Women in Charge

The Sweet Reward by Joy (Part Three)

2011-12-22T22:12:00.000-08:00

I thought about all my friends who had contributed a bead to my Blessingway necklace, I thought about all the mama’s before me who had given birth, I thought about how during a long climb on the bike sometimes you just want to quit but you can’t ‘cause you know that once you get to the top there will be a sweet reward. Come on Baby G, we can do this! Let’s DO THIS!

Once back on the birthing stool I knew this would be it. I felt a ring of sting during the first set of contractions but no Baby G yet. I pushed and pushed but my body was tired. I thought about how during a bike sprint your legs just want to lock up after your first jump and you keep down shifting to get more torque and speed, you have to take your adrenaline and energy to mentally psyche yourself out to keep going. This is what I thought about when sitting on the birthing stool! “PUUUUUSH!!! Down shift. COME ON JOY!!!!” Down shift. “YOU CAN DO IT!!!!” Down shift. “HERE COMES THE BABY!!!!” The ring of sting was overwhelming, I pushed with everything I had and then it disappeared. Jamie’s hands caught Baby G. The air was still and Baby G’s cry was like music to my ears. BABY G IS A GIRL! SHE’S AMAZING!

Date: Sunday, September 18, 2011 4:00 PM
Subject: Our new addition is here!!!!

Hi Everyone!

We are pleased to announce the arrival of Celeste Napali Gilpin! Joy and Celeste are doing wonderful after a beautiful home birth. She was born here in the Presidio at 5:44 am today, weighs in at 7 lbs 7 oz (3.37 kg), and is 20 inches (50.8 cm) long.

More information soon. We are focused on learning how to be parents right now so hold tight. Keep your eye on Facebook and email for more info and pics.

Love - Jamie, Joy, Celeste, and Eddy

PS - Spread the word! So please feel free to forward this on to others.

The Sweet Reward by Joy (Part Two)

2011-12-09T06:49:00.000-08:00

When we returned to our building for the second time that day, I felt a contraction coming on at the base of the stairs. While draped over Jamie, I let the energy out with my deep birth cry. The increased pressure down there along with my scream resulted in a pop and release of warm fluid rushing down my legs filling my boots and creating a puddle by my feet. I pointed down to the ground during my contraction, which puzzled Jamie. When the surge passed, I asked, “Is this what you mean?!?” Everyone laughed. Lu kindly hosed off the amniotic fluid for the sake of our neighbors. With Jamie’s help, I went upstairs and stepped into the shower.

I was on all fours in the shower; the warm water provided a massage as it pelted onto my back. I had several contractions in the shower and wailed away during them. There’s no doubt that my neighbors can hear me, I hope they don’t mind! It was a quarter to 5pm and I was feeling a strong urge to push accompanying my contractions. I told Maria about this and wondered if this meant I was fully dilated. After the shower, Maria had me lay on our bed for the second time that day and checked my cervix...I was 6 cm dilated, which meant I couldn’t push yet! Hmmmm, but my body is telling me to push during the contractions! How do I work with this?

Maria instructed me to blow through the urge to push, she also told me that my cervix was mostly in the front and that I should avoid being on all fours. This would assist opening of the cervix by not adding unnecessary pressure to that area. She also mentioned that if I did push during the contractions, while not fully dilated, my cervix may get swollen and this would make it more difficult to become fully dilated. Whoa, so I need to tell my body NOT to push even though that’s what my body is signaling to my brain?!?! Imagine having diarrhea and not being able to push it out because you aren’t at the toilet yet. Like you have been holding it for HOURS but you just can’t shit your pants, - that’s how much pressure I felt down there with each contraction. There’s no release, you CAN’T release ‘cause your cervix isn’t fully open yet, (and if you do push, well, there may be a trip to the hospital and I definitely did not want that) so you have to release the energy somewhere, and that’s what I did...

Here is what I remember about the next several hours:

The quality of the contractions to follow and how I dealt with them was much different than the contractions before our second walk that day.
I was breathing differently during the contractions, as if blowing out a candle a foot away from my face with strong hard breaths and pursed lips.
Every other contraction I was able to overcome the urge to push and “blow it away” (I was pretty quiet and Maria had to ask me when my contraction had stopped...some of them felt like I was blowing away the urge to push for a loooong time!)
I thought about how my breathing was similar to how you breathe when you’re on the bike climbing and going anaerobic. You get into a rhythm.
Every other contraction the urge to push was just TOO strong. Even though I had to tell my body NOT to push, my body surrendered to the urge and I felt like a bucking bronco as my brain and body conflicted with this. (Think about how a fish flops around when they are out of the water, that’s how I looked during these surges.)
I was LOUD!
I visualized my breaths blowing open my cervix!
I was in the tub and Jamie had a compress on my butt to prevent my hemorrhoids from getting worse. Lu was stroking my hair.
Jamie whispering encouraging words in my ear about riding bikes in the Alps.
Toasted crumpets from Trader Joe’s with butter, honey, and sea salt cut into bite sized pieces.
Hypnobabies playing in the background. Today is your birthing day...
Forcing my chin up during the contractions, even though I wanted to bear down.
Relaxing my face and shoulders, and being VERY conscious of the effort to do so.
Thanking everyone after a set of contractions. Subconsciously thanking the contractions for bringing Baby G closer to me.

Almost 2 hours into the VERY-strong-urge-to-push-but-cannot-part of my labor, I got out of the tub. My bladder felt engorged, I attempted to pee but nothing came out! I stood in the shower, bent over with my hands resting on the hot and cold faucet knobs (remember, I could not be on all fours!) and tried to relax and pee, but even my urethra couldn’t release! I think I was in there for what seemed to be at least 10 minutes. Maria said she could catheterize me to release the pee. I freaked out. I didn’t want MORE discomfort! I listened to the water, I thought about waterfalls, I recalled how this sensation was exactly like the one when you have to pee SO BAD, and you’ve been holding it for SO LONG that it takes like 30 seconds before you start to pee, and when you do it burns a little at the beginning. I had that burning sensation a few times and thought Oooh, this is it, my pee is going to come out! But it didn’t, so I agreed to have a catheter put in me for the first time in my life.

I resumed the exam position on our bed; on my back with my legs spread. My bladder was so full that I had a separate pooch from my baby pooch. Lu even said that my bladder was so large that she thought that the baby may have turned and her mind started to stir. After 750cc’s of urine drained out of me, I felt MUCH better. We used the old Brita pitcher to contain the pee. Ha, I will always think of being cathed when I see a Brita pitcher now! There may be nothing worse than the feeling of being cathed, but there is: having a contraction with the urge to push-but-you-can’t while being cathed! I was 7 cm dilated.

I got back into the tub and breathed, bucked like a rodeo bull, listened to Hypnobabies, drank more (but not as much, cause I feared that I would fill my bladder again and have to get cathed sooner than later), kept my chin up, visualized blowing my cervix open. I even divulged to Maria some childhood stuff that I had intended to tell her prior to the birth during one of our visits, but always forgot to. I thought that perhaps this information might be blocking my cervix from dilating quicker. I read about a birth in one of Ina May’s books where after many hours of labor, the birthing mama’s cervix progressed and dilated quickly after she admitted some of her fears to the midwives. So while we were in the tub and Maria was sitting on the sofa, in between my bucking bull contractions I told her some stuff that I only share with close friends. And just like a best friend, Maria listened intently and asked genuine thought provoking questions.

It was 11pm, we got out of the tub and moved to the bedroom. The game plan was to get some rest. My contractions were even stronger now with the urge to push growing steadily. It felt like I had a poking coconut-head! Maria said she would check me again at 3am, but if I felt that the baby was dropping and the pressure was increasing she would check me earlier.

During the contractions I remember Lu massaging my hips and legs, Jamie lying next to me face to face, my hands squeezing his. The pattern resumed with my blowing away the urge to push with the contractions, and with the urge to push taking over my body and me bucking hard on my side. I started to feel my back cramping in between contractions. It was becoming difficult to relax as my muscles were fatigued and seizing from the bucking. Later Lu told me that I looked at her and said, “I’m beginning to have doubts.” I remember weighing the risks and benefits of driving to UCSF. How long will it take to get to UCSF? How shitty would it be to have a contraction in the car?! I don’t know how much longer I can do this! I think I need an epidural. What if I’m not fully dilated when Maria checks me again?

For sustenance, I had a GU and water sometime past midnight. Lu had cut up a baby watermelon into bite-sized pieces and my spirits lifted. That was exactly what I needed! The cool sweetness and juicy bits satiated me. My confidence was starting to waver and I had to tell myself to stay positive. I continued to visualize my breaths blowing my cervix open and hearing Maria say I was fully dilated. At 2:30am I told Lu that I wanted Maria to check me at 2:45am. That’s a good compromise. I will give my body a little more time to open up. Please be a 10, PLEASE! Just before 3am, Maria checked me. I remember the look of concentration on her face. “We’re where we want to be. You’re fully dilated!”

Lying on my back, I remember the muscles on my face forming into a smile while slowly raising my hand to give everyone a high five. “You mean I can push now?!” I asked.

I couldn’t have been happier. I could FINALLY push! Now this was a challenge for my mind to grasp since I had been forcing my body to overcome the urge to push for the last 10+ hours. I had to wrap my mind around the fact that I could actually push. OK! Change in game plan! YOU CAN PUSH NOW!

For the next two and half hours I pushed. Here is what I remember:

Getting cathed one more time so that Baby G had as much of an opening as possible.
I was so exhausted that I was falling asleep in between sets of contractions.
I pushed in 7 different positions*
For more than half of the sets of contractions, I had to rely on my mental state and environmental factors to initiate my body to have a contraction and push.
We listened to my energizing playlist, when a song came on that wasn’t energizing enough I had Lu skip to the next song.
The quality of my breath and how I dealt with the contractions was much different than before. Contrary to what we were told in my prenatal yoga class, I had to hold my breath while pushing. I was releasing too much energy from my throat and out my mouth, when I needed to be releasing energy down my core and out my yoni.
In our Bradley class we were told about the “Ring of Fire” which is a burning sensation you feel when the baby’s head is crowning. I didn’t feel a Ring of Fire, I felt a “Ring of Sting!”
Everyone offering words of encouragement when I would have a contraction. It felt as if I had my own cheering section. This really helped me push and stay focused. In fact, there was 1 time when it was silent during my contraction and I couldn’t really get into the push. I communicated to everyone that I really appreciated the cheers and I needed the words of encouragement to get Baby G out!
Our apple TV scrolling through our photos on the TV and feeling as if our friends and family were in the room with us.
Lu handing me a teacup full of warm miso soup to keep me going.
Talking out loud to Baby G in between contractions and telling him/her how we were ready to meet him/her.

Another amazing midwife named Sue arrived and we moved to the main room. I was on the birthing stool when I first felt Baby G’s hair. This is really happening! We’re about to finally meet Baby G!!!! We moved to the tub since we intended on having a water birth. Jamie and I engaged in some nipple stimulation. This seemed to work, however the warm water was also extremely relaxing. I encouraged Jamie to do some clitoral stimulation since I had to rely on extrinsic triggers to initiate my contractions. Believe it or not, I had a short but satisfying orgasm and a contraction followed. I pushed and pushed and Baby G just wasn’t coming out! In fact, Baby G’s heart rate had dropped significantly enough such that Maria had us get out of the tub. I remember hearing the difference in Baby G’s heart rate on the Doppler. This definitely caught my attention and everyone was calm.

We resumed on the sofa. I was lying on my right side and as I was falling asleep I would force myself to bring my left leg up to bring on a contraction. Stay focused. We’re soooo close! I recalled another Ina May birth story where the birthing mama’s cervix closed after being fully dilated! I can’t let that happen to me! I found that for over half of the contractions, I had to mentally bring on the first contraction, then my body would take over and the next surge would be more visceral and I could REALLY push. Baby G’s heart rate returned to normal, but I was so comfortable I was falling asleep. This position was no longer working for me. “I think I need gravity’s help. Let’s move back to the birthing stool.”

