On December 1st, 2018, Sara's Birth Services became Summit Birth Utah. This post contains the blog archives from www.sarasbirthservices.com/blog.
Book Review: "The Healthy Pregnancy Book" by William and Martha Sears
This post is the second in a series of related posts: book reviews of the titles in my lending library. Stay tuned for more!
As you can tell from the sticky notes, this book is packed full of good information!
I appreciate the Searses' well-rounded and positive approach to pregnancy they take in this book. They begin with detailed information about how to have a healthy pregnancy through wise nutritional choices, movement, sleep, and self-care skills. This starts the book off on a great foot for helping women be the responsible agent in their pregnancy and birth, which I believe is critical! They list helpful nutrients for pregnant women and their developing babies, the foods that offer them, and even recipes to incorporate them in your diet. In the section on exercise, they emphasize the importance of moving healthily and the wide range of activities that pregnant women can do to stay in shape and help their bodies and their babies be as healthy as possible.
The next section of the book details the month-by-month changes that occur in the developing baby and the pregnant mother's body. They address concerns and discomforts that may arise by offering helpful tips and solutions. In the section on birth, they offer a detailed explanation of the "hormonal symphony of birth" and beautifully describe how mom and baby's bodies work together to bring baby into the world. They address common interventions and when they can be helpful and when they'd be better avoided.
In the final section, uncommon pregnancy complications are addressed. The section begins with the directive to read only those sections that pertain to a complication you have, as there's no need to worry about things that could but likely won't--wise advice for an expectant parent! I especially appreciate their re-framing of the term "high-risk pregnancy." They explain that this term is necessary for doctors to be aware of women whose pregnancies and births should be monitored more closely, but invite women in this category to instead consider their pregnancy as "high responsibility":
"Instead of resigning yourself to the high-risk label, becoming a passive patient, and leaving all birth decisions up to your doctors, become a high-responsibility mother. Take an even more active role in your birth partnership; cooperation between you and your care providers is essential. You need to be more informed and more involved in decision-making than the average mother, and you need to take better care of yourself. The first question you should ask your doctor after you are classified as high-risk is what specific things you can do to lower that risk."
I especially appreciated this advice because both of my pregnancies have been "high-responsibility," the first because I was carrying twins, and the second because I have a blood-clotting disorder and was planning on a VBAC. In my first pregnancy, I resigned myself to the "high-risk" label and stopped asking many questions and taking personal responsibility for my pregnancy, and I ended up with some complications that I believe I could have avoided if I'd been a more active participant in my health care. In my second pregnancy, I made sure I was well-informed and the responsible agent for caring for my extra needs, and I had a very positive experience as an active birth-giver!
In all, I definitely recommend this book as a comprehensive guide to having a healthy and positive pregnancy. It's the best book of its kind in that category!
On December 1st, Sara's Birth Services is getting a makeover and a new name! I'm really excited to unveil my new brand, but I'm still working on perfecting all the pieces. :)
So... in the meantime, while my new website and business cards and such are baking, I need to get rid of some Sara's Birth Services swag. And to sweeten the deal, I'm throwing in a FREE BIRTH PLANNING VISIT.
This mini package offers a two-hour birth plan visit to help prepare you for labor and birth and access to my lending library. During the visit, we'll discuss your birth plan and preferences, and we'll practice several comfort measures for use during labor, such as:
To enter the giveaway, just click the button below. It'll pull up an email to me (firstname.lastname@example.org). Just write "Giveaway" in the subject line and hit send!
Book Review: "Gentle Birth, Gentle Mothering" by Sarah Buckley
This post is the first in a series of related posts: book reviews of the titles in my lending library. Stay tuned for more!
Ah, this book. It’s such a great read. Sarah Buckley, an Australian family physician, expertly walks the line between instinctive/super-crunchy/holistic and scholarly/super-well-researched/academic. It’s just brimming with quote-worthy snippets, so I’ve sprinkled them throughout this post for your reading pleasure. Enjoy!
