cheer me on and Daddy says I am pushing well. Apparently I am using a lot more strength than I realized I had. I keep checking the time but I can see that you are moving. This is going to work.

Finally around 8:30pm they call the team in and you are going to be born. A few more pushed and your head comes out! This is amazing. I have to stop though because the cord is wrapped around your neck twice. Dr Finnegan clamps it and cuts it quickly. Unfortunately Daddy did not get to do the ceremonial cutting of the cord, but your health is most important. Now we're ready to push again. Just another push and you are out! Finally!! You were born at 8:43pm. It was a struggle, but I was determined.

Immediately after you are born they take you to the warmer and Daddy heads over to inspect. Of course he says you have Connor's hands and feet. The nurses clean you off as I deliver the placenta, thankfully with only one push. You are not crying like I wold like and it seems like you are grunting a little too. After they let me hold you for a short time, but then the nurses and Daddy take you down to the nursery to check everything out. I am worried because I don't know if everything is alright.

While you are in the nursery I called Aunt Lisa & Uncle Tony, Grandma & Grandpa King, and Aunt Kathy to tell them the good news! I don't even know what your statistics are yet! I am guessing that you weigh about 7 pounds.

Finally Daddy returns from the nursery with your stats. You are 8lbs 1oz!! I can't believe it. No wonder I had trouble pushing. You are 21" long and your head circumference is 13 3/4 " (75% on the charts). I can't believe it! Now I am so glad that you were induced, if you were much bigger I don't think I would have been able to deliver you! You are 3lbs 7oz bigger than Connor was when he was born.

The Dr decided that you should spend the night in the nursery just to be safe. So after a while Daddy and I head down to the nursery so I can nurse you. I am so happy when you latch right on and eat like a little piggy! I love it!! Daddy and I stay and cuddle you until midnight. We love you so much! We're just happy that you are healthy. Daddy then goes home so he can catch some Zs and pick Connor up in the morning. I nurse you again during the night and at 6am the NICU nurse Erika brings you down to our room. I am not going to let you out of my sight from now on.

Griffin on the left Connor on the right, same Pooh Bear (two totally different babies)

Birth Story - Kim's First Birth

Posted by Kim:

I have been promising my birth stories and after an aggravating, sweaty search for my birth journal I finally found it and will transcribe the words from the actual birth experience. I have been looking for a week and I was starting to get a little sick to my stomach because I thought I had the journal out since we have been in our new house, frankly I felt a little taste of vomit in the back of my throat for every day that went by and I couldn't find it. Never the less, I was successful and without any more pointless details about my search I will get to the story!!!

Look at this picture? If you ever wonder why we "invented" BINSI this is why. To say the least I am not looking like I am ready for the challenges of labor and birth. I look like someone stuffed into a sausage casing. Thank goodness I wore BINSI for my second birth

October 20, 2002

written by Paul (Daddy)

Today is the big day! We arrived at the hospital around 12:15pm to begin inducing the baby. We are inducing the baby because the baby is a little bit smaller than expected, but the baby is healthy [original due date 11/16/02]. The Doctor believes at this point the baby will grow better on the outside than inside [had an amnio the previous week and lungs are developed].

Our first nurse is Polly and she has been wonderful. Our room number is 2010, pretty ironic since today is 10/20, we think it might be a sign that the baby will be born today (so naive we were). Also the Bills are beating the Dolphins 20-10, coincidence? The first thing Polly does is put Kim on the fetal monitor for about an hour while going through the formality of admission paperwork. During the course of conversation we find out that Polly is from Elmira, NY and that Kim and Polly share the same birthday. It seem that everyone has a NY connection.

At approximately 1:30pm Dr Finnegan arrives applies prostin gel to begin inducing the baby. Kim is about 1cm dilated, so we have a ways to go, but almost immediately after the gel is applied, Kim starts to feel cramping. We are also starting to see contractions on the external probe, a good sign. Kim describes the pain as similar to menstral cramps she used to have.

Since our arrival we've been catching up on our NFL action. Unfortunately the hospital does not have the NFL ticket, so we didn't get to watch the Bills today, Kim and baby are disappointed. Dr Finnegan says the head is in position for delivery and that the baby's head is looking in the direction of the football game, must be a football fan!