* Side-lying on our bed, side-lying on the sofa, sitting on the birthing stool, side-lying on the floor, in the tub, back to side-lying on the sofa, and sitting on the birthing stool.

The Sweet Reward by Joy (Part One)

2011-12-07T05:07:00.000-08:00

It is just over 24 hours after Celeste’s birth and I’m lying in bed with her to my right, staring through tears at her gorgeous little face. As the sun rises, I think about how I should have known my labor was going to be as challenging as it was, because after all we did travel to 5 different countries while I was pregnant. We went zip lining and repelling in Costa Rica, continued to do amazing bike rides here in the bay area, rode bikes in Panama and in Switzerland, drove some of the most beautiful roads in the French Alps and Pyrenees (ascended over 120,000 feet in 50 days), and flew back to the states at week 33. To top it all off, I was a bridesmaid in my best friend’s wedding 4 days before Celeste’s due date. So from the beginning, in utero, I was already challenging her, and she was challenging me.

The following email is from me to my dear friend Laura (aka Lu mama or Lu). Laura was an invaluable part of our birthing team at home. She has recently finished her midwifery program and played the role as our overqualified doula! My due date was September 14.

date: Tue, Sep 6, 2011 at 10:12 PM
subject: Re: hey girlie

lu mama,

thank you for the lovely email and the vit K and eye drop info. that's actually how we were leaning (yes on K/no on eye drops) and your input pretty much solidified our decision.

well, i'm feeling ready, i mean mentally ready...not feeling quite physically "ripe" yet though but getting close. evenings are the most uncomfortable but tolerable. getting in and out of bed requires more brain power than i'm used to. hypnobabies is definitely coming to my aid. i have listened consciously to most of them, although i usually end up falling asleep and then waking up in the middle of one.

the past few days (ever since i stopped working) have been wonderful and full. every day there is something to accomplish, baby stuff is all washed and put in it's place, fridge and pantry are stocked full of food and good eats for a while, and JOY biscuits have been baked (although i would like to bake a few more batches, and 1/3 deliveries have been made)...we have an appt with maria tomorrow along with an appt with a potential pediatrician. i've been going to yoga and swimming which has been awesome as well!

we've watched orgasmic birth and i have to say, i think it's VERY possible with me. in fact i've been having pretty sexual dreams lately and even had one dream that i started to feel contractions with a menstrual cramp like feeling and was like OH this is IT! i've been WAY more attentive to how much moisture i have down there too. nothing out of the ordinary so far.

so i don't know if i told you this, but car's wedding is on the 10th. i'm a bridesmaid, but with little responsibilities. i plan on showing up unless i'm in labor! it's a super low-key-casual-backyard love celebration with ribs and potato salad and karaoke. once the wedding is over, i know i will feel more grounded. now i just feel like i'm in a holding pattern but open to the possibility that baby G will come when he/she is ready. although, just today i was talking to a girlfriend and was feeling and saying that i think baby G will come closer to the due date...only time will tell. i see the harvest full moon is on the 12th-hmmmmm.

btw, i've been envisioning a pretty quick labor (like less than 24 hours from the very first contraction when i know to put on my blessingway necklace to 3rd stage), and way less than an hour of actual pushing. the middle time i've been thinking about walking, enjoying the daylight, stretching, doing all the poses we've learned in bradley and yoga birthing class, and having a fresh, simple but wholesome meal all while listening to my mixes and maybe even watching some bike racing. i've been thinking a lot about when i've had to dig deep mentally and physically and the closest analogy i have is bike racing or long ass climbs where i get into a rhythm and get into the zone.

ok hon, enough for now. time for this mama-to-be to go to bed. if we don't end up going down to mtn view on friday for whatever reason, would you like to head this way? that way you'll have some time to settle into your new abode and environment. a trip to the city for some fresh ocean air will be refreshing and it'll be good to catch up with you in the flesh. also, we can talk about how/when i should contact you once i'm in the baby G birth zone!

love you bunches!
-mama G

Car is my best friend from 2nd grade and I was fortunate to make it to the wedding! Reading that email makes me smile and laugh out loud, especially the paragraph with my envisioned labor and delivery details...HA, if I only knew!

Our plan was to keep quiet until after the birth. We did not share when I started labor as we felt that it would increase the phone calls and texts, and we wanted that time to be solely focused on bringing baby G into the world. The following “waiting room” email is something I sent out to some friends and family to ease the anxiety and excitement that came with the 14th, since that was baby G’s due date. Emails, texts, phone calls, facebook messages, and such were stirring and we felt the need to respond...(Actually, this email was intended for some extra support for my mom and Jamie’s mom-the new grandmas, as they were going a little stir crazy!)

date: Thu, Sep 15, 2011 at 5:20 PM
subject: the "waiting room"

hello loved ones!

as you may know, we are planning a home birth here in the presidio to be attended by our midwife, her assistant, our doula, jamie, eddy, and myself. we realize that since there is no physical "waiting room" it's a unique situation especially for the soon-to-be-grandparents!

SO, consider this your "virtual waiting room" and a little note to say that all is well.

you will find out when baby G joins us via email or phone call (well BEFORE it goes public on facebook!).

please feel free to email or call one another!

we love you all and know that you are thinking of us especially at this time. oh yeah, and if we don't respond to a text, email, or call it's just 'cause we're enjoying each other, and trying to be as low key and relaxed about our little new arrival...

love,
joy&jamie

ps. NO, we haven't started labor!!!!

Wednesday and Thursday came and went. But Thursday late late night is when things started happening, like early first stage type of things! In the following email I communicate with Lu to let her know what’s going on, even if she doesn’t read it until later on Friday morning. Judah is Lu’s son (he turns 2 on September 18th) and Eddy is our rescue greyhound.

date: Fri, Sep 16, 2011 at 4:26 AM
subject: hillo, good morn!

lu mama,

my third eye is telling me to contact you...

after dinner we watched a moobie, then i went to the bathroom and saw some blood on my undies, mucous plug perhaps? then i saw a small clot in le toilette-it was 11:15pm. we went to bed around 12:30 after i had what i'm pretty positive was my first contraction!

we've been sleeping, although i've been up to pee at least 3x. contractions have definitely started to be more frequent but no 4-1-1 yet.

call jamie when you're up with the sun. baby G may just want to arrive before judah's birthday! jamie mentioned something about you taking the BART over and hopping in a cab (even though your presidigo idea was brilliant), then when you arrive he'll come outside and pick up the tab.

love u,
-mama G

That first contraction was exactly what I heard and read about: a Braxton Hicks contraction coupled with a menstrual cramp sensation. Friday was a beautiful sunny day in the city with bluebird skies accompanied by a light breeze. Throughout the previous night, my contractions woke me. I would squeeze Jamie’s arm once to indicate a contraction was starting, twice to indicate the contraction had finished. Jamie would then press a button on his phone using an application he found for tracking contractions.

When we felt the surges getting more significant, I decided to put on my Blessingway necklace my close friends made for me. Sometime before 5am, the necklace was placed around my neck after I sent Lu the email above. I looked at Jamie and said, “We may meet Baby G at this time tomorrow,” as my intentions were to give birth within 24 hours of putting the necklace on. Ha! My intentions are usually made with a desired outcome in mind, not a specific timeline. How quickly I forgot that Mother Nature couldn’t be rushed.

The morning’s activities were uneventful. We contacted Maria to tell her my contractions had started the previous night. Lu and I texted each other to give updates. Jamie and I walked our dog, Eddy, up Lovers’ Lane in the Presidio to the top of the Lyon street steps. I had gone up and down the upper half of the steps 4 times the day before while envisioning Baby G’s head getting settled into my pelvis with every step. I figured I could do the steps and stop if I had a contraction. I ended up going up and down 4 times again, except this time I had a secret-I was in labor!! I felt an urge to tell everyone, but I held back. My due date was 2 days ago people! So what if I’m going slow?! I had a few mild contractions at the top, which I breathed through with my hands on my knees. I walked up and down those Lyon street steps with a purpose, while tourists marveled at the view and locals did their step workouts.

During that afternoon we took Eddy and our neighbor’s dog Kyo, a Rhodesian Ridgeback, to the ball field up the street from our apartment. More walking, yes! This is pretty much what I envisioned with the beginning of labor: a beautiful sunny day being spent outside with Jamie and Eddy. With this walk, we were accompanied by our neighbor who was also pregnant and due 5 days after me! I had a few contractions during the walk and at the ball field with the dogs running around. The contractions were still pretty sporadic and mild (relatively speaking;)), however I started leaning on Jamie during them. When we returned from our walk, I looked at this chart in our Bradley Method book entitled “Overview of Birth and Labor” and something definitely caught my eye. Under the “Needs” column it said to “Keep busy and don’t become too excited. This may or may not be actual labor.” Huh, how long could this early first stage possibly last?!

Later on that day, we decided to go out to dinner. While in the shower, I noticed a bright red blood clot on the floor of the tub. I reached down to feel where it came from, I felt a thick mucous-y substance and saw even more blood. OHH, THIS is the mucous plug! Not that bit of spotting I saw last night. This was definitely more substantial and well, plug-like. There was NO doubt that what I was seeing in the shower was my “bloody show.” Eeeee! A surge of excitement came over us as we got ready for dinner. We ended up walking to La Terrasse, one of our favorite French restaurants in the city. Lucky for us, La Terrasse is a short 15 minute walk from our apartment sans contractions, 20-30 minutes with contractions!

La Terrasse was lovely as always and I ordered my favorite dishes. This could possibly be our last dinner as parents-to-be instead of PARENTS! Again, I felt an urge to tell everyone who we interacted with that I was in labor. And we did, or at least we told the wait staff and the people sitting next to us. Exclaiming I was in labor had a dual purpose that evening: 1. To share our excitement and great news, and 2. To inform people that my occasional deep breathing and light moaning was due to a contraction!

When we arrived home from dinner, Jamie set up our rented Aqua Doula, filled it with water, and put the insulation cover over the water to keep it warm. Ohhh, another benchmark - setting up the tub! My contractions were getting stronger and I was doing cat cow poses during them while still in bed. Jamie started applying pressure to my hips during the surges and we played my relaxing playlist of songs to pass the time. Candles were lit around the apartment to provide a cozy calm feel. Jamie had cut up a Luna bar and put orange segments on a cutting board. The orange was juicy and cool and I ate almost all of it, the Luna bar was too dry and I only ate one bite size piece.

Lu arrived around 3AMish and in her calm and positive way assessed the situation. We got her up to date on my contractions and decided that Jamie should get some sleep while she kept me company. Lu and I stepped outside on our deck with me wrapped up in a blanket. The early morning was cool and the dark sky had a glow from the moon. I told Lu about my friend’s mom back in Panama who has had 7 vaginal births! She says that childbirth is analogous to pooping out a coconut!

The intensity of these contractions had definitely gone up a notch from my contractions when I went to bed. My deep breathing was now accompanied by more audible moans and I had started to feel more pressure in my pelvic floor. There is that coconut pushing down on my cervix and pelvis! I vaguely remember a mosquito buzzing around (I’m horribly allergic) so we stepped back inside. After a couple of hours of contractions, we decided to ditch the contraction app and get a more organic qualitative feel for the surges.

I got into the tub for the first time and the warm water instantly provided relief to my body and mind. I am a bath person, so I knew the tub was going to be a huge asset during labor but I didn’t anticipate it would feel this good! I felt weightless, the warmth of the water brought an aspect of relaxation that one could only know while in labor. I found comfort in leaning back with my head resting on a towel draped over the side of the tub, and from being on all fours with my head resting up against the towel. We put a wash cloth in the tub so that I could cover my chest to keep it warm while I leaned back. After a while we also added an old Brita pitcher to the tub so that Lu or Jamie could pour water over my back while I was on all fours and having a contraction.