“Birth is women’s business; it is the business of our bodies. And our bodies are indeed wondrous, from our monthly cycles to the awesome power inherent in the act of giving birth. Yet in our culture I do not see respect for these extraordinary functions: instead we diet, exercise, abuse, conceal, and generally punish our bodies for not approximating an unobtainable ideal. This lack of trust in and care for our bodies can rob us of confidence in giving birth. Conversely, an experience of the phenomenal capacity of our birthing body can give us an enduring sense of our own power as women. Birth is the beginning of life; the beginning of mothering, and of fathering. We all deserve a good beginning.”
The book begins with a few chapters on instinctive birth and trusting your inner self, and how healing birth can heal the earth.
“We cannot birth our babies through sheer force of will. We need to learn the more subtle—yet equally powerful—path of surrender.”
“In surrendering to birth, we also learn about our role on the Earth: we are neither the rulers nor the architects of creation. Life comes through us, simply and gracefully, when we allow it.”
Buckley then gives a step-by-step guide to sound personal medical decision-making. She calls this the BRAN method, and encourages her readers to consider the Benefits, Risks, Alternatives, and possibility of doing Nothing when they are faced with a medical decision. She then applies this method to common pregnancy and birth procedures (Gestational Diabetes, Group B Strep, Going “Overdue”), outlining the research as she discusses each option.
“If the baby is truly large, it is likely that the mother’s body will have maximum pelvic softness and flexibility (due to peak levels of hormones such as progesterone) on the day she spontaneously goes into labor, giving her the best chance to accommodate and birth her large baby.”
In subsequent chapters, Buckley thoroughly reviews the research on common birth interventions, such as ultrasounds, epidurals, and cesareans. Each chapter has literally hundreds of footnotes—it’s clear that Dr. Buckley has done her homework!
“On average the first stage of labor is twenty-six minutes longer in women who use an epidural, and the second (pushing) stage is fifteen minutes longer.”
“The combination of epidurals and Pitocin, both of which can cause fetal heart rate (FHR) abnormalities and fetal distress (reflecting a critical lack of blood and oxygen), markedly increases the risks of operative delivery (forceps, vacuum, or cesarean delivery).”
She also peruses the evidence on gentler birth and mothering choices. With great detail, she describes the beautiful hormonal cocktail that accompanies and enables undisturbed birth.
“When birth is undisturbed, our birthing hormones can take us into ecstasy—outside (ec) our usual state (stasis)—so that we enter motherhood awakened and transformed.”
“Birth is a peak bodily performance, for which our bodies are superbly designed.”
She shows the safety and beauty of home birth for low-risk mothers; she tells the story of how love and attachment can be naturally and gently formed in the baby’s early days.
“One study showed that newborns who experienced “kangaroo care”—that is, uninterrupted skin-to-skin contact with the mother—in the first hour after birth were less stressed and more organized in their behavior, cried less, and slept longer, compared with babies who were routinely separated.”
She examines the vast research supporting breastfeeding and the many benefits it offers mom and baby, and she goes over the benefits of co-sleeping and how to safely practice it.
I’d highly recommend getting your hands on a copy of Sarah Buckley’s Gentle Birth, Gentle Mothering. It will open your mind to new ways of thinking and fill your mind with evidence-based information. As I closed the book, I felt energized, empowered, and grateful for Buckley’s great contribution.
“A recent review of satisfaction after childbirth found that personal expectations, support from caregivers, the caregiver-patient relationship, and involvement in decision-making are the most important factors in determining satisfaction with the experience of childbirth.”
Have you read Gentle Birth, Gentle Mothering? I'd love to hear what you thought of it!
Labor Lessons from Long-Distance Running
“Like a marathon runner, a woman’s task in birth is not so much to avoid the pain—which usually makes it worse—but to realize that birth is a peak bodily performance, for which our bodies are superbly designed.”
-Sarah Buckley, Gentle Birth, Gentle Mothering
About two weeks ago, I ran the Run Elevated half marathon in Little Cottonwood Canyon. Near the end of my training, I came across this quote from Sarah Buckley, and it got me thinking: what lessons can be learned from comparing labor and long-distance running?
One at a time
Mentally, I didn’t run 13.1 miles. I ran one mile, 13 times. As I would pass each mile marker, I would think ahead to the next mile, and not focus too much on those beyond. Similarly, in labor, it’s a good practice to focus on one contraction at a time. A helpful affirmation can be, “I can do anything for 60 seconds.” Thinking of all of the contractions that have already happened and the unknown number still coming can be daunting. Focusing on one at a time feels much more manageable.