Amy Jones arrives around 2pm to visit us. Shortly after Amy arrives we go for a walk outside around the hospital. It was a short walk, but it felt good.

The Bills won today 23-10, so maybe its a sign that we're not having a baby today.

After a shift change, a new nurse Kelly, our friends Mark and Becky visit bearing gifts. Becky brought a sleezy sex mag (Cosmo), a baby Magazine (Martha Stewart) and Fortune with an article on Super Dads for me.

Dr Finnegan returned around 7pm to check on Kim's progress. Contractions are still occuring and the baby looks good, so the Dr will not give another dose of prostin gel tonight. Our progress indicates the baby may not come until Tuesday, but he'll re-evaluate on Monday morning.

After the Dr leaves Kim, Amy and I watch Monsters Inc. After the movie I run home to pick up a few things and get some food. As Day 1 comes to a close Kelly is relieved by Missy who will be our nurse throughout the night. I think we were both very anxious for the baby to arrive and with the news it may be Tuesday before baby comes is disappointing. The hospital and nurses are great but I think we'd both like to be home with our new baby!

October 21, 2002

Day 2 starts early with Missy coming in to take vitals every couple of hours, with a pelvic exam around 5am to check Baby T's progress and prepare for Dr Finnegan's first visit. After the prep work for the Dr visit Kim heads for the shower to freshen up. I slept on the sofa bed in the room. It was nive to stay in the hospital, but the comfort could be improved.

written by Kim:

Dr Finnegan stopped by around 8am or so, just before breakfast arrived. I was very hungary and wanted to eat, but didn't get a chance. The cramping from last night's gel had pretty much worn off so he decided to start with gel again today, not pitocin. Dr Finnegan checks my progress and I am 3cm dilated and about 80% effaced. He applies the gel and it seems to instantly spin me into labor. Our nurse today is Stacie and she says that the gel may be enough. I may not need pitocin.

Stacie constantly monitors my progress and I feel the contractions come on strong. They are approximately 2 minutes apart and 45 seconds in length. Stacie checks my progress and vital signs. She can not believe it, I have not dilated that much, but I am 100% effaced. She is going to call Dr Finnegan, it may be time to break my bag of water.

Around 9:15am Dr Finnegan breaks my bag of water and the contractions start to get stronger. He thinks we may have a baby by 4:30pm today. Mean while, throughout the whole labor process Paul has been wonderful! He hasn't even had a chance to shower or anything. He just sits by my side, counts my breathing and holds my hand. After Dr Dinnegan broke my bag of water he had to put the internal fetal monitors on me to check the baby's heart rate and my contractions. For some reason my contractions were not showing up on the monitor. I find this very odd because I know I am having them. The pacement of these monitors restricts where I can go, but that's ok because it seems like lying on my right side makes me feel best any way. Every time I move I throw up! I feel sea-sick.

The contractions keep coming and they are getting stronger. Nurse Char comes in to relieve Stacie so she can go to lunch. Char suggests I try some different positions, maybe this will help. I try sitting in the glider chair, but the rocking really makes me nauseous. Then I try to stand up and lean forward on the bed while Paul rubs my back. While Paul's massage feels great the standing and swaying makes me sick to my stomach again. So I just opt to sit on the bed. The baby's heart rate is best if I just lay on my right side so this is what I do.

The pain is really starting to get intense now. Epidural is running through my mind, but I can do this, I can endure! I will wait until Dr Finnegan comes over on his lunch to check my progress.

Around 12:30pm Dr Finnegan stops in to check my progress. I am only 4cm dilated! 1 cm? How can that be? I don't htink I can do this too much longer [this is where a doula would have intervened]. Stacie said I may need to get pitocin to regulate my contractions. this will probably make them more intense, regular and closer together. UGH!! Call for the epidural. I need it now.

We hear Dr Schneden is the doctor on call and I am nercous about this, but all the nurses say he is the best. At 1pm he starts the process and it takes about 30 minutes to complete, well it would have taken only 20 minutes if he wasn't so concerned about deleting a message on his beeper. By this point I could have picked up his beeper and slammed it on the floor inro 1000 little pieces. But eventually it is placed and the medicine starts to work.

