Monday, December 29, 2008
Sunday, December 28, 2008
Sunday, December 14, 2008
Friday, December 12, 2008
Amelie Renata Pan arrived on Thanksgiving night at 8:55pm!
Height 21 inches, Weight 8.5 lbs.
She was born at our home with the help of our excellent midwife, Maria, and our terriffic doula, Alexis. It was a fast labor with no major complications and the team did fabulously. We're so grateful for a healthy mom and baby, an amazing birth experience, and for Stacy's parents' incredible help and support.
Roland, Stacy and Amelie
Thursday, December 11, 2008
Tuesday, December 9, 2008
Friday, December 5, 2008
On Monday night Jennifer and I attended our birth class held at our midwife's practice. We had a great instructor, Jane Austin, who also teaches pre and postnatal yoga classes. Jennifer was taking the "pre" courses and now will move on to the "post" classes. Luckily, Monday night's class was devoted to labor. Little did we know that 13 hours after leaving the class we would have a little one on the outside. That night Jennifer was having some pain in her lower abdomen and felt some contractions but just assumed they were Braxton-Hicks contractions (practice contractions for those unfamiliar). In retrospect, she may have just been hoping that was the case since we would have liked her to stay in a little longer (at the time - now we are thrilled she's here). We went to bed and Jennifer woke up at around 3am and was having contractions. I woke up around 5am and we talked about it and I gave her a massage to try and help. I got up and left for work and thought everything was normal. Meanwhile the contractions continued and Jennifer grew concerned. Next thing I knew I get a phone call at 9:30am. Jennifer was upset and concerned and needed to go to the hospital. I left immediately. Ella wasn't even born yet and she's already getting me out of meetings. Good girl! I was very worried about Jennifer and baby at this point and literally ran out of the building and did my best impression of how I used to drive at 17. I'm a little slower but I am still able to maneuver quite well in traffic. I made it home safely and picked up Jennifer. She asked me to grab her a jacket on the way out and of course I grabbed the wrong one. :-) She was in some pain and concentrating on her breathing. I got a little impatient with the city traffic when Jennifer brought me back to reality and reminded that my role in labor is to support her and not ADD stress but REDUCE it. She said that my "words of advice" to the other vehicles on the road wasn't helping her and she had to waste precious breath on that reminder. Whoopsy. And by they way, she added, watch the bumps! We went to St. Luke's Hospital because it was the designated back up when we arranged the home birth. We got into the building and waited about 47 days for the elevator. We went to the third floor and were taken into labor and delivery room 3. They put Jennifer on the bed and it was approximately 10:30am. Things were a little slow from my perspective and the gravity of the situation wasn't readily apparent yet. Not everyone knew yet that this was early and an unexpected labor. That changed quickly and they brought in the monitor to check Ella's heart-rate. Now, we had been going to a midwife and Jennifer had not been hooked up to any equipment to this point except for a "quick" ultrasound at 16 weeks. When they first put the monitor on there was not a heartbeat but that was because they had to find the right spot. Not knowing this, I was a bit freaked. Luckily they found the heartbeat but it was fluctuating a lot due to the contractions. At 32 weeks the little ones aren't as well suited to deal with the stress of labor. They gave Jennifer some magnesium sulfate to try and stop the contractions. Let me just say that Jennifer and I made decisions about how we wanted her pregnancy to proceed as well as how we will proceed with Ella Marie's healthcare. We make no judgments on decisions taken by anyone else, just do what we think is best. I say that because this is a sensitive topic. One reason we wanted a home birth is because we wanted to avoid medical interventions if possible and once in a hospital setting, in a tense time you have a knowledge gap, even when Mama is a health professional. It's the classic if I knew 2 days ago what I know now I think we would have avoided the magnesium sulfate. It hasn't proven to be effective at stopping labor and Ella proved that. What's done is done but it's overwhelming when you have a room full of people telling you what should be done. Which led us to a moment I'll always remember. They had already tried the magnesium sulfate and were giving antibiotics and some steroids to help Ella's lungs when the doctor mentioned to Jennifer that she would like to give her something else, perhaps for the pain. Jennifer very clearly stated that she didn't "want any more crap put into her body," to which the doctor responded, "it's not crap." Good stuff. No more crap added. Jennifer went from 3-cm dilated at approximately 11am to 10cm dilated at 12pm. The most difficult part from the time we arrived until 12 was that the labor was being treated as a problem to be stopped, not a birth to embrace. That is not stated to point fingers, just describe what was going through my mind. It was between 11:30 and 12:00 where it just became "we're going to be parents today." Game on. After that I wasn't worried that something was wrong with Jennifer and baby although it's very difficult to watch someone you love in pain. Don't like it one bit. In the meantime we had put in a call to our midwife, Maria Iorillo, and St. Luke's had a midwife, Emily, on duty as well as a pediatrician named Karen. These 3 women were amazing and kept the mood positive, explained things and were who provided a profound sense of calm. Once it was determined Jennifer was 10cm dilated they decided to move her to the OR because Ella was a premie but they also broke out the C-section consent form. That's where it was great having Maria who we had spent time with discussing all these things and we all knew that there was no need for that. Ella made the decision for everyone. They didn't have time to move Mama and Ella to OR. At this point there was a tremendous amount of activity in the room with machines, doctors, nurses, midwives, Mama and Papa. Someone directed me to the right side of the bed. I went over but realized my view was terrible and I was restricted from being close to Jennifer. Maria said to come back over to see the baby be delivered. As I was making my way around the bed through the maze of people and equipment, Jennifer was saying "I feel a lot of pressure, I feel a lot of pressure." Boy did she. As I got to the left corner of the bed, Jennifer's waters burst. It was projectile and doused Maria and Emily. I thought, "Whoa, I'm not sure if that's something you see everyday." 2 minutes later Ella's little head was crowning and she entered the world. She was brought right over to a little bassinet to be checked out by Karen and me. Karen explained what she was doing and I chatted with Ella and we looked into each other's eyes. I then cut the umbilical cord. After a couple of minutes I went to check on Mama and said, "ok, let's deliver that placenta!" Papa too late once again. Already done said Mama. Karen brought Ella over to Mama for a kiss before taking her upstairs to wait for the transfer over to UCSF (Univ. California San Francisco). After about 20 minutes Jennifer was asking when she could go up and see Ella. She was told she needed to rest and then they would bring her up in a wheel chair. She hurried that along and pushed the chair aside. After some quality time with Ella the transfer team showed up and brought Ella to UCSF. Jennifer was transferred at 5pm as I went home to collect clothes and vote. I heard it was a big day for some other reasons. We've now been spending all our time at UCSF with little Ella Marie. She's on the 15th floor and has an incredible view of San Francisco, the Golden Gate bridge and beyond. I know other parents already know and it's a cliche, but all we want to do is sit and hold Ella. We're transfixed and love this little person in a way I can't articulate. She's too small to hug her the way I'd like to but some gentle nose petting is quite fun. To put the feeling into an easily watched, pop culture reference I point you to this link (http://www.youtube.com/watch?v=1nqP3p5IBx8) and advise you to watch from minute marker 7:12 to 8:18. For those that already know the reference, it is when Ed is handed Nathan Jr. (so they think) by one H-I McDunnough. Her spontaneous teary announcement of her affection for this child is how it feels.