Preparation Makes all the Difference
I couldn’t have run the half marathon without the significant training I put in. The (increasingly-long) three-four short runs and one long run I put in each week made it possible for me to run the 13 miles on race day. My body was prepared through incrementally-more-difficult runs each week. Similarly, you don’t grow a baby in a day. The body stretches and prepares over nine months. The uterus has practice Braxton-Hicks contractions in later pregnancy. Early labor often lasts for quite a while. All of this is your body preparing to birth your baby.
Preparing yourself mentally with quality birth education and fining the right support system also makes a huge difference. I personally noticed a huge difference between my two birth experiences, and much preferred the one I had better prepared for!
The Body is Amazing!
It was so exhilarating to realize that my body is capable of running 13.1 miles! This was my second half marathon, and I even shaved off a couple of minutes from my last time (which was eight years ago, before two pregnancies, three babies, and with chronice venous insufficiency to deal with)! The human body is amazing. More amazing that that, though, is the woman’s ability to grow and support and birth a baby. Labor is awe-inspiring.
Chiropractors Help with Back Pain!
Seriously people. I mean, maybe this is obvious, but chiropractic care was so helpful in nearly eliminating lower back pain in both late pregnancy and at the end of my training. I prefer a chiropractor who incorporates deep tissue massage as well. I feel like some sort of magic has been worked when I get up from the table and can walk freely without pain!
You Can Have Pain without Suffering
During my training runs, I passed another runner wearing a shirt that said “Pain You Enjoy” from a previous race shed run. Immediately, I thought, “can’t that apply to labor, too?” While many women may say that the word enjoy is a stretch, I do think it’s important to differentiate between pain and suffering. (Rebecca Dekker does that beautifully in this podcast, which, coincidentally, I listened to on one of my training runs!) A few women experience painless births, but for most women, childbirth is some of the most intense pain they’ll ever experience. Rather than try run away from it (which tends to just make it worse, as Sarah Buckley points out in the opening quote), laboring women are most successful when they learn to work with their pain. They realize that the pain has a purpose and is an indication that the body is doing what it needs to be doing. Labor is a “peak bodily performance”!
It’s Worth It
Crossing the finish line was so fulfilling, and being able to say “I did it!” was so empowering. This is true one million-fold in pregnancy and birth. The nine months of pregnancy and hours of labor and birth bear a priceless fruit: a new baby, complete with snuggles and perfect baby smell and a beautiful cocktail of hormones that help you fall in love with each other.
Take Time for Recovery
For two or three days after my race, I was super sore. Going down stairs was especially difficult, since the majority of my half marathon was downhill and my quads burned! My awesome husband was understanding about doing a little more of the up-and-down childcare and housework while I mended. After giving birth, recovery time is critical for the new mother. It takes six to eight weeks for the uterus to return to its pre-pregnancy size, and the perineum takes time to mend. Baby’s frequent need for feeding during the early weeks encourages mom to be sitting or lying down much of the time, a welcome position for a body that has just grown, carried, and birthed another human being!
Happy Labor Day, everyone!
A Peek into My Lending Library
One perk I offer in my birth doula package is access to my lending library about pregnancy, birth, and newborns. My library is still growing and I plan to add to it forever (because you can never have too many book!), but here’s a look at my top three on my shelf right now:
1. Ina May’s Guide to Childbirth by Ina Many Gaskin
Ina May Gaskin is a midwife genius with piles and piles of wisdom born of experience. This book is half birth stories (gotta love ‘em!) and half explanations of physiological principles related to birth. Here’s a favorite: Sphincter Law. Sphincters are ring-shaped muscles that occur in a few places in your body, notably your throat and cervix. And it turns out that relaxing one set of sphincter muscles helps others in the body to relax and open! So blowing out with “horse lips” and making low, loose vocalizations helps your cervix to relax and dilate. This and other gems are found in Ina May’s Guide to Childbirth!
2. The Gift of Giving Life: Rediscovering the Divine Nature of Pregnancy and Childbirth by Felice Austin, Lani Axman, Robyn Allgood, Heather Farrell, and Sheridan Ripley
This book is a beautiful collection of essays and birth stories written by LDS mother and birthworkers. In it, the authors faithfully discuss the divine role that women play as co-creators with God. It addresses topics from infertility to the role of agency in birth to infant care. It’s an empowering, thought-provoking, and life-changing read!
3. Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth by Marshall H. Klaus, John Kennell, and Phyllis H. Klaus
Did you read that subtitle? A shorter, easier, and healthier birth—how awesome is that? This one’s an oldie, but a goodie! Referencing evidence collected in studies around the globe, the authors explain in depth the way that having a doula can positively affect your birth experience.
Here are the other titles on my shelf:
Why Hire a Doula?
Birth is an exciting, joyous time! It’s also unpredictable. Having a doula by your side ensures that there will be at least one person at your birth who knows you and your preferences and has an in-depth understanding of labor and birth. When nurses and midwives/OBs come in and out, your doula will be there from the moment you need her until your baby is born.
Here are some other awesome perks to hiring a doula, as shown in numerous studies (see References).
You may be thinking, “How is that even possible? How can having a doula at a birth make that much of a difference in so many ways?” The studies I cited don’t attempt to answer the questions of how or why, but here are some possible explanations.
Women labor differently around sympathetic women. Ina May Gaskin, one of the nation’s foremost midwives, is huge on this point. Women are able to progress more quickly, feel more comfortable, and better do the work of labor when they have another familiar woman in the room.
Doulas know stuff. Stuff that can make a real difference! We know a variety of labor positions and can recommend helpful ones throughout your labor: early labor, active labor, stalled labor, pushing, positions for when baby is having trouble descending, positions for when labor is coming waaay hard and fast, positions to help mom continue to progress when largely immobilized due to an epidural, and more!
Doulas give constant positive support. Throughout labor, doulas give moms positive feedback, leading to further confidence and renewed energy and focus.
All of this means that mothers who labor with a doula have a higher likelihood of shorter labor, fewer interventions, and a more positive birth and postpartum experience. You still won’t be able to predict the twists and turns that your labor may take, but you’ll have someone in your corner every moment!
Have you had a doula at a birth? What was your favorite part of the experience? I’d love to hear about it in the comments!
(Apologies for my stylistic inconsistencies.)
Katy Backes Kozhimannil, Rachel R. Hardeman, Laura B. Attanasio, Cori Blauer-Peterson, Michelle O’Brien, “Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries”, American Journal of Public Health 103, no. 4 (April 1, 2013): pp. e113-e121.
Will Chapple, MPH; Amy Gilliland, PhD, BDT(DONA); Dongmei Li, PhD; Emily Shier, MSEd, CD(DONA); Emily Wright, RN, BSN, CD(DONA) “An Economic Model of the Benefits of Professional Doula Labor Support in Wisconsin Births”, WMJ : official publication of the State Medical Society of Wisconsin. 112. 58-64.
MH Klaus, JH Kennell “The doula: an essential ingredient of childbirth rediscovered”, Acta Paediatrica. 86:10. (October 1997): 1034-1036
MH Klaus JH Kennel, PH Klaus Mothering the Mother Addison-Wesley Publishing Company Reading, Massachusetts: 1993
Campbell, Della A., et al. “A Randomized Control Trial of Continuous Support in Labor by a Lay Doula.” Journal of Obstestric, Gynecologic, & Neonatal Nursing, vol. 35, no. 4, 2006, pp. 456-464.
Katy B. Kozhimannil, PhD, MPA,1 Larua B. Attanasio,1 Judy Jou, MPH,1 Lauren K. Joarnt,1 Pamela J. Johnson, PhD,2,3 and Dwenda K. Gjerdingen, MD4. “Potential benefits of increased access to doula support during childbirth”, The American Journal of Managed Care. 2014 Aug 1; 20(8): e340-e352.
“Benefits of a Doula Present at the Birth of a child”, Pediatrics. Nov 2004, 114 (Supplement 6) 1488-1491.
My Journey to Doula-Hood
Doula? What's that?
If you’re asking, you're not the only one. A few years ago, I was asking that, too. And now I am a doula! Here's my story.