Before I knew it, morning came and I could see sunlight peeking in through the drapes. While I was happy to see the sunrise, I wasn’t feeling entirely ready to transition into the day. This would mean blowing the candles out, and to me candles symbolize warm comfy relaxation. I wanted the sun to linger behind the trees for a while. After all, I was in my ZEN cocoon: focusing on breathing through my contractions while relaxing in the water and listening to my relaxation playlist!

Sure enough, the drapes were drawn open and the sun rose over the trees, in a few hours sunlight would spill into our main room where the tub was. But I want my ZEN candles and calm candlelit space! Oh well, I can always close the drapes later to achieve the same effect, right? Eventually, I did close them up again to block the bright sunlight, and then Maria arrived! It was just before 8 AM.

That morning was the beginning of Lu providing me (and the whole birth team) with flavorful and wholesome nourishment. I remember the most amazing oatmeal that morning; it was wonderfully warm and agave-sweet with a little sea salt. It was the perfect texture - not too lumpy but also not too watery. I ate my whole bowl while sitting in the tub, talk about comfort! Then I got out of the tub and Maria examined me while I lay on my back on our bed.

It was difficult not to think anything like Please say I’m greater than a 5! or I hope I’m at least a 5 ‘cause that would mean I am halfway there, right? Maria said I was a 4 and I was happy but shocked at the immensity of how much a number can make you feel. That is less than 5! In my fuzzy but somewhat clear mind I remember feeling a little down, my contractions had slowed and they weren’t picking up in frequency. The intensity of them was also pretty inconsistent. Like most everything in the world, my contractions were non-linear and definitely not progressing textbook style.

Baby G was also at station -1 and I was 80% effaced. I quickly calculated and thought about how we were definitely more than 24 hours from when I put the Blessingway necklace on. With my inconsistent contractions, there was no way to predict when I would be fully dilated. My ego wanted to be able to predict and control the process. Oh well, my body will do what it needs to do. It’s not all about the numbers and trying to get that 4-1-1, or is it?!

Maria recommended we open the drapes and get some energy into the apartment! She also recommended walking and squatting to welcome the contractions. We set up a circuit where I would have a few contractions at different “stations” in the apartment. The stations were a good way for me to keep my blood circulating and for me to move about. I sat on the glider and leaned forward on Lu or Jamie while they sat on the ottoman and we would glide in sync. I sat and did hip circles on the birthing ball. I was on all fours on my yoga mat leaning forward on the birthing ball. I did hip circles with one leg up on a chair in the kitchen. I walked into Baby G’s room and leaned over on the crib. I went into our room and leaned over on our bed. I remember the contractions in the kitchen being the most intense. I remember some one's hands on my hips pressing my pelvis together towards my sacrum and really liking it. I started to feel pressure on my hemorrhoids during the surges and we made a witch hazel compress which I placed in between my butt checks. This provided a nice cool sensation and a large wet mark on my underwear!

After about 2 or 3 circuits, Maria suggested that we go for a walk, and get some fresh air. I was to welcome the contractions, do squats, do whatever I needed to do. She said something about energy and that I needed to release, open up, and let the energy OUT. In hindsight, I was still in my ZEN birthing state, and Maria was getting me to transition into the “bring it on” state. She also mentioned something about how I was breathing during the surges and how I needed to really let it out. Huh, I feel like I AM letting it out! Any louder and the neighbors will surely hear me! Our neighbors knew we were doing a homebirth, and I’m not the type who is easily embarrassed. But for some reason I was holding back. Going for that walk was like a slice of cake from heaven allowing me to be as loud as I could possibly be!

Saturday morning in the Presidio brings a lot of hikers, bird watchers, joggers, and families out to take a stroll, especially on a sunny Saturday morning! Lu, Jamie, and I walked along MacArthur Road. I did a few squats and sure enough, I would have a contraction shortly afterwards. I draped myself over Jamie’s shoulders while he bent his knees (he’s 1 foot taller than me!) and supported me. Lu took pictures and smiled at all the passersby as well. A runner ran by and cheered us on, an older couple passed us and asked if they could do anything. Young families with their strollers smiled while walking by. The runner cheered us on again when she passed a second time exclaiming, “You can do it! I was just there a few months ago!” When we reached the brick bridge on Lovers’ Lane we stopped.

It was at this bridge looking at the eucalyptus trees where I had an epiphany - the visceral kind that makes you laugh and cry at the same time and say to yourself, “I GET it, now I really TRULY GET IT.” The kind of realization where your mind and body grasp that cliché saying to a whole new level of not just understanding, but RELATING TO. Putting this moment into words is a challenge because I know that reading this does not measure up to the intensity of the event. I remember having a contraction and REALLY letting go, virtually screaming and moaning simultaneously - it felt SO GOOD! I was letting the energy out, just like Maria had said. I didn’t care about the people walking by…We are HAVING A BABY!

On our way back to the apartment we decided to do a squat at every lamp post (I am a very visual person, even when I ride my bike I give myself landmark goals). Every squat brought on a contraction that I welcomed with all my being. We ran into Hope, an 11 year old shepherd retriever mix. HOPE! You are EXACTLY what I need! How did you know?! She looked vibrant and had a more than usual lightness to her energy. She leaned on me while I pet her freshly groomed fluffy fur. Our crossing paths with Hope was another sign to me that this was REAL, and just saying her name out loud made me cry. Geez, this is the largest natural high I’ve had since my wedding day. I remember Lu saying my eyes were glassy clear and bright* while we talked in between contractions about my enlightened birthing perspective. THIS is true hard-core surrender…

We returned to the apartment with great news to report to Maria! Even though the contractions were still inconsistent and dependent on the squats, I felt energized. I let my oxytocin-riddled brain drop the desire to know numbers that was Maria’s job. My job was to welcome the surges, rest in between, and go with it. I am OPEN to the energy of birth! Lu prepared poached eggs with avocado and fresh parsley on toasted pumpkin seed bread. I ate a slice and Maria made a proposal: You can rest or we can do some things to bring on your contractions even more, but I need your full commitment! “Can I do both?” I asked. “Yes!” Maria responded.

Jamie and I retreated to the bedroom and napped, I had contractions about 8-10 minutes apart during our nap. I woke up rested an hour and a half later, then everyone got up and we regrouped. The pressure in my bottom was growing during the contractions. It felt like a coconut had come down a station. Maria placed acupuncture needles on the same spots Jamie had been applying pressure to on my body. We started this routine after Car’s wedding. We learned about these points in our Yoga and Massage for Labor class we took with the Marbles at the Mindful Body. I drank an herbal tincture every 15 minutes for just over an hour while I had the needles in my body. I continued my circuit but detoured from the kitchen, as it was difficult to get one leg up on a chair while standing!

I decided to take a shower and try to pee before Maria took the needles out. I drank a lot of grapefruit juice diluted with water, water, and nuun electrolyte drink. I was definitely hydrated and peeing was becoming increasingly difficult. That morning before the walk, I had discovered the only way my body was going to urinate was to stand or squat in the shower with the water running.

Maria took the needles out and I exclaimed that I wanted to go for a walk! I think this surprised everyone. We went a different route and brought Eddy with us. I have never...walked...so....slow....in.....my.....life, but I was happy to be outside. Eddy would wedge himself in between Jamie and I when I would have a contraction. My water had not broken yet and I started to ask questions. “So I heard that some women experience a slow trickle over time, will I know when my water breaks?” Both Lu and Maria assured me that I would definitely know when my water broke. A “huge gush of warm liquid” was how I recall it being described to me.

* When we came home I looked in the mirror and was surprised to see that despite my crying Lu was right, my eyes were clear and bright. The sclera part of my eyes were milky white, they weren’t bloodshot at all!

Birthing Rhys by Loraine

2011-12-01T06:47:00.000-08:00

It began with an urge to visit the ocean. I had felt centered and “ready” throughout my pregnancy, yet all of the sudden at almost 39 weeks I was on pause.. Something inside me seemed to be waiting. It told my Mom I needed 3 more days to feel “ready”.. and that I really wanted to visit the ocean.

So that Saturday (October 8) my husband Magnus and I drove south from San Francisco towards Half Moon Bay. The first moments of the ocean came into view, (around Noon), I felt my first contraction.. though I wasn’t 100% sure that’s what it was yet: A light cramping in my belly and some back aches. We had a quiet romantic lunch at an oceanside restaurant.. and at one point I wondered to myself if this could be my last meal before I gave birth. I was 39 weeks and one day along.. I knew it could be any moment, or weeks of waiting, and I let the thought go.

We walked along the ocean at Dune Beach and sat for a while.. and while I was aware of the small surges happening within me.. I was more tuned into the big surges of waves and wind around me. It felt good to be near to something enormous- much bigger than myself & natural, powerful, rhythmic, mysterious, as I prepared for the power of what was ahead. On the walk back I began to feel tired.. and suddenly it felt like it was too far to walk to get back to the car. So I leaned a little on Magnus and we practiced a labor essential: forgetting about the distance ahead, just taking it one step at a time, relaxing and breathing through it. In fact, labor had begun. We were entering the tunnel.

We took it easy that night and I went to bed early, though I couldn’t sleep much as the cramping and back ache persisted in small, intermittent waves. I still didn’t know how early this early labor was, so I tried to rest as much as possible and wait for things to get strong and regular before calling our midwife Maria. I watched the sun come up on Sunday October 9th awake in a different way. I knew for sure then that I was in labor. The surges were still short but more regular and we began tracking them periodically. We called Maria at 8:15am, when the surges were regular enough to be reliable- at that point they were 30-45 seconds long and about 5 minutes apart. Maria told us to keep doing the things we were doing and call her when the surges were consistently a minute long or more and 3-4 minutes apart. I had the urge to eat something, to shower and to take a walk.. and Maria thought all those things would be good to do.

A shower felt good, especially good knowing that labor had begun and that I would “soon” meet my baby. It was a beautiful sunny San Francisco day and our apartment filled with sunshine as I did pelvic rocks and moved through the surges in different positions, feeling my way through. I felt so positive and connected to my husband and in awe of my baby and my body. I tuned into earthy soulful music, like Ladysmith Black Mombazo. I wasn’t thinking about time, other than checking in to see how the progress of the surges were coming along. (It really helped to know, because I couldn’t gauge well how long they were. A surge that felt like 20 seconds could be a minute, and the time between felt shorter than it was). I was glad to have Magnus tracking enough to check in with.. so I could know we were making progress.

Around 3pm, Maria arrived. By the time she showed up I was within myself and really feeling the power of the surges, breathing deeply through them and making low sounds when I needed to work through. I threw up once before she got there. She took my blood pressure, which was a little high and asked me, how do you feel?, and while I could tell by her face we were earlier in labor than I had thought we were.. I replied truthfully: “I feel rocked.” Maria checked me and my cervix was no more than 1 cm open, which she helped along to 2 cm. It was the first of many times that night I could not believe we were not farther along on the path, based on how I felt. The beach lesson came back to me.. Don’t worry about the distance.. just keep taking the steps. Maria told me to relax my shoulders, relax my face, and let my body do the work. This simple instruction was easier said than done: My mind and body struggled a bit to get in synch at this point, as I tried to find an inner foothold to manage the next level of surges. My blood pressure was higher than we wanted at this point.. so Maria had me lay down on my side with Magnus beside me to help me relax. We switched the music to calm meditation (it stayed on that channel for the rest of the birth!) and Maria went to get herbs. While she was gone I took another shower and gathered myself- I came out of the shower calmer and more centered and confident that I could manage whatever was ahead. My blood pressure came down.