It is amazing what a difference the epidural makes. I can hardly believe it, and I think Paul is pretty amazed too! The break in the action allows him to take a shower. I guess he doesn't want to be in his pajamas when the baby is born.

Around 1:15pm Paul calls Amy to give her an update. Very shortly Amy calls back. She got our message when she was in her car because she was already on her way to the hospital. She was just too excited to stay ay work. It works out well because Paul hasn't had anything for lunch and he asks Amy to stop by Wendy's and pick him up his favorite #2 combo.

Amy arrives around 2pm and Paul goes to eat lunch (switching of the guard)! I tell Amy all about the day and we are chatting when Stacie comes in to check my progress. She can't believe it, I am dilated to 10cm and I can start pushing! It is 2:30pm now and Amy runs out to get Paul and let him know we are going to start pushing. Paul runs into the room he can hardly believe it. In a little over an hour I went from 4cm to 10cm. Stacie says maybe th eepidural helped me to relax.

I begin pushing and it is really nice because it is only Paul, Amy, Stacie and me. The cameras are ready for action and the pushing begins. Soon the warmer comes into the room with our nursery nurse Brenda and Kristi the tech is present as well. A few contractions come, so they tell me, but they don't want me to push because the baby is too close. I have been pushing lying on my right side Stacie is counting and holding my left leg. Amy is cheering me on, but I think Paul is so excited and overwhelmed he forgets about me. He doesn't count, I think he is speechless. Finally Dr Finnegan arrives and he says we need to push him out now or we may need to use the vacuum because the baby's heart rate is going down. Just as he says that I push as hard as I can and out comes the abby. For what seems like an eternity I think "What is it? Boy or Girl?" Finally Dr Finnegan says it is a BOY! I can't believe it, I was so sure it was a girl. Paul was glowing with pride!! It was the cutest thing I have ever seen. Connor was 4 pounds 10 ounces and 18 inches long.

After Connor was born they laid him on my belly and cleaned him off. We had a short time together, but then they took him to the warmer so the nurse could check him out. Of course at this point the only person paying attention to me was Dr Finnegan [again a place where a doula would have made a major difference]. Dr Finnegan said I better get use to it. I don't mind my boy is healthy and beautiful!!!

Connor was induced 5 weeks early due to low in-utero fetal movement. We had been sent to Denver for an amnio and his lungs looked developed and the Dr there said I could either have the baby now or wait a week on bed rest and then induce the labor. Upon Dr Finnegan's recommendation we decided to induce sooner than later (the day of my planned baby shower actually).

While typing these words out I felt tears of joy coming to my eyes thinking about the birth of my first son. While at the same time I feel tears of pain stinging my eyes for the naive choices we made, the lack of knowledge I feel I had going into the birth (we did take a childbirth class), and some mourning for the birth experience I did not get to have, but had been planning all along. I have often wondered why we didn't listen to our friend Chuck when he said "Get a Doula. It's the best investment you will make." While hindsight is 20/20 and I can't change anything about Connor's birth there is a feeling of loss and sadness that I did not accomplish the natural birth I had been wanting. I really think we made the choices we had to at the time and as Carri always says, I have to embrace Connor's story because that is HIS birth story and in the end we have a happy healthy 6 year old now who I adore and is truly one of the lights of my world!

Little did I know that Connor's birth was going to be the easy part. The next two weeks were to be the hardest weeks of my life!

To Be Continued.......

The Late Preterm Infant & Getting to Know Your Baby

Posted by Kim:

I am the Coordinator of a non-profit group called Exceptional Families and we provide parent to parent support to families who have children with special needs. Part of my responsibility as the Coordinator is to attend the Boulder County Health Department's monthly cross-disciplinary meeting for children birth to 3 years old. This month we had a therapist from the Tiny Tim Center present the following information to us. It is shocking and eye opening considering our current birth environment and the prevalence of preterm induction and cesarean birth.