Lastly, we've also been thinking that she took us too literally when we read to her in utero. The book we would read to her is "Oh, Baby, the Places You'll Go!" adapted from the works of Dr. Suess. The last page of reads:
You'll find that this world's
a great place to begin,
but it could use some help–
which is where you come in.
So now, as my voice
burble-urps in your ear–
with a bump-thumpy sound
that is not very clear–
the words I am saying
you hear in your heart,
and know that I wish you
the very best start.
It's a scrumptulous world
and it's ready to greet you.
And as for myself...
I can't wait to meet you!
It seems she was ready to meet us too and decided to come out. She's her mother's little girl.
But, she is also her own strong little self. We later found out that the reason for the pre term labor was the bodies anticipation of a placental abruption. Once the placenta was delivered, a tear was noticed, indicating its beginning of coming away from the uterine wall. Placental abruption is a complication wherein the placental lining has separated from the uterus. It is the most common cause of late pregnancy bleeding. In humans, it refers to the abnormal separation after 20 weeks of gestation and prior to birth. It occurs in 1% of pregnancies world wide with a fetal mortality rate of 20-40% depending on the degree of separation. Placental abruption is also a significant contributor to maternal mortality.
It is our belief that the body is so efficient, as is little Ella, that the body and her knew that they needed to exit and enter the world before the abruption happened. And thankfully all that 'crappy' magnesium sulfate did not work to stop the labor or we would have been in real danger.
Ella was discharged from the NICU on December 3rd, weighing in at 4 lbs. 14 oz.
Wednesday, December 3, 2008
Childbirth – The Natural Way is the Best Way
There’s nothing in the world that’s more natural than childbirth, so it’s a more than a little ironic that we’re talking of learning how to give birth naturally. The advent of medicine and technology has made us so dependent on drugs to deal with pain of any kind that we’ve taken to using it for childbirth too. Research has proven that births without painkilling drugs and epidurals of any kind are the best kind, because the baby is born more alert and the mother is also more refreshed and in tune with her child. If you’re pregnant and want to deliver your baby naturally, here’s what you can do to make your task easier:
• Choose a good place: You need to decide if you’re going to have your baby at the hospital or at home. If it’s the latter, you need to be prepared to deal with any kind of emergency or at least be able to get to the nearest hospital in time to prevent any untoward complications relating to the birth.
• Childbirth classes help: You’ll learn how to cope with the pain and pick up relaxation and breathing techniques that help minimize your discomfort.
• Gather a support group: If you’re planning to have the baby at home, you’ll want supportive people around you, one of whom must be a qualified midwife who can guide you through the birth, and in case of any complications, suggest that you move to a hospital to prevent any untoward occurrences.
• Get familiar with birthing positions: Natural childbirth is easy when you’re in the right position, so learn all you can about the right positions that both ease your pain and help the baby move along your birth canal.
• Learn about water births and hydrotherapy: The women who’ve tried it swear by it – giving birth in water is supposed to be the easiest and most natural way to deliver your child. The lapping warm water soothes your body and eases the passage of your baby through your birth canal. Since the baby is surrounded by fluid in your uterus, it feels more comfortable when it comes out in water as opposed to air. If you’re planning to give birth in water, get someone who knows the procedure to assist you during the delivery.
• Learn how to relax: There are various techniques that help you relax once your water has broken and your contractions start to set in. Choose the method that works best for you and learn to relax before the birth. If you’re tense or anxious, it’s bad for the natural birth process. Use birth balls, music, different positions, walking, massage – anything that works for you.
• Read up on the subject: I know they say that a little knowledge is a dangerous thing, but it’s best to be as prepared and informed as possible when you’re getting ready to deliver your baby naturally. Reading about natural childbirth and talking to people who’ve done it will help you learn more and be better prepared when the big day comes.
This post was contributed by Kelly Kilpatrick, who writes for http://www.collegetrainingschoolsonline.com/. She invites your feedback at firstname.lastname@example.org.
Sunday, November 23, 2008
The pediatrician described my labor and delivery as death by a thousand cuts. I’m not sure I would describe it that way, but it was intense. My water broke on Friday morning at 7:30. Contractions started by 8. My friend, Theanna, and Maria, the midwife, came over to the house. The morning and afternoon went as expected. Lots of rocking and swaying, humming, breathing, and counting. Cassie applied counter pressure to every contraction which also helped. I hung out in the shower, draped myself over an exercise ball, dropped into it instead of resisting, walked around outside in the sunshine, listened to the soothing music Theanna brought over, and did everything else we had learned to do to manage labor. I had an IV drip of antibiotics every 4 hours (to combat GBS which I tested positive for. GBS is a virus(?) that lives in the vagina of some women and can cause sepsis if it gets on the baby on the way out the birth canal). Cassie chased me around with water and OJ which I threw up on two occasions which was awful but usual apparently. Every few hours the contractions shifted to something more intense and we found a new rhythm, new pain management techniques, and kept moving through it.