The next hours became more intense and harder to remember in sequence. I was living in the moment trying to learn from one surge to the next what would help me manage the powerful forces rushing through my body (physically, mentally) and how to sustain energy between them. Sometimes it helped to be on hands and knees.. and sometimes it was agony. Sometimes it helped to have my husband rub my back or speak to me, sometimes I needed total quiet to find my way through.

Finally Maria said I could get into the birthing tub. I was encouraged, because I knew that getting into the tub too early in labor can slow it down. That must mean we were making progress. The tub felt good, and I could move easier and relax better between surges. I was also able to find positions leaning against Magnus that worked better than out of the tub..and if I needed to adjust mid-surge it was less painful to do so. I labored for a long time in the tub, it felt like. Maria asked me if I was having the urge to push (from my body, not my mind) during any of my surges.. Once I felt that she would check my dilation. A while later I thought I was having this “bearing down”/pushing feeling.. It felt like I was getting close to meeting my baby. I was moaning and om-ing through most surges and feeling pushed to my limits. However when Maria checked me at around 9pm Magnus and I were both shocked and discouraged to find out I was only 4 centimeters dilated. I couldn’t believe it. Especially when Maria then said it could take 1-2 hours for each of the remaining 6 centimeters and to try to stay calm and keep breathing well. Something in me resisted: This baby HAD to come sooner than that... I could not imagine birthing like this for 6-12 more hours! Something again had to shift, and in that moment, I asked for guidance. I said, “I know I can do this but I don’t know HOW I will do this.” Maria reminded me that I didn’t have to know how to birth my baby out, my body knew how to do it. And she gave me a couple of things to focus on to get out of my own way: “All you have to do is breathe. Keep breathing your baby down” and “between surges go deep- let go completely and take deep rest- don’t think about anything.” She also said I could move or make noise however I needed to move through each surge.. which liberated me to tune into my body even deeper and let go of any remaining inhibitions. Two hours later, I felt a definite urge to push. “Pushing! Pushing!” I said in a low moan. Maria checked my dilation in the tub and was surprised to find me at 10 centimeters! I had gained the remaining 6 centimeters in only 2 hours. Pushing time had arrived and Maria went off to call the second midwife to come help birth our baby. Somewhere in the distance between huge surges I heard something like “we have a speedy mama here who is ready to birth her baby. I think you should come right away.”

I tried pushing on hands and knees in the tub- I had always intended to birth my son in the water.. But when the time came it didn’t feel right. So I got out of the tub and Maria and Nile, our second midwife, helped me onto the birthing stool. I thought we were moments away from meeting him, and I was ready! However, pushing was more slow, patient, hard work, just like the rest of labor. I had been present for my 3 younger sisters’ births.. but most conscious for the last two, who seemed to “slip right out” during pushing. I didn’t realize that a normal first timer can push for about 2 hours. With my husband supporting me from behind and the midwives in front of me, I pushed. I thought about opening wide. I thought about breathing my baby down. I knew I was making progress but it felt slow and my energy didn’t seem to match the enormous task of getting him out. I wondered again.. HOW can I do this? Again, Maria told me to trust that my body knew what to do.. to just stay focused on my breath and each individual surge/push. So I went deep inside, closed my eyes, and kept pushing. We tried this for a while on the birthing stool, then on hands and knees getting onto the bed, then sidelying (which I immediately knew would not work for me) and then finally sitting on the bed with Magnus supporting me from behind. Maria told me to hold my knees up and curl forward as I pushed. Somehow this was not working well and I was really getting exhausted. So Maria suggested maybe I walk around the apartment and get some energy to try pushing again. Again- something in me strongly resisted this idea: I knew we were closer than it seemed. And I wanted to use my energy for pushing, not walking. So I pressed my feet into the bed and just started to push.. and push.. and push. I heard encouraging words from Maria and Nile in the distance, and felt my husband’s energy and love, but I was someplace deeper, pushing my baby through me. And then: I felt his head emerge, pushed and felt his body slip out of me... and felt the joy rushing through my husband as he saw our child for the first time. I was so shocked in my own body, I felt these sensations first through him. And then there he was.. our beautiful boy was placed on my belly for the first time, and the umbilical cord was cut right away so he could be moved up to my chest. He cried and my whole body shook and melted at the feeling of him being right there in front of me. I didn’t know HOW I did it really.. All I knew was that I was his mother, that we were finally together after so much waiting, and that the love for him was infinite.

Our little Rhys Henry is such a miracle.. and his birth at home, with my husband by my side at every step, birthed in our bed with no drugs or machines and with deep persistence and love is such a miraculous gift- a strong beginning for a wonderful life together. I am simply in awe...and indeed, rocked.

~Loraine

Rhys was born on Monday October 10, 2011 at 12:59AM at home in San Francisco, CA, 37 hours after the first contraction, and after ~12 hours active labor. He weighed 7lbs 14oz and was 20in. long.

I Trusted Myself by Chelsea Torres

2011-11-06T20:55:00.000-08:00

Believe it or not my labor began at Ikea in Emeryville. I had spent the prior two weeks wanting desperately to go into labor, and had become obsessive and a bit down about the waiting period. But that morning I woke up feeling bright, if not a bit humble, acknowledging that at just 39 weeks, it wasn’t up to me when it would happen. I wanted to get out of town with my 2 boys, at 2 and almost 4 they also needed an adventure to get through the day. I had a nesting urge and so the adventure was Ikea: picture frames, plants, and shelves, here we come! It felt great to walk and let the boys run through the showroom, and at some point while testing beds we didn’t plan to purchase, I felt the first sharp cramping sensation. I stayed calm, remembering it could mean another week as easy as it could mean today. So I casually checked the time and moved onto the café. 15 minutes, another one. 12:30pm. Still, I was calm. On to curtains and frames, another one. On to plants and checkout, another one. Every 15 minutes, sharp cramping, but totally manageable. I just relaxed, took a breath, knowing it wouldn’t last more than a minute or two. I could manage anything for a minute, right? Back to the car. As we are driving out the boys notice the railroad tracks. Please can we watch for a train? I didn’t know if they came sparsely or frequently, but everything felt a little magical and so, Yes. Yes, we will wait for a train to go by. First another contraction, then I hear the train, I think I am as excited as they are! We all watch as it speeds by, right in front of our eyes. I feel very connected to them, like we are all sharing the same feeling together. In this euphoria we head home, the contractions are shifting between 10 and 15 minutes. At home the nesting begins: framing photos, cleaning, hanging shelves, and then at 7-8 minutes apart, I call my husband. It’s 4:30. I give the midwife a heads up, but I don’t want to get ahead of myself. Sure I need to pause when the rushes come, but they are not dominating me, yet. Paul gets home and I decide we need to go to the grocery store. I want the house well stocked for the birth and beyond. On the drive I get a call from an old dear friend I haven’t spoken to in months. She is a apprentice midwife and she is pregnant! I tell her I’m in labor and we both giggle at the coincidence of her call. She gives me her blessings for a beautiful and safe birth and we say goodbye. In the grocery store, who do we run into but our midwife, Maria! What a surprise, and another lovely serendipitous moment. We agree we should all head home to eat dinner and catch up afterward. We get home and call our close friend, Dave, to watch our boys. Now, at 5-6 minutes apart, I am wanting to hold out until our children are sound asleep. I get into a warm bath and munch on celery and crackers. I turn out the lights and the boys come in to tell me they are getting things ready for the baby. I realize I need my husband and ask that Dave put the children to sleep. This is a leap of faith because we are the only ones who had ever put them to sleep, but magically, without a single cry, they fall asleep. I lay in our bed, lights out, some candles burning, as my husband massages my back. We laugh at the moment: candles, massage, nudity, and it makes us giggle that labor could seem so romantic! Now, at 3-4 minutes apart, I ask Paul to call Maria. She arrives just as a thick fog rolls in. She checks me, I have a feeling I’m 3 centimeters. I’m right. I don’t feel discouraged, I know things will move quickly now. Dave sets up the labor tub and I get in. From there I just follow my instincts. I stay loose, I stop timing contractions, I stop looking at the time at all. I simply remember, stay loose, you can handle anything for a minute or two. And that’s all I focus on, just the moment at hand. From the outside my path seemed a little aimless. I meander: first to the tub. Then on to the floor. Then to the couch. Down the hallway. Stopping at each spot for a contraction. To the bathroom, to the bedroom. 5 centimeters. From here I’m not sure what happened. I wasn’t afraid, and I trusted myself. I could feel her moving down, I felt at every moment I knew exactly where she was. Then I wanted to push. Everyone said that sounded like a great idea. I thought so too. Dave has a solid frame so I asked if I could hold onto him while I pushed. What are friends for? And like this, with a couple pushes, out came our beautiful baby. Her cry sounded so sweet, like a little song. We actually didn’t know she was a girl yet. We didn’t check right away. We just savored the moment that this beautiful, whole being had been born. What’s more is she was born at 12:45 a.m. on September 21^st, which happened to be her brother’s 4^th birthday! The name came to us immediately: Francesca Olga Margaret. Yes. That’s it!

Full Moon Baby by Audrey Haller

2011-11-03T21:37:00.001-07:00

Marcello was born on a full moon, ten days before he was due. I started having very cramp-y Braxton Hicks contractions around 3am. My partner Josh heard me fussing and woke up around 4am. I still didn't think it was labor but josh thought it might be, I was convinced the baby would be late because I had read that so many first time mothers are late. As the feelings continued and intensified I realized Josh was right, this was labor. We stayed in bed till it got to intense to just lie still. I walked around the room some and went to the bathroom, but mostly rocked back and forth on my knees at the foot of the bed, my arms around Josh's waist, leaning my head on his chest during contractions and in between resting my head on his thigh. We moaned low together and labored together. I tried to relax into the contractions, to let them open me as fast as possible, to bring me my baby, to surrender to what was happening at every second as much as I could. I also kept thinking, "my body knows how to do this, let it happen. I am going to get huge, sooo big, open right up so my baby can come out easy."

Josh called Maria around 6am to tell her we were in labour, she said things sounded good, call back when it gets further along. Josh and I moved back and forth from the floor to the foot of the bed, changing positions between contractions. When things got a little more intense, Josh called my mom, and we asked her to come over. Thinking she'd have a full day of hanging around during labor, my mom packed a bag with clothes book which it turned out she never needed... it's a bit of a joke now. Upon arriving she came right in to our bedroom and joined us on the floor rocking and moaning, massaged my back and legs, put socks on my feet and a heating pad on my lower back. Around this time Josh realized that we never got the final birth tub / sink hose connection so as to be able to fill our tub. So, we dutifully sent my dad on an early morning hardware store run. By the time he arrived with the connection and filled the tub I was fully dilated.

My contractions intensified quickly: between each I threw up a little until there was nothing left to throw up. I remember thinking, "I don't think I can do this for nineteen hours." I thought I would have a long labor because so many first time mothers do. That was certainly not the case for me! We decided we should call maria again---by now my contractions were four minutes apart, two back to back---and she said she would be right over. When Maria arrived I was deeply involved in laboring, my whole world was laboring. I could tell things were going on but it didn't really matter: only laboring mattered. You hear women report that birth felt like they were in another world, or high, but to me it felt like I was extremely here, very of this world, of this moment, like an animal. I was here on this earth to do one thing: get this baby out! Like a wave passing through me, a tsunami, it seemed unstoppable, the only thing to do was to surrender and ride the wave.

My mother always said to me that the body in labor won't give you more then you can handle. It was true---the pain got intense but it was never more then I could handle. While pregnant I read a lot of birth stories and thought a lot about my paternal grandmother, who, back in Ireland, had seven children, all home births. "If she could do it seven times," I thought, "I can do it once!"