I am making no judgments here because I am all the things that I would now preach against (unfortunately I have learned more about birth since my children were born). My first son was an induced preterm labor due to fetal distress. While there was nothing I could do about this induction the statistics below are still frightening to me and make me cringe that I never once doubted my doctor or sought a second opinion. This being said, I do believe we did right by Connor inducing his birth and providing him with a better chance of survival outside the womb (I will post Connor's birth story soon). Griffin however is a different story. His induction was the typical convenience birth at 40 weeks. It has taken me several years to process his birth and I will always regret the induction (birth story also to follow).

Please read over the following information and consider it carefully. Share it with friends, family and clients. While it is particularly focused on late preterm births (and sometimes this can not be avoided), I think the "Get To Know Your Baby" section can also be applied to full term children in some situations. Every baby is different, but if you can read their signals you can better respond to their needs.

Children need their 40 weeks!

The late preterm infant is:

• born 34 - 37 weeks
• 75% of all preterm births are in this category
• Many are from induced deliveries or C-sections
• Studies have shown an increase in morbidity rate, as well as long term outcomes showing developmental delays, special education for pre-k and behavior problems that persisted to 8 years of more.

Brain Development

• At 34 weeks the brain has fewer sulci
• During the last 4 weeks of gestation there is an increase in the development of axons, dendrites, synapses etc
• The is the most active phase of synaptogensis (40,000 new synapses per second)
• At 34 weeks the brain only weighs 65% of term brain weight
• Frontal lobes are last to develop
• Late preterm babies are more vulnerable for bilirubin induced brain injury and neurological injuries

Medical Issues for Late Preterm Infants

Respiratory Control

• 33-38 weeks there are changes in lung compliance, they are still developing how to
• breathe, they may have apnea and bradycardia
• Increase incidences of SIDS

Thermoregulation

• Less body weight, decreased ability to regulate body temperature

Infection

Jaundice

Motor Challenges

• Mild hypotonia, decreased stamina & endurance
• Difficult feedings secondary to tone issues
• May hear respiratory sounds due to decreased muscle activity in intercostals and upper airway
  

What we might see

State Organizational Challenges

• Decreased arousal and alertness (can affect attachment between baby and parents)
• Sensitivity to environment (light, noise, activity) therefore may have problems getting to deep and active sleep (brain development occurs when in active REM sleep)

Feeding Issues

• Less effective suck and swallow
• Breastfeeding may be difficult because they are sleepier, have difficulty stabilizing their temperatures and they are unable to coordinate suck/swallow/breathe

Interventions

• Education and support for parents
• Scheduling babies activities for when they are in arousal states
• Kangaroo mother care (skin to skin)
• Infant Massage
• Knowing awake/sleep states and stressor signs that baby is communicating to you
• Using environmental modifications keep lights, noise and activity down preserve active REM sleep

GETTING TO KNOW YOUR BABY

Organized Physiological Behaviors

• Skin is pink and stable throughout
• Breathing is regular and smooth
• Gastrointestinal is stable and there are regular elimination patterns

Disorganized Physiological Behaviors

• Cough, breathing intervals are variable (too fast or too slow)
• Gasp, Startle, Twitch, Sneeze, Tremor

Organized Motor Behaviors

• Tone is balanced
• Posture is flexed and relaxed
• Movements are smooth and close to the body

Disorganized Motor Behaviors

• Tone is hypertonic or hypotonic
• Posture: arms salute, sitting on air, toe or finger splay, fisting, high arm position
• Movements: squirm, jerky, gape face, tongue extension, arching

Organized State Behaviors

• Awake States are calm alert, alert and focused, and may be fussy and crying
• Sleep States are deep sleep, active sleep and drowsy sleep

Disorganized State Behaviors

• Hypoalert, hyperalert, gaze averting, uncontrollable fussing and crying, upward gaze, staring, grimace

Behaviors that help baby become organized/Helpful self regulation behaviors

• Hands to mouth/face
• Hand & Foot clasping
• Leg/foot bracing
• Sucking and suck search
• Tucking
• Grasping and holding
• Looking and attending

Ways to promote Baby's Development at Home

• Light reduction
• Noise reduction
• Positioning
• Comforting
• Look for signs of stressors indicating need for a rest
  

To see this complete presentation please visit
http://www.uchsc.edu/cfii/Documents/Getting%20to%20Know%20Your%20Baby.pdf