This all went fine until late in the evening when we hit some new pain intensity that I could not believe. I had no idea it would hurt that much. None of the previous tricks were working and I was so tired. I had never lain down all day because it hurt too much. The midwife got me lying on the bed somehow so I could rest between contractions. That roller coaster was an amazing ride. Up with the excruciating pain, Maria talking me through the panic and sense of being trapped. Then down, still stiff and shaking, while Maria coaxed me to breathe, relax my shoulders, and rest. I would actually fall asleep during those 1 to 3 minute breaks and it was the most restful relief of my life.
We had one last secret weapon -- the warm birthing tub in the middle of the living which was set up with much hullabaloo in the morning. But I suppose we miscalculated when to use it. I threw up one last time during one of my rests on the bed which did it. My hold on control was so tenuous at that point that the trauma of coughing and spitting out vomit on the pillows sent me over the edge. I was done. I wanted it over. I was 5 centimeters.
I hung in there 20 more minutes for one last IV while bags were packed and we got ready to go to the hospital. I knew that complete relief was only moments away. I sort of remember having a contraction on the walkway on the way to the car, in the car, and again in the hallway of the hospital as I staggered towards to elevator. I'm sure I looked and sounded like someone dying a painful death. Finally the labor and delivery room, vital signs, blood drawn, fetal monitor attached, and news that they wouldn't even call the anesthesiologist until the blood work was back. I think we waited nearly two hours.
Maria said that she wanted me to do my best but that it wasn't supposed to be torture. It was torture. I continued to feel trapped and panicked every time. I remember staring at one spot on the ceiling to try to stay focused. My mind kept screaming to Cassie to "get me out of here!" Maria (I'm sure) did her best to guide me through. I refused some narcotic that was offered, knowing that the anesthesiologist would be there any minute. She finally arrived and I truly felt like she was the angel of mercy. Within a short period of time the needle was in. Someone looked at the monitor and said, "You're having a contraction." "I am?” I said. Cassie, Theanna and Maria looked at me in disbelief.
Then we slept. I am in tears of gratitude now thinking of the dedication of my birth team. Theanna slept in a chair, and Cassie and Maria slept on the cold, hard hospital floor. I could not believe it. Three or four hours later it was morning. I was 9 and more centimeters. Hooray! They said we would have a baby by noon.
There was only a little lip of cervix left which everyone thought wouldn't impede progress. I was absolutely done with pain and didn't want the epidural turned down so I could feel the contractions and know when to push. Maria and the hospital midwife coached me, and the pushing felt incredibly weird since I couldn't feel anything. After a few tries, the midwife checked and said I was pushing right but the baby wasn't coming down. Also, that little remaining bit of cervix wasn't moving. One problem with epidurals is that they can slow down contractions. So I agreed to a little bit of pitocin to get things moving again.
What happened after that gets blurry. There was much fiddling with epidural and pitocin levels. I could feel contractions again. I was exhausted from pain by then and shied away from every contraction. It hurt and I couldn't focus. I finally accepted the narcotic which didn't take the pain away but kept me fairly relaxed during contractions, and totally relaxed in between, without me having to do anything. I cried really hard. I couldn't see my way through. Everyone was helping me relax and get through it moment by moment. My dad appeared and held my hand.
Suddenly we changed gears. They wanted me to push. The nurse said something about if I wanted to avoid a c-section I had to work harder than I ever had in my life. I would not. I could not. I couldn't even get mad. I still felt trapped and powerless. Then I realized that, in fact, I was absolutely powerless over what was happening and what was to come. Theanna said a prayer with me, and then I let go of everything knowing I would be taken care of. I focused on a spot on the floor, blocked everything else out, and, following the cues from the contractions and the voices around me, put every ounce of myself into pushing.
This went on for some time. I could have gone on like that forever. We tried two positions. From time to time Maria or the hospital midwife checked. There was a swelling on the head that was moving down, but the bones of her skull were not passing under the pubic bone. They just bumped up against each other over and over. The hospital midwife said my pushing was stronger than any she had seen in a long time.
About two hours into it, the hospital midwife said it wasn't going to work and recommended a c-section. Maria agreed. I let down my guard and cried. That was it. It was over.
Or was it? Maria said there was one more position we could try. I said I could not do it. I couldn't regroup. The hospital midwife didn't come back. Maybe the hospital had given up. It was just me, Cassie, Theanna and Maria again. I regrouped enough to agree to try three more pushes in the new position just to say I had tried everything. We did more than three, and then Maria checked. She said she thought maybe a little something was happening, but she couldn't really tell. She said that she had a little bit of hope with this position, but that it could be two or three more hours of pushing, maybe two or three hours before we even knew anything. I freaked out. I couldn't go on this roller coaster ride anymore. What to do? "Little Bit of Hope" versus "Two or Three More Hours." I said no. I would not do it. At once, I was wheeled away for a cesarean.
That is the moment. The one I replay in my head over and over. "Little Bit of Hope" versus "Two or Three More Hours." Did I make the right call? I said I would do everything I could. I could have pushed for two or three more hours, couldn't I? Maybe, but I could not accept the idea that we might not know if it would work. My spirit and mind were totally exhausted and overwhelmed by then. Maybe I did the right thing. But I am sad. I cannot believe how terribly sad it makes me. I am starting to move through the feelings of utter failure, but the grief over being cut open is still strong, as is the loss of a vaginal birth, of finishing the experience, of being complete. Not to mention knowing that the possibility of ever having a home birth or even a vaginal delivery in the future is very compromised. I am surprised at the level of grief that I feel, but it is definitely there.