As soon as Maria checked me she said I was fully dilated and if I wanted to, I could push. I didn't know what I wanted. I got in the tub for a while, which was very relaxing, yet still I had a limited desire to push. After one intense pushing effort Maria said, "That's great pushing! Now next time try to do it twice as hard for three times as long!" I remember thinking, "Is she crazy?! that's impossible!" But I tried. I tried pushing on the birthing stool. I tried pushing laying down on my side, which I hated. I yelled out, "I have to move!" Josh suggested we get back to our original position at the foot of the bed. That sounded right. Then I knew I was ready to Get This Thing Out!! I got loud and the pushing got serious! The baby began to crown, which was intense, it hurt, I could feel it stretching. Maria asked if I could wait and let it stretch, which I did, and was really glad about later: I didn't have any tearing or have to get stitches.

At 1:41PM, eleven or so hours after waking, Marcello was born at the foot of our bed, into his fathers hand's, a slippery little being from another world! I was on my knees, elbows on the bed; Josh caught him from between my legs and passed him through my legs up to my chest. I remember Josh calling out, so excited, "It's a boy!!"

Our baby was here! We both, baby and I, had worked hard to get him out, we were tired and I was hungry. Maria weighed and tested Marcello, made sure that I was all good, and then Marcello, Josh and I snuggled into bed altogether, a little family for the first time.

Reflecting on my home birth, two aspects seem most special to me: the intimate beginning stages of laboring with my partner Josh; and with Marcello finally in my arms, being able to lie in bed, the three of us enjoying the afterglow.

Homebirth in the News!

2011-10-06T21:53:00.001-07:00

Check it out! Homebirth in the news: HERE.

Back to San Francisco Births: Mila Arrives!

2011-08-30T12:53:00.000-07:00

I absolutely loved being pregnant. I have never felt so beautiful. Feeling my baby dance inside of me was one of the most incredible experiences of my life.
I felt so blessed to have the support of such an incredible community. Midwives, doulas, Waldorf teachers, yoga teachers, open minded friends...
all surrounding me with encouragement, faith, and priceless advice. But, no one is able to tell you what your birth experience will be like. Not even guess.
But, it seemed that everyone around me was experiencing 3 day labors and was at least a week overdue. Cesar and I were prepared for the long haul.
I was due on the 4th of July. The anniversary of our first date, five years earlier. The night of July 2, I was glowing:) I felt so full of energy and spent the evening with a close friend. We were making plans to go to the farmer's market early the next morning. I came home and fell asleep.
At 5:30 a.m., the feeling of warm tea being poured between my thighs woke me up. The water just kept flowing. I did not move, but whispered to Cesar, "Love, I need a towel." He seemed completely confused by my request. I think he thought I was dreaming. "Really, Love, there is a lot of water coming out!"
"OH!" I put the towel between my legs and waddled to the bathroom. I sat on the toilet and listened to the dripping of the fluid. After a minute or so, I checked the color and smell. Seemed fine. I could hear the voices of both Maria and my doula, Jamae, telling me to go back to sleep.
I snuggled up to Cesar but could not stop giggling. The water was still dribbling and I was wide awake. Cesar had to leave for work at 6:15 a.m. We knew that he had two weeks paid off when the baby arrived, but figured that nothing would really happen until the evening. We decided that he would go and I would call if I needed him.
I kissed him goodbye and began to strip the bed. I felt happy, calm, and excited to prepare the house for my sweet baby.
I started down to the laundry room and suddenly had to grip the railing. Whoa. I have never even experienced a menstrual cramp,so this was fascinating.
The contraction lasted about 30 seconds, so I assumed an hour or so would pass before the next one arrived. I put the sheets into the washer and began pouring in the soap when another contraction came. I remember saying to myself, Maybe they are just cramps because so much water came out. Uh, yeah, it's called labor. Haha.
I made it back up the steps and called Maria to let her know things had started. It was only 6:30 a.m. so I decided to wait to call Jamae. I went back to my household chores, pausing about every 7 minutes to meet a new contraction. By 7:30 a.m. I called Jamae and told her how the morning had gone. She seemed a bit in disbelief and told me she would come make us breakfast and take a look at me. When she arrived I was trying to get the attachment for the hose onto the kitchen sink but the intense pain in my lower back had control over the skill of my fingers. I kept dropping it in the sink and was getting frustrated. Jamae was laughing, politely, at me and told me to back away from the sink and come into the living room to relax. By this point my back was killing me. It was as if the contractions lived there and every few minutes would vibrate around my lower torso and meet at my navel. All of the advice we were given in our birthing class seemed irrelevant. I wanted to let go. I wanted to practice my release and meditation skills. I did not remember anyone talking about back labor.
By 8:30 a.m. Jamae was paging Maria and calling Cesar. Without noticing, I had lost myself. Even writing this, my memory is foggy. I remember Jamae saying, "Wow, I think this baby is coming before lunch. I have to make some phone calls!" I was trying everything to escape my back. The birthing ball, the chair, the bed, the couch, walking, leaning...nothing helped. I was crawling along the floor watching her fill up every large pot in my kitchen with water and place them on the stove to boil.
"Don't worry," she said, "you will be able to get in the tub really soon!" I was confused. "I thought I could not get in until the end?"
She looked at me with wide open eyes, "This is the end! You sped through the beginning and the middle!"
I am not sure how much time passed as I wandered the house in attempt to find a comfortable tone in which to moan. I always assumed I would be too embarrassed to make any noise. But, the low OM vibration was the only thing that gave any relief.
I had reminded myself every day while I was pregnant not to fight the pain. Surprisingly, it worked. Every part of me wanted to give in to it. The hardest part was dealing with my physical existence. How do I explain that? I wanted to fall completely into the pain and let it bring my child to me. But, I had to stay conscious enough to work with my body and place myself into different positions. One thing that I realized later, must have helped so much, was that I was rarely asked any questions. I was never forced up into my mind, but allowed to stay in my meditative state.
When I was finally allowed to lie down into the 100 degree water, it felt like heaven. Now I know why they call it the midwives' epidural.
It was not only the heat in my back, but the buoyancy of my body and sides of the tub embracing me. I felt safe and held.
I was not aware, but Maria was at the hospital at another birth and was worried she may not make it on time. So, she asked Sue to come right away.
I remember feeling someone's presence and opening my eyes to see her looking at me with a sweet smile. She simply said, "Hi Christina, it is so good to see you like this."
She checked the baby's heart rate and assured me that I was doing great. She added such a lovely energy to our space.
Another mystery amount of time passed as I floated and moaned to cooperate with the work of my body.
The next thing I know, Maria is there asking me to turn around so she can check me. As soon as I looked at her and felt her touch me, a deeper part of me was able to relax. It was not that I was waiting for her, but remember thinking, now that she is here, everything will be fine;) She has an incredible inner strength and way of making you feel completely safe and supported.
I was fully open with just a bit of a swollen cervical lip. She moved it aside and the baby's head slipped passed. Moving right along.
Cesar told me later that he had never ridden his bike so hard. It usually takes him an hour to get home and I think he made it in 40 minutes.
Hmmm... I never asked him why he did not take a cab!;)
Because all of the windows were open, when he arrived he could hear me moaning loudly. It scared him a little and he ran inside to see everyone here and a ton of supplies and emergency equipment. He thought something had terribly gone wrong and just stood there in shock.
Maria smiled at him and asked him if he wanted to jump in. He changed his clothes, got in the tub, and began rubbing me in a way that was never taught.
Instincts are a beautiful thing. He said it took him a few minutes to not feel completely worthless. I was sweating, moaning, and pushing so hard and he just wanted to help me. At some point I voiced my urge to go number 2 and Maria suggested that I come out and sit on the birthing stool.
When I opened my eyes and looked at that hard wooden stool covered with pads, it looked so scary. Not one part of me wanted to leave the tub.
But, I figured it was not purely for her entertainment and so I did. My body felt so heavy and the pain so intense. I do not think I lasted very long before tipping forward onto my hands and knees. My urge to use the restroom increased and I asked to sit on the toilet. The second I landed on the seat I had my "best" contraction. Every tiny muscle I was holding released at that point. I could feel the baby coming down. I was squeezing the life out of my husband and telling him to get me back into the tub. The walk seemed like miles. But, I was so relieved to be back in the water.
After pushing for a while longer, I asked Maria, "Where is she??" "Reach in and find out.:)" she said. I put my fingers inside myself and I could feel her tiny head and tons of hair!
Everyone kept reminding me that I was doing great and that the baby was moving down with each contraction. Her heart continued to beat at a healthy rate and she was working hard with me. I think I pushed for another 20 minutes when I heard Cesar say, "I can see her head!" When she began to crown I could feel the ring of fire that everyone warned me about. For a couple of my friends, this was the worst part of labor. For me, it was a welcomed distraction from the excruciating pain in my back. It was 11:30 a.m. when I was suddenly handed my baby. I cannot explain at all what it felt like for her body to come out. I truly feel like I was drugged. Nature is brilliant that way. I am sure if I could remember, I would never have another baby;)
But, I remember distinctly the second I held her and saw her face for the first time.
This was profound for many reasons. Throughout my pregnancy, some part of my ego held onto this fantasy that the moment I looked into her eyes, I would see a part of myself. That I would recognize her as "mine".
This could not be further from the truth. I held this precious being in my hands, and realized she was not mine. She is a child of God and it is my responsibility to help her on her own destiny. I am so blessed to have been chosen by her and I remind myself of that every day.

Leaving Haiti

2011-08-19T16:09:00.000-07:00

Even our exit from Haiti proved to be a metaphor and a challenge. When we had arrived 2 weeks prior, I knew that one of our most challenging moments of the whole trip would be getting out of the airport with all of our baggage and wits intact. Last year, gratefully, Sister Mary from Matthew 25 House, met us at the immediate exit from baggage claim. Calm and seasoned, she greeted us and led us through the maze of porters to our van. Even with our “chosen” porters, there was still jostling and arguing as others tried to get a piece of the action. This year, Sister Mary was not there to greet us at the gate. Courtney, Susan, Dina and I were in our most unwieldy moments — Courtney had 3 large duffels plus her personal items, the rest of us had 2 plus carry ones. At least we had 2 carts to carry the mother load.

Since Sister Mary wasn’t there, I implored the group to stay together and to stay put. I went further down the exit way and looked for our ride there. No one with the Matthew House sign was about. I went back to where everyone was waiting and we decided to make our way down to a waiting area that was underneath an awning. Of course, the porters followed suit and wanted to help us every step of the way. I didn’t want to engage them just yet because our ride wasn’t even there yet. Of course, now everyone said they knew Sister Mary and Ricardo, the driver. Most of this was just a rouse to get us to pick them as our porters. Annoyed by the constant pestering, I finally gave in to one of the porters who insisted that he knew where Ricardo might be and that we could wait there. Again, I told my group to wait while I investigated. I was highly suspicious about this “VIP” parking lot that this man was talking about.

As suspected, the porter led me over to a secluded parking lot that did not contain the Matthew 25 house van. Instead, I recognized it as the place where, last year, a group of men surrounded one of our volunteers and stole her iPhone. There was no security here, so it is a perfect place for a heist to an unsuspecting visitor. I told the porter thanks, but no thanks and made my way back to the shaded waiting area. I would know our guy when he arrived. Thirty minutes later, we were safely on our way to Matthew House.

Leaving Haiti proved to be an even greater challenge. Last year we went on American, simply waiting on line with the rest of the travelers to check in and go through customs. This year we were at the other gate.

Haiti’s airport is small by any standards. It does not have terminals. It simply has two entrance ways: one for American Airlines, and the other for all other international flights. An even smaller airport down the road services in-country flights on 6-seaters and small prop planes. The international airport, named after an ex-slave, army commander who led the country’s fight for independence, is frenetic at best during midday when most planes take off. We arrived with 4 and half hours to spare (little did we know that we would need every minute of that!). Porters again were vying for the few dollars they would earn by carrying our bags. This time, the tease was that they would take us to a special line, “just for us”, ahead of all the chaos. Somehow I felt that this was unjust and metaphoric. Don’t the rich always do that? With the power of money, we literally step over those at the bottom, those without means, and give ourselves the best ride. I was happy to patiently wait with the Haitians on line; we had 4 hours, after all.