I love pregnancy. No, not the nausea or the joint pain or the fatigue, but the baby kicks, the hiccups, and the wonder of having another person (or two) inside my body! Breastfeeding, too, amazes me: my body, without my conscious thought, can produce all the necessary nutrients and even protective antibodies for my babies! With all three of my children (and two pregnancies), I've loved bonding with my babies through pregnancy and breastfeeding. My two birth experiences, however, were drastically different.
My first birth experience felt like a medical emergency. After five weeks of bed rest to hold back preterm labor, I returned to the hospital in active labor. I got an epidural because I'd read that's what you "should" do with twin pregnancies. Then I laid in bed and waited for this labor thing to happen.
After about four hours, I was told, "you've stopped progressing, so we're going to start Pitocin." I thought, "I've been lying in bed for five weeks trying NOT to have these babies, and now you're telling me my labor's moving too slowly?" I wanted desperately to do whatever would keep my babies safe and healthy, but I wasn't educated enough to know which procedures were recommended for safety, and which were offered for convenience or hospital efficiency. Not confident enough to ask, and being just generally compliant, I didn’t say anything.
The Pitocin didn't effectively accelerate my contraction pattern, so a few hours later, the doctor told me he was going to break my water. Again, I consented, not really knowing I had another choice.
Forty short minutes later, I was all but fully dilated and ready to push, when baby B's heart rate dropped. Giving me oxygen didn't help it rise, so an emergency cesarean was called. The second dose of my epidural hadn't quite kicked in, though, so I was given IV anesthesia that made me "a little loopy."
In just minutes, I was the proud mother of two tiny, beautiful, perfect daughters. But I didn't really remember their birth. I remembered swirling blue and white ceiling tiles and taking several minutes to recall my own name, my husband's name, and what was going on. I remembered trying to pucker my heavy lips to kiss my first daughter on the cheek, and the nurse writing a birth time on her arm.
When I became pregnant again two and a half years later, I knew I wanted this birth to be different. I'd always wanted an unmedicated birth, so I started planning for my unmedicated VBAC. I looked around for a birth class that fit me, and found Birth Boot Camp. They didn't have instructors in our area (at that time, Boston), but offered a ten-week online class that worked perfectly for our situation. Over the ten-week class, I learned about my body, how it was made to carry and birth babies, the benefits and risks of various interventions and procedures, and how to relax and work with my body.
“Birth is something that women do—not something that happens to them. The birth-giving woman is the central agent in the ancient drama of life bringing forth new life.”
-Ina May Gaskin
After my little boy was born, friends asked me how the birth was. "It was awesome!" I would say, and their faces would say, "no, Sara, I mean the part where you gave birth. How was that?"
Awesome. Amazing. Incredible. Knowing what my body was doing and that I was working to give life to my beautiful son, I labored in various positions, sounded out each contraction, listened to my body, and was flooded with natural oxytocin as he was brought to my chest. I couldn't get over how perfect this little person was, how amazing he smelled, and how hard we'd worked to meet each other. And I was just overcome with awe for the birthing mother's body.
I should mention, lest I'm misunderstood, that his birth wasn't amazing because it was easy or ideal or because I didn't feel any pain. I passed out and threw up in labor. I had a third-degree tear that took an hour of stitching to repair. But that didn't change my perception of the labor and birth process. What was different this time? To paraphrase Ina May Gaskin, I had been the agent in the process this time. Birth wasn't something that happened to me; I was a birth-giver.
I should also clarify that I don't believe that unmedicated vaginal birth is the only way to be a birth-giver, nor does having an unmedicated vaginal birth necessarily make a woman a birth-giver. A woman with a cesarean can be a birth-giver. A woman with an epidural can be a birth-giver. A woman with unforeseen complications, even medical emergencies, can be a birth-giver. Birth-givers have an active role in the work they're doing. They ask questions to gain understanding and make decisions. They are in awe of the beauty of birth.
A little while after my son's birth, Birth Boot Camp sent me an email advertising their doula training program. I archived it without much thought. A little while after that, I had a weird dream that I was with a friend as she was having a baby. When I told her about it, she said, "Were you my doula? You would be a great doula!"
Doula? Doula! I would be a great doula! I fished out that old email and started making plans. I chose a workshop, registered, started reading and watching and learning, and continued to feed my love for birth.
I believe that birth is beautiful. I want to help other women feel that way, too. So I became a doula.