But, on to the good stuff. Within an hour of my decision, little Anna came to us. Her large head was turned the wrong way which explained the mystery of the ineffective pushing. They lowered the curtain at just the right moment so I could see her birth with my own eyes. Suddenly she was actually there, she was real! She cried just like in the movies. Cassie stayed with her at the table where they checked her out, and soon she was on my chest.
People said that any sadness or pain about your birth experience would disappear at the sight of your child. That is absolutely not true, but I do not ruminate on the grief and sadness. It immediately recedes to the corners of my mind at the sight of her. She is completely perfect and beautiful. I am in utter awe and deeply in love, on a cloud like never before. The bliss and joy is like they said it would be -- like nothing else.
As for the cesarean, I think of it as Cesarean Section Homebirth Style. My midwife says that homebirth is a state of mind, and I agree. I received excellent prenatal care which was compassionate and thorough. Every appointment lasted an hour, all of our questions were explored and concerns addressed thoroughly. Through those appointments and our excellent 6 week homebirth preparation class, we learned about every tool available to us at home and at the hospital. My fear of labor and delivery diminished over time and was replaced with confidence and respect. The folks in our class have kept in touch and encouraged each mama, holding her in love and light, as she brought her baby to the other side.
The memories of laboring at home bring me peace and joy. I hear the music and see the sky and sun and feel the soft breezes. I am very proud that I labored for 17 hours without intervention, mostly at home. Those were homebirth moments. My compassionate and dedicated partner was with me every single step of the way. She knew what to do thanks to her homebirth training. My beautiful and supportive friend, Theanna, got into the groove right away. My homebirth midwife was with us to the end guiding us in the ways of homebirth.
I don't see how I would have experienced all this if we had planned a hospital birth. We would have had perfunctory 15 minute prenatal appointments. I understand that many hospital oriented birth prep classes are cursory. We would probably have gone to the hospital early. I would have been given the epidural, pitocin and narcotics early. I may not have even known I had a choice. I would have missed the many hours of uninterrupted, quiet, natural labor at home. As it was, I was able to make informed choices at every turn with the help of my trusted birth team. I chose the epidural, I chose the narcotics, I chose pitocin and ultimately, I chose the cesarean, but only in the moments when I knew it was right for me and my baby. Those were also homebirth moments. I felt completely empowered through the entire process.
So that's my story. It's different than I expected it would be, but it's mine and it's perfect in its own way. And of course, most importantly, we got a beautiful baby girl out of the deal. Somehow we get to keep this little bundle of joy. She's ours! We're parents! The journey has just begun.
Finn Loch Taylor-Ladas was born on November 9, 2008 at 5:11pm. We waited 42 weeks and 3 days for his arrival. Mamas Debbie and Suzanne (the Scottish gals) are happy as clams with the wee one. The dogs are happy too!
Friday, November 21, 2008
Thursday, November 20, 2008
Cosimo is receiving visitors effective immediately!
With much love,
Grant and Viola
Sunday, November 16, 2008
Tracey Bowman from the Bridge Club had an opportunity to shake Barack Obama's hand while he was on the campaign trail. Here is what he said about her being a midwife: "It must be the most joyful professon in the world, bringing new life in." Tracey says, he said a bit more about that and we talked about how important healthcare is and he moved on to the next hand. BTW he is very tall and thin and has thin long hands!Our new president knows about midwifery! Opportunities abound.
Thursday, November 13, 2008
Wednesday, November 12, 2008
Theresa Shaver, Executive Director of the White Ribbon Alliance for Safe Motherhood, today praised Senators Blanche Lincoln and Olympia Snowe for their leadership to focus the nation’s attention on the #1 killer of women in the world today – maternal mortality – and welcomed this week’s passage of Senate Resolution 616 as a critical step to hold the United States accountable to play its part to reduce maternal mortality at home and abroad. Shaver made special note of the Senate’s recognition that access to quality and affordable health care is essential to improving maternal health.
“More than 536,000 women die during pregnancy and childbirth every year,” said Senator Lincoln, Sponsor of S. Res. 616. “While the majority of deaths occur in developing countries, the United States has one of the highest maternal mortality rates among industrialized nations. This is not a problem we can or should ignore. A mother’s health affects the health of her child, her family’s well-being, and the productivity of a community. It’s time we made maternal health a priority.”
Thursday, November 6, 2008
Saturday, November 1, 2008
Mothers Naturally Awards commend outstanding achievement in childbirth activism, advocacy for normal birth, and empowerment of women in childbirth. Mothers Naturally Awards recognize films, books and websites highlighting midwifery and home birth. The Midwives Alliance of North America congratulates and thanks all of the award winners.
We were honored and thrilled to have Ricki and Abby in attendance at the awards ceremonies. We saw a very funny intro of Ricki Lake that you can check out here: Mothers Naturally 2008 Award to Ricki Lake. Both Ricki and Abby have joined the natural childbirth movement as strong and valued allies. The Business of Being Born has been seen all across the globe. Netflix reports over 150,000 views! That is such an astonishing accomplishment. We thank and honor Ricki and Abby for their work.
You can be a part of next years awards selection. Simply nominate a film, book, or website you think deserves recognition and we will send your nomination on to the selection committee. Nominations must be received by August 31, 2009. Winners are announced at the Midwives Alliance conference .
Saturday, October 18, 2008
Wednesday, October 15, 2008
We had an exciting and productive Joint Board meeting which is where MANA, NARM, MEAC, CfM, NACPM, FAM and ICTC all get together and brainstorm. You can google all those acronyms and learn a lot about midwifery! The conference starts tomorrow morning and I will try to keep you in the loop. Sure wish you were actually here with us!
Tuesday, October 14, 2008
The Midwives Alliance is one of the most vibrant women's organizations in this country. We are growing and evolving very quickly. This year, in Michigan, we are having our 25th conference. In some ways, we are still a very young organization. Midwifery has that unique distinction of being old and new at the same time. Are we the tradition or the alternative? A recent TV show mentioned a "good, old-fashioned, hospital birth." So, home birth is the new, cutting edge thing. It just takes time before the new way will take greater hold and women will have more options in childbirth. For now, home births represent just shy of 1% of the births in the US. My goal is to reach 2%. Together we can reach that goal.