But it wasn’t really a line. It was a cramming of people up against a door, that wasn’t open yet. No one was moving, just waiting. Even those on the “VIP line” were just waiting like the rest of us. It was hot. Dina and I had a lesser load than on arrival, but we still had our wheeled luggage, plus my jump bag, back pack, Dina’s Timbuktu bag and her heavy camera backpack that held thousands of dollars worth of video equipment. We had to keep an eye on it all, carefully holding onto our spot in the throng. It took an hour before they even opened the door and started to let people in. It was the worst of bottlenecks. 6 or 7 porters at a time, trying to make good on their promises to get people in first, the “secondary” line trying to cram it’s way in through at the same time. Literally around 300 people trying to make their way through one small doorway, and don’t forget their luggage. As you can imagine, we moved by inches. When we finally got to the ramp that led up to the door, we were boxed in by people. Tensions were high and shouting matches erupted more than once. I didn’t feel anxious, just curious to witness this glaring example of disorganization, a metaphor for life in Haiti. No one wanted to be last. Everyone was in a me-first, dog-eat-dog frenzy to get what was rightfully theirs. The line was moving, even at a snail’s pace. We still had 3 hours.

Once we were at the top of the ramp, I thought the pressure would ease as we entered the airport lobby. For a moment, we had breathing room as we all made our way down a ramp to the first x-ray security check. All of our bags had to go through and I am quite sure that they did not do a thorough job. I was only concerned about getting to the other side and collecting our bags before the masses enveloped us again. On the other side of the security check, the wall of people was immense and still. It seemed that no one was moving. It was unclear exactly what to do, but I figured that if we followed the crowd, we would get to where we needed to be. We were travelling to St. Maarten on an airline called Insel Air and we had met a few people on the line that were doing the same. I figured that if I kept one eye on these few markers, I would know where to go.

At one point we found ourselves waiting in the middle of the sea of people that now completely filled the airport lobby. Again we inched our way forward, trying to keep our spot in the “line.” Dried mango slices and one water bottle sustained us for the hours of waiting and inching. We were passed by a number of American Christian groups with slogans like, “Puttin’ Feet to Faith” and Rock Solid Church. They wore the tell-tale dusty sandals of mission work in Haiti. A college group from the University of Pittsburg had done the same. All were headed back home on the Delta flight. All had paid their way to the head of the line.

At this point, an airline agent said to everyone on the right, “Insel Air,” and pointed to the left. So now everyone on the right had to cram their way through to the other side.

It was almost 2 hours later before we reached the check-in counter. But an even more curious thing had happened. By the time, we reached the counter, Dina and I were almost exactly at the end of the line. How had all those people passed us? I had always seen us in the middle of the pack, jammed fore and aft with someone else’s suitcase. It was fascinating. I also realized that it had really been no big deal. We were going to get through with time to spare. Dina noticed that the man at the very end of the line was trying to cut in front of us. Would it really make a difference if he made it in front of us now? With great effort, he snuck his luggage up to the counter in front of us, causing an argument with the meager security guard. It was that important for him not to be last. I told the guard in Kreyol, “N’ap prale.” We are all leaving. “Pa gen pwoblem.” Leave it, it is not a problem.

After passing through Customs, there were roped queues and plenty of space. The fight was over. The same group of people who moments ago were clawing for position melted into a calm group of civilized travelers.

We had half an hour to spare.

The fight for the bottom is something that is demonstrated wherever human stratification exists. Who is first? Who is last? Who is the richest? Who is the poorest? No one wants to be the bottom. It is demonstrated with midwifery politics: CNMs versus CPMs versus “lay midwives;” gang fighting: Asian vs. Black vs. Latino; abusive households where the man beats the woman, the woman abuses the child, the child kicks the dog. In Haiti, there is a desperation to not be at the bottom of every heap, already having claimed that spot in the Western hemisphere for such inglorious attributes as maternal mortality, infant mortality, literacy rates and poverty.

We all got on the plane. We all made it out of there. Most Haitians fly to St. Maarten for employment. We were perhaps 2 of only 5 white people on the plane, headed to an inconceivable resort island, too close to justify the disparity, too far to share the wealth. When Dina and I arrived at our timeshare on the island of St. Maarten, we were astounded by the beauty and opulence. We had dinner and went back to our room, cold, by the way, from air-conditioning and a ceiling fan. After two weeks of sleeping on the porch in a mosquito tent, Dina’s only comment was, “This pillow is ridiculous.” We settled underneath the down comforter, and didn’t wake up until 12 hours later.

Cholera: Up Close and Personal

2011-08-16T03:51:00.000-07:00

Our last night at San Therese was peacefully uneventful. We had two live births within a half hour of each other around 2am. The rest of the night Susan and I napped on a yoga mat or chatted, disturbed only once by the keening of a woman across the courtyard. I immediately recognized it as the signal that a loved one had died.

Friday was our last full day in Hinche. My day was crowded with last minute filming of Genette, the bright, young clinical professor at Midwives for Haiti; packing; stopping for one last time at the Ebenezer (the air-conditioned super market); making Grandma’s tomato sauce one more time on the open charcoal fire; going to Magdala’s for dinner at 4pm and figuring out how to carry the still warm sauce with Dina and I on the back of a moto bike; getting back from Magdala’s in time to meet Genette and my other Haitian midwife friend, Esther, at the Crystal Bar for one final farewell.

Within the folds of my busy final day, I was introduced to cholera. When we went up to the hospital to film Genette, we asked if we could observe the UNICEF cholera tents set up in front of the hospital. Twelve large, white tents were set up, each with a UNICEF stamp on the front. They were much more like circus tents than camping tents, having the neatness and formality of a well-heeled NGO. There was a triage tent as well as men’s, women’s and pediatrics. Most of the tents were empty or only partially occupied, which was a relief to the senses. Each tent had 8-10 stretchers lined up in two rows. Each stretcher had a hole in the center with a bucket underneath, carefully containing the vector of a deadly disease.

Most people did not seem in intense suffering. Many had IVs, but most were hovering about, biding their time for the disease to run its course. There was a fascinating container that was the encampment’s water supply, a 12 ft. by 12 ft. giant water balloon, used for bathing and drinking. A naked man on a stretcher was being carried away, perhaps after a needed rinsing off.

To leave the cholera area (the whole encampment is walled off with security at entrance and exit), you need to have your hands rinsed with water treated with bleach and step on a pad soaked with disinfectant to clean off the bottoms of your shoes. We had made our observation. No photos allowed. My obligation to witness the suffering of the Haitian people is fueled by my desire to comprehend the magnitude of the disparity that I wish to amend. I am constantly trying to evaluate whether we are making a difference.

Nilove

In the afternoon, I had an even closer look at the cholera epidemic. When we arrived at Magdala’s house for dinner, a very special invitation I might add, she said that she had to place an IV in a child up in the tents on her land. Of course, I offered to help and we all trekked over to the small plot of land that she had let the government use as a cholera encampment. There were only 4 tents, each labeled: triage, observation, transition, morgue. A small, dehydrated 3 year-old girl, dressed only in her underwear, was on her mom’s lap. She was sitting up and animated, but the two nurses who monitor the encampment had decided that her condition had gotten worse and that she now needed an IV. We set about to work, looking for the most accessible vein to place an IV. On a healthy three year old, this is always a challenge, tiny veins, a scared patient, few options. Working with Nilove proved to be no easier, her dehydration making it even harder to find a strong, plump vein to work with. We tried multiple times to insert the IV catheter, each time to the wailing and tears of our little patient. Her cries were eerily reminiscent of the laboring women, a uniquely Haitian song of pain and suffering. It was heartbreaking to understand what she was saying in Creole, “Mama, let’s go home, let’s go home.” We tried on her hand; we tried in the antecubital space. None were successful. I found a small toy in my pocket that I had figured could be given away at some point. Here was that point. The toy calmed Nilove for a few moments. We finally got a good stick in her hand but the sigh of relief was only momentary as the little girl jerked her hand away and the catheter pulled out. Both Magdala and I looked at each other in disbelief. Our only good stick was now worthless. We tried in her foot, the other antecubital, and the other hand. After 6 tries and running out of the smallest angiocaths that we needed, we gave in to our own failure.

Nilove would have to continue her oral hydration therapy and hope for the best. She would not die; she simply needed hydration support until the cholera passed, and isolation to help prevent the spread of the disease. The only other patient at Magdala’s encampment at this time was an older woman, in her 70s. She too was ambulating and would not die, simply biding her time. We rinsed our hands and stepped on the disenfectant pad. As I saw the iodine-colored water run up over my flip flops and onto my bare toes, I wondered how effective this ritual was.

It had taken us an hour to finally acquiesce to our lack of success. Magdala is an amazing midwife, giving of herself in areas where she should not be taken to task. She says they have seen over 50 people in her tents. We walked back to her house for an amazing Haitian feast of fried tilapia, beet salad, a green salad with fried goat, avocado, cornmeal cakes, a “lasagna” of sorts (layers of lasagna noodles separated by a ground meat) that went perfectly with Grandma’s tomato sauce, Haitian spicy coleslaw, spicy goat sauce with onions, fried plantains, a few fried potatoes, and black rice with dried mushrooms. It was a feast of appreciation and hope for our future working together. Magdala’s husband is a pastor and deeply religious, he asked me to say the prayer before the meal.

When a pastor asks you to say something, you speak: I prayed for the little girl up in the cholera tent, I prayed for the continued strength of Magdala and her family to offer safe haven for the poor and the sick. I prayed for Magdala’s continued work as a midwife, to reach the pregnant women in the villages and bring them a better birth experience. I prayed for strength for us all and for hope, for our continued working together, each year, to create a better world.

The Candor of Death

2011-08-11T11:56:00.000-07:00

Last night we were met at the door of San Therese hospital by the candor of Haiti’s infant mortality rate. We arrived around 7:30pm or so for our 11 hour shift. There was a woman in labor who, within moments, was pushing out her baby. The student midwives were not ready, and I scrambled to find supplies while the others delivered the baby. While gathering instruments we needed, I uncovered a crumpled chux on one of the delivery tables. I opened it up to see if it was usable and found a full term dead baby. In my hurry to deal with the delivery, I was unexpecting and vulnerable. It took me by surprise. But the midwives were working, business as usual. No one seemed very interested in the body. I asked the student midwife what we were going to do with the body. She didn’t have an articulate response. Finally someone, the night janitor, realized that we needed a box for the body. She ran and reappeared wth one. We placed the baby in the box and of course the question, then what? We needed to keep the baby here until morning until the janitor would dispose of it in the appropriate way.

This is life and death in the maternity ward. I would later learn from the day janitor that he buries 2, sometimes 3, stillborn babies a day. The math is too horrific to calculate. The midwives deal with this tragedy with calm and flat affect. They are unemotional. They seem disconnected from the possibility that this small body represents more than the products of an ill-conceived conception. This must be the callous of years of death’s relentless mocking. Even with the best of nights, there is the reminder that babies die here on far too regular a basis.

The precipitous birth of the live baby is finally under control and the baby is dressed and weighed. The live baby also is left on the scale for a long time without an attentive eye. I occasionally go over to check the baby and make sure that the quiet is from sleep and not death’s gnarly grip. The mother is dressed and readied to go into the postpartum room.