The Midwives Alliance is constantly asking the question of who we are and how we can serve our membership. The more we hear from you, the more you get involved, the more good that we can do for women and babies in North America. To join The Midwives Alliance, go to www.mana.org. You can join as a midwife, a student, a supporter, or simply make a donation. Come join one of the most exciting organizations for women!
Monday, October 13, 2008
Sunday, October 12, 2008
Mothers Naturally, Public Relations, fundraising, vision: The Midwives Alliance is off and running on our first board day. 12 very dedicated midwives are brainstorming, advocating, visioning, creating for midwives, mothers, babies, families. If you haven't been to the Mothers Naturally website yet, get thee there quick: Mothers Naturally.
We are in such an exciting time in midwifery politics. Ghandi said, "First the ignore you, then they laugh at you, then they fight you, then you win." So we are about to win. Now is the time to join the midwifery movement. There is so much to do, so much fun and inspiration, so much to learn. If you are a student midwife and would like to receive emails from the Midwives Alliance about how you can get involved, contact me at email@example.com.
Saturday, October 11, 2008
Thursday, October 9, 2008
I am writing to announce the release today of a new report, Evidence-Based Maternity Care: What It Is and What It Can Achieve.
The report takes stock of the U.S. maternity care system, identifies many opportunities for improving the quality, outcomes, and value of maternity care, and presents policy recommendations. It was developed through a collaboration among Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund.
For access to the report, please go to http://www.
The report was covered in two articles in today's USA Today:
Consumer Reports also posted an article and a quiz:
Carol Sakala, PhD, MSPH
Director of Programs
Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care for all women and their families.
Wednesday, October 8, 2008
Oct 5th -- Travel to NY from San Francisco
Oct 6th -- Travel to New Haven, CT to meet up with Heidi Biegel, CNM, and speak with Yale Student Midwives. Welcome, SNMs, to MANA!
Oct 7th -- Back in NY, waiting on my sister's baby, Presidential debate, Polls declare Obama the winner of this one, note to send Obama info about the cost effectiveness of home birth midwifery care
Oct 8th -- waiting on my sister's baby....
Friday, October 3, 2008
The Rose (my birth story)
In 4th grade our teacher invited us to describe in words our fantasy life as adults. My future tumbled out in shades of blue and slate grey, except for a bright red pick up truck. I was an author/illustrator who kept house on the tippy top of a mountain. 10 children and for each child—a dog. Of course, that was fair. No husband, no other grown ups, only me.
On the 4th day after my son, Manuel, was born on the kitchen floor, I hit the wall. Every muscle in my body throbbed with memory and exhaustion. My bones gritted against each other, my eyes dry with aloneness. I had been doing so well, healing so quickly, loving so deeply, appreciating the profoundness of each foggy hour. My friend, Luis, came to bring sacred beads to the baby and to lay healing hands on me. He spoke about a struggle between the male and female energies inside, about the appropriateness of relinquishing control and about the courage to rest and melt into the warm smell of the earth. And of course, birth leads me again into the darkest cave. My old story of fierce survival, of reckless fleeing and diligent mistrust just won’t cut it. I am broken down again, knealing on a mirror, cool rain on my back. The word ‘survivor’ splinters around me, my own heart as soft as Manuel’s skin draped over my chest.
Saturday night we did what everyone had told us to do. That thing we would lose immediately after bringing our baby into the world. We went to the movies. A kooky, yet poignant Czech film with lots of popcorn and blackberry soda. On the way home, I told Eric I needed to ritualize our connection. Somehow, in a dance, a song. We shared our fears about breaking the strong rope of friendship during labor and held each other close. As we crawled into bed, yawning, I told him, “I am ready to do this.” Half an hour later my contractions started at regular 15 minute intervals.
Early labor was a celebration. We cuddled, showered, took a long walk down 24th street and stopped to eat pupusas at Alba’s restaurant. We made it to an event dedicated to birth down at the Brava Theater. So funny, gliding into the lobby, arm in arm and pronounce, “We are in labor!” I breathed through each mild contraction, surprised at the calmness and ease washing over me. We even rented a movie to watch that night, ran into some friends on the street and then got into the birth tub to relax. Contractions picked up in frequency and around 10 pm, my sister, Jamie and best friend, Jesse arrived. We ate soup and Jesse led us in a round of ‘Freight Train’ on the guitar. I moaned low tones and rippled my spine through the pain. By 2am, the waves were approaching every 4 minutes and our midwife, Maria arrived. The next 38 hours belong to a different landscape. The precise time of and duration of each passage are unknown to me. This is the story of my body learning to open. And along with my body, my awareness, my familiar framework and my heart.
At a certain moment in my late 20’s, my memory disclosed to me the knowledge that I was sexually abused as a child. I was already aware of incidents of rape and sexual abuse as a teenager and on into adulthood, but uncovering that key piece pulled the rug out from under me. I crumbled. A small circle of intimate ones gathered around me as my primary support, and eventually I sought the coaching of a somatic therapist who also identified as a survivor. For over 3 years my healing road has unfolded, guiding me through dark tunnels, blinding explosions, agonizing confrontations and empowering breakthroughs. I have been incredibly fortunate to have shared resources and guidance with dedicated healers, activists, movers, and thinkers who are committed to understanding, challenging, and preventing sexual abuse and the injustices in our world which allow sexual abuse to be so prevalent. I came to believe profoundly in slow change, in people’s ability to self-determine their own healing, and in humanity’s potential to build bridges and stand in solidarity. All of this, outside of the confines of government, police, prisons, and other institutions created to destroy our creative problem-solving skills and our potential to shine. I believed in all of these things, but had never put them so into practice as I did in those 66 hours birthing my son.
My first dream directly related to pregnancy rocked me out of slumber with a roaring laugh. I was incubating a tiny dragon. A baby dragon, writhing and igniting my uterine walls with his precious fiery breath. I adored him and after that dream, our growing child would be nicknamed Dragoncito, baby dragon.
When Maria arrived, I was laboring hard, using low growling sounds, bracing myself on tables to rock and grind my body together with each contraction. She checked my vitals – normal. Baby dragon’s vitals – perfect. And my dilation – only 2 centimeters. I was disappointed but convinced that the task at hand was doable. My body could do this. Afterwards, I learned that an average progression of dilation for first time moms is one centimeter every 1 to 2 hours. My cervix opened one centimeter every 5 to 7 hours. There were moments when I hated this. I was angry, frustrated, disbelieving. Why? Why wouldn’t my body open? Maria reminded me to seek strength and energy in the tools I had available: hot water, sips of soup and juice, the sound of Jesse’s voice and guitar, my pre-made mixes on the stereo, pillows, the solid grounding presence of my sister, the love and trust and reassurance of my partner Eric, the traditions and wisdom of midwifery, the comfort of my own familiar surroundings. Reminders also of the incredible privilege to be free to birth in my own home. No prison walls, no bureaucrats barking in an incomrehensible language, no enforced hospital policies due to dependence on state money. My low back and pelvis ached, and each contraction brought lightning pain radiating from my sacrum. I imagined rabid dogs tearing apart my hip bones. My only relief was having strong hands apply pressure on either side of the sacrum. Literally undermining these furious dogs. “SQUEEZE…HARDER!” I, too, growled and snapped, furious to win over the pain. Eric squeezed and pushed, laboring as hard as me for those last two days. Maria left for another birth and Jesse washed all of the towels we had. Nancy, another midwife, came and sat with us for some period of time. Her presence was reassuring and yet my dilation did not speed up. Maria returned just as my contractions were back to three minutes apart.
My first moment of doubt hit in the middle of the night. My eyes glazed over and I begged Maria to talk to me. “What are my options? What if I can’t do it here at home?” She laid beside me in bed, our hands in a power lock. She laid out all possibilities, calmly, respectfully, with no judgment. And at the end, she urged me to rest. I remember vividly my own disbelief- How could I rest? Shouldn’t I keep trudging forward? What if I actually PROLONGED labor even more by resting? Maria reminded me of the importance of rest, to start with a renewed source of energy before making pivotal decisións. I agreed to try.
That night I lay with Eric in bed for six hours, sleeping in between contractions, waking every ten minutes to face the pain. For the first while, Jesse sang from the corner of the bedroom, his timeless melodies touched my soul and helped me sink into the mattress, sink into the truth of the present moment. Eric woke for each contraction, there with me, an unflinching embrace, a steady crutch. So many images penetrated my half sleep. A dance performance by Kara Davis, two steps forward and one step back. A flock of birds in a cloudy sky over Cesar Chavez and Mission streets. May Day 2006, marching with my sisters in struggle to support immigrant rights. Those visions I have had since childhood of mythical beasts. The rain on my stiff body as I walked away from Eric in Washington Heights one year earlier. The images flooded my head, blood crowded my ears, but my body rested. “Trust Birth”. I remembered reading that phrase.
At 5 a.m. I called the birth team together. Trust Birth. I can do this. We can do this. The rest had served me, and I was ready to plow onward, no matter how slowly my cervix was opening. Another day of labor. I felt truly like a warrior, my voice pronouncing louder and louder my conviction. I no longer cared about worrying the neighbors. Our apartment had been transformed into a sauna. I roamed half-dressed and dripping. Finally, I entered the transition phase of labor. Vomiting, shaking, my eyes glazed over. Jesse played a drum and I locked eyes with Jamie from the birth tub. No words at all. Two hours later I was pronounced fully dilated. I wanted to be done. It had to be over soon. I needed it to be over. And still my body was not ready. Maria assessed the situation and told me I was too exhausted to push. With my energy level so low, I could not get my baby out. And again she asked that I rest.
But this time, it was different, a different kind of rest. She led me into the bathroom and shut the door. I got on the toilet and she faced me from the edge of the tub. She told me to go inside, to find the deepest place in my heart. A place with no sound, no words, a place only I can reach. She told me to retreat there and let my body and voice be completely still. Again I was incredulous. Not fight the contractions? Not attack the pain head on? Not use my strong voice and body and community to help me through this final passage? The fight… Somewhere I had read, tagged on a bathroom wall: “Being a fighter doesn’t mean always fighting”. But for me it did. My art, my activism, the drive to make ends meet, to live fully. Even in my own healing, I surged forward with fierce velocity. Of course I had been reminded on other occasions by friends, lovers, co-workers, to slow down, sleep late, take a break. But never when the stakes were this high, and never to such an extreme abandonment of all my coping mechanisms. Leave everything behind and go inward. In such a depleted state, I knew I had to try. The first contraction came and I dove inward. I tasted the pain in its most raw form. No buffers, no distractions. In four breaths the contraction was gone. Tears trickeled down my face, the tears of knowing my own heart. Deep in that place, I found a survival more potent than “the fight”. There was softness, there was beauty. I imagined my heart as a rose. With each contraction I slipped into the soft spiral of petals and silence. Four deep breaths and then nothingness, pure rest.
We transferred to the bed and I lay in this meditation. I am told I lay there for close to two hours. During this expanse of self-discovery, I collected the tools I had been missing, the tools that allowed me to deliver my baby safely and lovingly on my kitchen floor. During those hours, I found strength beyond “the fight”. I found that my power source has its roots way deeper than the labels of feminist, survivor, anti-capitalist. I found the belief that my body is not broken, that it is the perfect body to birth my baby. I found confidence that I can walk alone, that I have already survived, and now I am thriving. By letting go of my old crutches, I emerged as a mother. I saw Manuel’s body inside of me and knew that the love I felt for him was a thousand times greater than my need to scream during a contraction. I found the softness that would bond me to my son forever. A softness so rich that it melted away my need to “be done”.