Another woman has come into the labor room with a referral from an outlying clinic. She is in labor. We have a hard time understanding the French translation of her referral note. Our interpreter insists that it says that the baby is lying up against the mother’s back, a simple posterior presentation. Susan is sure that she sees the French word for twins on the paper. It is all for naught because the student midwife cannot find the baby’s heart tones. Susan tries too and is unsuccessful. We are here to teach the student’s so I ask Marie Carmen, what does she think? What would she do now? What she thinks is best is to wait until the baby is born and to tell the mother then. I disagree, telling her that if her baby is dead, that we must prepare the mother as soon as we know. If the student has difficulty finding the heart tones, they should always ask the senior midwife for help. Marie Carmen and Susan tried one last time to find heartbeat, met again by the mocking silence of death. The staff midwives decided to send this woman on to Cange, to the Zamni Lasante hospital there. She had a ride , otherwise the transfer would not have been an option. We would not bear witness to her grief.

The second baby of the night was born precipitously in the antenatal room. A student ran out saying that the baby had been born. We all ran in to help and to see the baby that had been born so quickly. When we approached the bed, the baby was on the mother’s abdomen but not breathing. The baby remained quiet and limp, eyes wide, even with our immediate tactile stimulation. I asked for an ambu bag and one of the students ran back to the delivery room to get it. The hospital has no oxygen, so the resuscitation effort would simply consist of forcing room air into the baby. The ambu bag arrived and I quickly set to reviving the baby. Even though the baby’s heart rate remained strong, the baby did not perk up as I had expected. It was hard to say why this baby was having such a hard transition since no one had actually seen the birth take place. Had the baby inhaled amniotic fluid on the way out? Was there meconium? Was this baby infected? I continued bagging the baby for what seemed like a long time, repositioning the mask, the baby, asking for a better ambu bag. Long enough to begin contemplating next steps. There was no oxygen, no pediatricians, no NICU to fall back on. This baby would either live or die right here in front of us. I occasionally stopped the resuscitation effort to stimulate the baby again. We were beginning to see the barest of muscle tone and an occasional small cry. A stethoscope appeared and we were able to hear breath passing, though labored, through the baby’s lungs. The baby had classic signs of difficulty breathing: grunting, flaring, retractions.

Since the baby, a girl, was breathing on her own, we decided to stop the resuscitation. She was out of the danger zone but the next moments would reveal whether she could make it on her own. She remained stable by Haiti standards. In the US, this baby would have been immediately whisked away for resuscitation and continuous observation. The student midwives did a good job of helping out, but observed with an air of bearing witness as opposed to the heroic obligations that drove Susan and me to act. The baby settled quietly onto the mother’s chest and I told one of the students to check the baby closely for the next hour. She should check the heartbeat and respirations every 15 minutes, then check in with me after an hour. If anything changed, she should also let me know.

A quiet calm settled onto the Maternitè around midnight. I laid down on the cement floor outside of the ward on a yoga mat that Susan and I brought from the orphanage. I told Susan that I was too wired to sleep. She told me later that I was snoring within 15 minutes. I awoke sometime later to find a laboring woman sprawled on the floor across from me. She was on her back, heavy in labor, complaining that she was dying with each contraction. She was accompanied by a shadow sitting next to her, her mother I had assumed. When I heard the American accent of Susan’s creole, I realized that she had moved over to support this woman in her labor. As she sounded pushy, we moved her over to the labor ward. A fifth timer, with 2 living children, I was surprised that it was taking her so long to push. Susan suspected a posterior presentation because of the amount and location of the woman’s pain. She continued to often say that she was dying, which is disturbing in a country where that is a distinct possibility. Her baby was born, without event, bringing us to three live babies for the evening.

At 4am, the praying began. From the depths of the darkened antepartum room, we could here gospel singing and the sounds of a female pastor calling upon God and Jesus to remember them in their suffering. The singing was beautiful and eerie, wafting up from the depths of Haitian spirituality. All 10 women in the antepartum seemed to singing in unison, in harmony, interrupted by the intermittent wail of a contraction. I got up from the yoga mat and watched through the half open, Dutch door for a while. The pastor was walking up and down the aisle between the rows of beds, calling on Jesus in her supplication for redemption. The women were calm and peaceful, obviously knowing the lyrics from years of Haitian church-going.

As the light of day brightened the courtyard of the hospital, a small, old man shuffled in to begin his day’s work. He is the janitor. He emptied the trash barrels into his wheel barrel and picked up the bloodied, medical trash strewn about by the nocturnal scavenging dogs. I knew that this was the man who would dispose of our baby in the box on the labor room floor. I was determined to see this process.

Eddy, for that is his name, loaded the box up on top of the rest of the trash in his wheel barrel. I followed him out of the hospital, explaining that I just wanted to see what he did with the dead baby. He was patient and kind with me, perhaps I was the only “Blan” he had ever spoken to. He loaded up his pick ax and shovel onto the wheel barrel and I followed him out to the back of the hospital. We followed a small dirt trail to the area where he burned the trash every day. The piles of plastics and IV detritus was encircled by a lush grove of greenery and vines. Eddy parked his load and walked into the grove. He selected a spot and began to dig. I asked him if he did this everyday. Yes, there are 2, sometimes 3, every day. The pick ax was almost as big as him and he swung and swung until a small, rectangular grave had been dug. I helped him by bringing over the box with the dead baby. I asked him if he had children. He said only one— the other he had already buried. The current box that the baby was in was too large, so he found a smaller one amongst the rubble and placed the baby inside. I offered him my gloves since his had ripped. I was called away at this point, but felt content with my understanding of the process. The fertile soil of the lush grove entombed hundreds of dead babies each year.

I said goodbye to the woman in postpartum whose baby we had resuscitated. The baby was breathing perfectly now and the mother was all smiles. The ride home on the moto taxi was cool and breezy. I held on to Susan, saying that we had survived the night. Tonight we will be at the hospital again.

Poorest of the Poor

2011-08-10T06:31:00.000-07:00

Hinche is considered the sticks to all who reside in Port Au Prince. This is where the poor people live, out in the countryside. It is the 5^th largest city in Haiti, with 50,000 people, a hospital, bustling commerce, a central plaza, a large market on Wednesdays and Saturdays. The people here are poor. The hospital does not have running water nor 24/7 electricity. The Red Cross blood bank was temporarily shut down when their solar panels were stolen.

Hinche Market

At the orphanage, boys play soccer with torn, knee high soccer sox, no shoes. Some play without even that, kicking barefoot a soccer ball on the dry, dusty, rocky earth. The children here are orphans or have been left because their families were too poor to feed them.

The midwives are paid $1.50 an hour for work that saves peoples lives. A teacher can possibly get paid $3.25 an hour at the better schools. The midwives say that their pay is not enough. I ask them what they can do about that and there is not really an answer. I think they just live without enough. The unmarried midwives still live with their families. Midwives that are now working in Port Au Prince live communally to afford their living quarters. They say that everything in Port Au Prince is expensive.

We were invited by Gampson, a local boy, to visit his church. He told us that we were going to where the poor people live. A turn off of the main road, heading toward the river, told me that we were heading into the rougher part of town. There were less smiling faces calling out friendly greetings as we walked by. A young boy ran up to me and asked me to take his photo. I snapped the photo and was immediately reprimanded by an adult in the community. “Why are you taking his picture?” I told him that the boy had asked for the photo and his angry interchange came to an end. This is the ghetto, poorer than the Hinche poor, relegated to the river’s edge.

Women and children bathe themselves, their clothes, and pots and pans in the river. The river represents one of the town’s borders. Last year we were told that this was the only place that we should avoid. As we walked deeper into the ghetto, my hyper-awareness increased as the narrow dirt road wound its way closer and closer to the river. We stopped in front of a small tropical shack. This is their church—dirt floor, no electricity, a pastor that was outside to meet us. It seems that everyone’s father is a pastor here, so they don’t look very differently from the other men in town. Within the church, 8 benches, 4 per side, were lined up and filled with children. Dina asked what activity brought them all there this afternoon. The answer was us. It was hard for me to not think about the soccer games, jump rope, cards, chess, music and swing sets that the orphans had at their disposal at the Maison. The orphans weren’t so bad off after all.

Four plastic yard chairs were lined up against the front wall of the church. These were for us. We sat down and they clapped. Gampson’s mother appeared and soon Gampson was handing out the baby clothes that we had brought for them. He handed them out one by one and forced the women to pose with their babies and the new piece of clothing that they chose for their child. I felt badly that we only had baby clothes and nothing for the older children. I asked Gampson to he walk back with us to the orphanage later so I can give him a bag of piwilis (lollipops) for the kids.

Kids outside church

We are the curiosity and the hope and the problem. Gampson’s mother has been praying for someone like us to come along and take interest in their community. She wants us to come back and set up a health clinic for the people. We tell her that next year we will be coming back with the chiropractors and we can set up a clinic at their church. She feels that her prayers have been answered and she will pray for us all year until our return. A year is a long time to wait and a three-day fix is only a band-aid.

Gampson's church

With the mobile clinics, we travel to villages outside of Hinche where even poorer people live. They have minimal resources, sparse crops that can be brought to market in Hinche twice a week. Each Saturday, on the outskirts of Hinche, animal markets sell goats, cows, straw, saddles and rope. Crowds walk the sides of the roads and for a moment, I feel that this is what India must be like. This is the developing world, what Brother Harry calls the “fifth world,” where oxen pull wooden carts with bent axels, humans pull oversized wooden wheel barrels with unfathomable loads. More people than can be counted go without shoes, a change of clothes, enough food, clean water. At the mobile clinics, we see dehydrated children with fevers and skin rashes, old folks blinded by cataracts.

At the mobile clinic, the midwives charge 25 cents per visit. Some women don’t even have that. The midwives see close to 40 pregnant women at the busy clinics. At one impoverished village, a rare fight broke out perhaps a result of the heat and frustration of having to wait. One woman arrived topless to the clinic. As she was lying on the sheet-covered platform to have her prenatal exam, I thought her lack of clothing was just temporary. I later saw her speaking with the midwives, bare-breasted—the poorest of the poor. I wanted to give her the labor skirt that was donated by a mother from the US. On this particular day, however, tensions were high and the unfairness of giving to one and not all may have caused a riot.

The spectrum of poverty is multi-dimensional, flowing freely like the river. We observe from the river banks, sidelined, casting nets. If we can catch a few souls, even for an hour or a moment, we feel that we have done what we came to do. The river is endless and deep, such that the retrieval of a few makes an invisible difference.

It's 10pm in Hinche

2011-08-07T21:12:00.000-07:00

It is 10pm in Hinche and I am miserably hot. So hot that I can’t sleep. It’s probably not even 100 but the humidity is heavy and the air is still. The earlier thunder and lightning did not pan out to the rainstorm I had hoped would cool us down. The heat has chased us out of our rooms and onto the veranda to sleep. We, there’s four of us again, pulled out our mattresses and lined them up to be a little cooler. Dina and I use a mosquito tent but the other brave souls go without.

Courtney left a few days ago and is now safely home with her children, visions of the Azeal orphanage still swirling in her head. We have a nurse practitioner that joined our group yesterday, Jane Smith, from Virginia beach. Today, Sunday, was our day of rest. We hung around Maison Fortune, venturing out only to cross the way to see the girls or to cross the soccer field to our Kreyol lesson.

This morning I was enthralled with a young girl named Sofia. She had been assigned the job of making the chicken legs. The children here get meat once a week. Last year it was goat— they would bring in 2 goats every Saturday and that would feed 200 children. This year they have switched to chicken legs. 3 large boxes of frozen chicken legs from the Dominican Republic arrive every Saturday on the back of a motorcycle. On Sunday morning, they boil the chicken, then fry it. This is their Sunday midday meal. Sofia was frying the chicken, sweat beading up on her face. She wasn’t complaining, the heat from the charcoal fire obviously something she was well accustomed to.