And with those new tools, I was ready. I pushed my baby out in one hour. I felt my body split open and I alone pushed him out into the world. Manuel’s heart beat remained constant and serene for the entire duration of labor. All sixty six hours. His first act of love and patience. His skin against mine was a flood of warm light. Eric and I held him with complete sureness in our ability to be his parents. And now I watch him sleep. Another act of love and patience, letting me write this story during his afternoon naps. I hear Eric’s voice in the next room and smile at my ability to grow and change. I look back at Dragoncito. Maybe he will teach me about naps someday…
To Maria Iorillo, Sue Baelen, Nancy Myrick, Meredith Broome and Jane Austin for your wisdom and presence
To Jaime and Jesse, who have always been there with soup, humor and open arms
To the Grandparents Camp, all four of you, for your support and love
To Manuel’s godparents Roberto and Sparlha for your blessings
To Manuel’s tios y tias Larissa, Fiona, Lidia, Gina, Carmen, Eduardo, Beatriz, Yeni, Alicia, Mona, Carey, Alba, Luis and Maria Claudia for creating such a beautiful community
To our building-mates for weathering the noise with joy and to the other parents in the homebirth class for sharing in this wild ride
To our friends and family all over the world (y en la Mission!!) who lit candles and sent messages of strength and music
To the folks at Generation Five, Critical Resistance and Creative Interventions who help us see a brighter road
To my mom, Grandma Netty, who not only helped type this story, but held my hand into this world of motherhood
To Eric, Cantarito, for your friendship, honesty and everyday magic
and thanks to Dragoncito, for choosing us as your parents.
Sunday, September 28, 2008
This boy has a lot to cheer about! He was born at home, in the water, into the loving arms of his mama and papa, Kristen and Kevin. A speedy labor left us dazed, amazed, and full of gratitude. Welcome Dylan Patrick, born on August 18, 2008. Congratulations to all!
Friday, September 26, 2008
Thursday, September 25, 2008
Sunday, September 21, 2008
Tuesday, September 16, 2008
Saturday, September 13, 2008
My due date was September 2nd. Due dates, as I understand it now, are somewhat educated guesses, based on potentially inconsistent cycles, that may lead us to know the approximately four week window in which the baby is likely to join the world. Yes, not exactly a precise measurement. Babies choose to be born when they need to be, when it is their time. As pregnant Mama, I never held onto the due date as anything more than a pretty good estimate. I just wanted our baby to know s/he was welcome here.
In the end, now our most profound new beginning, all of these potentially faulty, pseudo-scientific, fully leading indicators would prove to be mostly right. I was “early” – by one day.
Our beautiful 7 pound 13 ounce baby boy screamed his way into the world on , September 1st at 4:38 pm.
So, why all the focus on the day anyway, when this story is about my birth and our baby boy? Well, I didn’t start labor on Labor Day. I started on Saturday night, around 11:30 pm. After some 44 hours in labor our son chose Labor Day, just as Ben and I chose one another three years before when we met at a dinner party that very evening. Of course, we believe this to be an early sign of his genius. This belief binds us to a chain, back through the generations, of parents sure that their child is the most brilliant, exceptional and thoughtful child ever born. Seeing fit to have me in labor for 44 hours and to wrap it all up on Labor Day, a holiday, also demonstrates a promising sense of humor.
My birth experience doesn’t live, though, in any of the dates or details or post-birth interpretations. It lingers the hazier spaces between words where I could unleash a deep growl and find a quiet I had never experienced. The two days of labor was the space granted for the two of us to invite the baby to arrive and with that, to move from pregnant to parent, from couple to family. By choosing to labor and birth at home, no one outside of us would name the stage of labor or urge an intervention to move it along when I despaired that surges would never cease. And, I did despair. And, Ben found the words and the connection to bring me back to present, to nothing wrong, to everything on course.
We were nimble, with few, but powerful tools - each other; a big full tub in the center of the baby’s room; our presence and all the inner work we had done to get to this day; phone consultations and then the presence of our gifted midwife Maria Iorillo; my Mother’s supportive mien; and a whole lot of time. We used every one. We found a slow groove doing what Ben dubbed the middle school dance, swaying slowly together through the minute-long contractions that would come quick, then slow, then quick again. When my hope turned to deep doubt, I asked again and again when Maria (our midwife) would come, bringing with her the light at the end of this long tunnel. I was still looking for some outside indicator that birth was happening. And then I wasn’t, realizing that naming doesn’t always help, that saying I moved from this phase to that, knowing how open my cervix was, or even counting contractions, are at best reflections of the thing that is birth, not the birth itself. The exquisite pain and power of birth created more than the space for him to arrive. It created the space for us to arrive.
And, now, six days later, I sit on the very day bed turned sofa where our baby was born, as he and Ben sleep peacefully in the next room. I finished nursing only a few minutes ago and felt him drape his limp arms over my shoulder as I burped him and carried him back to bed. I watched his flickering eyes close and saw his face still. My heart melts once more.
This week, a new television show premiered, called The Doctors. Here's what I have to say:
San Francisco—It is too bad that the producers of a new television show called The Doctors, which premiered this week across the country, aren’t paying attention to all this vetting that is going on in the news lately. Seems that they missed a few fact checks in their preparation for their show on home birth as well. For example, they start off the show with Dr. Andrew Ordon (don’t mind him, he’s a plastic surgeon— of course he isn’t up to speed on childbirth) saying, “Without a question, the safer place for mother and baby is in the hospital.” Hmmm, fact checker please. Where is the evidence to that claim? Is it in the 30% C-section rate, our abysmal U.S. infant mortality rate or the maternal mortality rate that is on the rise for the first time in 30 years? Those are hospital births we are talking about. As a matter of very known fact, most births in the U.S. happen in the hospital, given that less than 1% are planned home births. So, is the hospital really safer? What are they so afraid of?
Or did they forget to vet the statistics on home birth all together? You would think so, since the show was so slanted to the anti-home birth camp. Did the family that had a home birth even get to speak? Funny how Dr. Lisa Masterson interrupted their talk and subsequently never asked any follow-up questions. Where was the discussion or dialog? They didn’t even have an expert on home birth on the show to answer questions or refute what the doctor had to say. Midwives, of course, are the experts in home birth. Sounds like good ol’ boy politics to me—not what the show purported to be—fair and balanced. I should know because I spoke with the producer more than once. She claimed it would be a dialog about home birth and not a hit and run. Guess she didn’t know about the way doctors operate because I’m sure she wouldn’t lie to me. To the show’s credit, Dr. Sears had a few things to say: 4 of his siblings were born at home. But they silenced him too by saying those babies were just lucky. Yes, indeed, lucky to have been born into the loving hands of a compassionate family that chose the best for their baby. Not “lucky”, as Dr. Masterson implies, to have escaped certain death and irreparable damage from a home birth. Does Dr. Masterson know anything about homebirth in this country? Fact checker, please.
Midwifery is not based on luck. Midwifery is a time-tested profession that holds at its pinnacle a dedication to the safety of mothers and babies in childbirth. Ample evidence exists today to prove that US doctors, most notably the trade union ACOG, is behind the times. They cling to backward notions that the hospital is the safest place to have a baby while the C-Section rate climbs far above the 10-15% that the World Health Organization and the Healthy People 2000 Consortium deemed appropriate for our country. The induction rate is also escalating as pitocin is used with aplomb, as if two things were true: 1) that women can’t give birth without artificial stimulation, and 2) that its use has no health consequences. Dr. Masterson would like the world to believe that OBs would NEVER do anything for their convenience. Did she read the Listening to Mothers survey? Maybe she’s never done anything like that, but for sure her ACOG colleagues are. The Listening to Mothers Survey states, “Almost half of all mothers reported that their caregiver tried to induce labor, most commonly through the use of artificial oxytocin. More than one-third of those mothers cited a non-medical factor as at least partially the reason for the attempted induction.”
In the meantime, certified professional midwives attending planned home births have a 3.7% C section rate and much lower intervention rates than their planned hospital birth counterparts. All the while having a similar infant mortality rate as a comparable, low-risk group having their babies in the hospital. This data shows that by having your baby at home, you have no greater risk of your baby dying than by having it in the hospital. Too bad they didn’t have a certified professional midwife on the show to follow up on the inaccuracies presented. I guess Kathy Gulinello, producer of this segment of The Doctors, didn’t see it as a necessary voice. Dr. Sears spoke only once for 30 seconds and that was deemed enough to be the balance in their version of fair and balanced.
Too bad they are so old school. They are up-to-date on things like “informed choice” and the fact that having your baby at home or in the hospital can be “one of the most important choices” you will make. But Dr. Masterson misses the most salient aspects of maternity reform when she says, “You don’t want to take on the responsibility for your child, you absolutely do not.” Maternity reform is on its way, with women being more informed than ever, standing up for their birthing rights, and yes, indeed, fully taking responsibility for their bodies, their babies and their births. As maternity care evolves, more women will be empowered by their birth experiences. Midwifery care and home birth will continue to make in-roads as a solution to some of our most pressing maternity care disparities. In the meantime, hospitals will need to take a hard look at their sky-rocketing C-section rates, infant mortality and maternal experiences that beg the question: Are we really doing the best that we can for mothers and babies? More vetting and less kvetching will show that homebirth is not the problem. As the rest of the world moves forward, this new show will be left in the dust.
P.S. Have Dr. Masterson call me. I'll tell her how to avoid a 10-15% shoulder dystocia rate.
Please log on to their website and visit the forums and give them hell for trying to mess with us. Here is the address: The Doctors
Sunday, September 7, 2008
Dearest friends and family---
We are overjoyed to announce the arrival of our son, born at 4:38 pm on Labor Day, September 1, 2008. His name will be announced later this week at his Bris. Ben caught him and laid him on Mikaela’s chest and our boy announced himself with a scream the precise pitch and volume of a jet engine.
We are convinced he chose Labor Day to honor us, his parents, since it was Labor Day three years ago that we first met. Clearly he is a genius. This belief binds us to a chain, back through the generations, of parents sure that their child is the most brilliant, exceptional and thoughtful child ever born. Seeing fit to have Mikaela in labor for 44 hours and wrapping it all up on Labor Day, a holiday, also demonstrates a promising sense of humor.
We will be forever grateful to have brought him into the world at home, surrounded by all of the gifts and memories of friends and family. We are profoundly indebted to our gifted midwife Maria Iorillo who gave us complete confidence not just in her, but in our ability to do this.
In the blur of days since, we have been completely and endlessly fascinated by his every squeak and twitch and we are delighting in the perpetual twilight of early parenting, when night is day and day is night and the only a measure of time is how long he sleeps and when he needs to eat. The golden moments have been filled with the smiles of his grandparents, the generosity of family and community, and a whole lot of diaper-changing.
We have created a blog and have posted a bunch of photos of his early days. We will continue to post pictures and write some updates - as often as nursing, burping, diapering and jiggling allow- for those of you interested in coming along with us for the adventure.
The address is
Much love to you all,
Ben, Mikaela and the little one
Wednesday, August 27, 2008
"No way, no how, no McCain" -- Senator Hillary Clinton
Sunday, August 24, 2008
The Business of Being Born
Birth (The Play)
The perfect way to celebrate your labor....day!!
Thursday, August 21, 2008
Or at least the training part! Misty May-Treanor and Kerry Walsh defended their gold medal last night in Beach Volleyball. Their coach told them to follow the 3 B's: Battling, Believing and Breathing! Now that sounds familiar. I have recently had a number of clients take on birth like an athletic event and be incredibly successful. They reframed the work of labor into an athletic feat that they knew they could accomplish. With great determination and strength, their babies were born into the world. The Battling is symbolic of our fight against the American (obstetrical) way of birth, as women reclaim their power and triumphantly succeed.
Monday, August 18, 2008
born on May 31, 2008 to Mia and Matt
and big brother, Marcello!