Sofia

This evening I made my grandmother’s tomato sauce on the Haitian coals. I went over and called Sofia, asking her if she wanted to watch me cook since I had watched her cook this morning. Kennel, our fantastic 19 –year-old Kreyol teacher, helped me get the coals going. We used cans of tomato paste from the one air-conditioned market in town. The 14 oz. cans that we usually see at home with peeled or crushed tomatoes were filled to the brim with tomato paste. I made a large vat of sauce while the curious children looked on, laughing at how much tomato paste I was using. We also made hard boiled eggs and pasta. All of this was a welcomed change from the endless rice, peppered with beans, that has been our daily diet. Often we also have bean sauce, a soup-like liquid made from pinto beans but really much more water than beans. It is usually accompanied by another sauce with bits of beef or goat, onions, potatoes, sometimes a green.

Grandma’s tomato sauce Haiti-style was a complete success. I gave Sofia a small pot with the extra pasta and smothered it in tomato sauce. The children at the orphanage eat plain spaghetti here every morning, so tomorrow I am going to give the girls our extra sauce (of which there is plenty). They eat with their hands so I am not sure how it will go over, but I am sure that any change would be welcomed. I will be happy to see them get some Vitamin A and C, for once. We have wondering about how they are looking and seeming so healthy on a diet of spaghetti and rice and beans. Every day.

Tomorrow we go out on the Mobile Clinic again. We’ll meet the pink jeep in the morning along with the other midwives and students. A structured week lies ahead as we also follow the ebb and flow of visits from our new Haitian friends.

Snippets of Haiti

2011-08-07T11:33:00.000-07:00

Haitian Haircut: Monide is the best hairdresser! I have wanted to get my haircut since we arrived. Monide did a great job at her salon called, “Nice Change.” Certainly a nice change for me!

Boat ride on Magdala's man-made lake

Cholera tents

Cholera tents on Magdala’s property: We took a tour of Magdala’s incredible property where she lives. They are already running a school for 600 children. They want to build an orphanage, a guest house and maybe even a birth center with American help. Susan thinks that this is the answer to more humane birth here—Haitian-run, out of hospital birth centers. I am sure you will hear more about this. Magdala and her husband have allowed an acre of their land to be used for cholera tents. They have 7 patients living there.

Children at Gampson's church

Gampson’s church: Gampson is the young man that we met last year with his mother. They were both peddling their goods in front of Maison Fortune. I took a really nice picture of him and his mom, so this year I gave him the photos. They were thrilled and invited us to come down to see the children at their church. The church is a small, one room shack with benches for the small congregation. There were 4 chairs set up in the front. To our surprise, the chairs were for us. We shared with them some baby clothes and thanked them for sharing with us their beautiful country.

A visit from Marie Denise: Marie Denise, one of the midwife students from last year, showed up at Maison Fortune around lunch time. She brought us a liter of fresh cow’s milk, fresh eggs, mangos and corn from her farm. I was surprised and thrilled by her tokens of appreciation. We invited her to stay for lunch, chatting and sharing photos from last year.

Professor Kennel

Charles and Barry: Charles is a young man who teaches French, Spanish, English and Creole in the local high school. His uncle is building a high school called the Mahatma Gandhi School. We are meeting people everywhere we go. I now have two “Haitian sons” and many Haitian friends. Our Creole is getting better everyday, especially with the help of Kennel, a young man at the orphanage who gives us Creole classes almost everyday.

Tobacco lady

Tobacco lady and the Salt lady: My favorite ladies from the market last year were two women selling tobacco and salt. Of course we wanted to see them again, but the market has changed around some with the majority of the vendors now under a large pavilion. We walked around for a while and stopped to buy pineapples. While we were there, a woman said she could take us to where the tobacco sellers were. Before long, we found the tobacco lady who was thrilled to see us once we explained that we were here last year and gave her her photos. The salt lady was right behind her and we agreed to meet up next market day to chat with her.

A Birth at St. Therese

2011-08-06T05:07:00.000-07:00

(Days have been so packed that I fell asleep last night while writing this. All good in Haiti, “tout bagay anfom”. I’ll try to send shorter, more frequent updates this coming week.)

Wednesday night was our first overnight at San Therese. For Susan, this would be her first real introduction to birthing in the Hinche hospital. We are told that there is no running water (turns out no standing water either) in the hospital and now, there is no electricity at all. Because of that, there is no available operating room to do Cesarean sections. There would be a remote possibility to transport someone to Zanmi Lasante, Paul Farmer’s hospital in Cange, 45 minutes away if we needed. As the evening progressed, we would find out that the remoteness of that possibility means that only in the most dire of life and death circumstances would there be enough motivation to put all the pieces together for this type of transport. Here’s how the evening went:

When Susan and I arrived at the hospital, around 9pm, the antepartum room seemed full of women laboring. The antepartum room is a wide, open room with 10 beds, 5 on each side. The women labor here, sometimes with family, sometimes alone. The postpartum room looks similar, but there were only a few women there. A few days earlier, we met a woman in postpartum with a 27 week old premature baby. He was “wearing” normal sized newborn clothes that betrayed the size of his small body. Only his tiny head and legs foretold a story that this baby was probably not going to live. He was breathing well for now, and the mother and father were being counseled to take this baby to Cange, to go to Zanmi Lasante, where he would have the smallest chance of surviving. ZL has a “NICU” with 4 incubators, but that doesn’t mean that there is oxygen or the correct resources or personnel to care for an extremely premature child. The family said they would go and they were trying to find the money for the 45-minute ride. The nurse midwife was being summoned to break the news that this woman was also HIV positive.

That family was not there on Wednesday night. Only a few women were sleeping quietly in the dimly lit postpartum room. Some had newborn infants, more did not. In the delivery ward, which has 4 old, torn, and rusted gynecology tables for birthing, all was quiet for the moment. Susan and I took the opportunity to stock the cabinets with the supplies that we had carried on the moto taxi—the two of us on the back of a small motorcycle, loaded down with my jump bag and each hand full of a plastic bag with supplies. Susan is feeling more comfortable on the moto taxis if she sits in the middle. I love every minute of it, riding on the quiet streets in the otherwise pitch dark, a cool breeze relieving some of the heat of the day.

Through most of the night, we end up with only one person in the delivery room. Her labor is slow, finally reaching complete around midnight. She pushes for more than 2 hours with little progress and not very effective contractions. I check her around 2am and her cervix has closed down to 9cm around the baby’s head, a tight ring that is most likely the cause of the slow progress. We decided that it would probably be best to have her stop pushing for a while and wait until she was complete. We started a pit augmentation, which I hadn’t seen before, Haiti-style. A Pitocin augmentation in Haiti means that they put the Pitocin in a bag of Lactated Ringer’s and manually manipulate the drop rate until it is dripping at 1 drop every 5 seconds. Susan says that this is the way we did inductions and augmentations in the US in the 60’s and 70s.

Around 4am, we were concerned about signs of an obstructed labor. This mother still hadn’t delivered and her cervix had stalled. The Pitocin was turned off because at one point she had a long, continuous contraction. Her cervix was edematous and not complete. The staff midwife floated the idea that we transport this woman to Cange for pain meds and a possible C-section. When Susan and I started making phone calls to the in-country directors of Midwives for Haiti, no one was answering their phones. We finally called the driver, Ronel, directly, but he said that he would not drive because it was windy and rainy. It actually wasn’t raining, but the weather report was predicting a tropical storm within hours. Ronel wasn’t moving, he wouldn’t take us to Cange. This was certainly our darkest hour, having a mother who needed help, no possibility of Cesarean in Hinche, no one answering our telephone calls, a tropical storm coming, a driver who was unwilling to drive with superstitions around the impending storm. Susan and I sat back for a while, watching the now busy labor ward swirl around us, matching the energy of the intensifying storm winds gathering outside. A pregnant midwife was in one of the “rooms”, having her third baby. The woman in room 2 was keening in pain, finally settling into a dark corner on the floor all by herself. She needed doula support so I asked one of the midwifery students to support her by coaxing her out of the corner and rubbing her back. Another woman was suffering from the painful, spasmodic contractions of an incomplete miscarriage. We had gone from a fairly quiet and controlled space, with one woman in labor, to now all the rooms being full. I parsed out 1 student per laboring woman until the delivery area seemed in better control.

Back to our woman with the obstructed labor—to Susan and I, the idea of transport to a higher level facility seemed like the most natural and safest thing to do. Now we were left with the reality that that would not be possible. Would this baby die? Would this mother die after days of an ineffective process? Around 5am, I noticed that her “labor song”, as Susan calls it, had increased and she was really in a lot of pain. I went to her side and found that the student was no longer there. I spoke to her in Creole that we were trying to find a driver to bring her to Cange, that she might have a Cesarean there. Her wailing quieted down and she did not seem upset about this prospect. It seemed that she simply needed some companionship in her travail and some hope that it would be over soon. Truth be told, I didn’t know what was going to happen next. With the coming of daylight, would Ronel be willing to drive to Cange? Would anyone answer their phones? Would a dokte (doctor) magically appear from nowhere with the 8am shift? Were we really going to experience a tropical storm? I decided to give her one last check of her cervix. Lo and behold, she was COMPLETE!! Yay, some kind of change that we could work with. I found Susan and asked for her help, everyone else was sleeping now, but we were going to try to push again.

The midwifery students helped us with the pushing, and by 5:30am we were seeing a significant amount of the baby’s head, enough to give us hope that this baby was finally coming. We encourage and cajoled her in Creole as she pushed and pushed. The mother did a fantastic job and finally, at 5:59am, one minute before our shift was over, we had our first baby of the night—4300 grams! While doing the suturing, we heard the hearty cry of the midwife’s baby: 2 healthy babies, a successful night after all.

Susan and I soon packed up to meet our moto taxi for the ride home. The mom with the incomplete miscarriage had returned to the antepartum room and was now sleeping, having been given the only pain med that they had here. The mom with the doula was sleeping or walking about, her birthing slow but progressing. All was quiet and calm except for the bustle that would always come with daybreak.

Literally, right before we left, the staff midwife drew our attention to a stillborn baby on the counter. WHERE HAD THAT COME FROM?? Was it from one of the mother’s that we had initiated an induction on because their babies were no longer alive? Did someone new just walk in? I did not know. I only know that Haiti was sending us a clear message, “All is not well. “

Here are some photos from the last few days:

Manushka, orphan girl

Rachel, orphan girl, treating her for eye infection

Spaghetti for breakfast, everyday

Woman in the market

N'ap Kenbe!

2011-08-03T13:10:00.000-07:00

“N’ap kenbe”. We are holding. We are hanging in there, holding on. I feel that I have found one key into Haiti: communication. Last year Dina and I crash coursed ourselves through a couple of Pimsleur Creole CDs and used a free iPhone app for volunteers to Haiti to learn Creole. This year, Dina found HaitiHub, which is a Skype 2 week class with a wonderful speaker named Carlo. Dina took the class for 2 weeks and I listened in for a week before I left for NY. One of the most valuable things about the class was Carlo’s way of introducing us to sayings in Haitian Creole, which are many.

How are you? The simple act of greeting someone can set off a flurry of call and response answers that define village life. Pa pi mal, things are not worse. “Nou la”, we are here. “N’ap kenbe”, we are holding. “Tout bagay anfomm”, everything is “in form,” everything is good. “Jamn”, or “jamn jamn”, with each greeter’s fist coming together, means strong. We are here, strong, solid. A look into Haiti’s history of oppression, and their own liberation, directly reflects the pride and commitment that Haitians have for their own country. They affirm to each other that all is good because they are still here, holding on to their culture, their people, their children, their life together.

Being able to greet people like this, especially from a “blan”, a white person, has brought immediate smiles, a letting down of the barrier between foreigner and resident. I am here with you, I am holding with you, here in Haiti. I call and respond with you and we exchange a ritual of communication that has been passed down for generations. We are here with open hearts, learning, understanding, speaking with the people.

At the hospital yesterday, Dina and I waited for Susan outside of the prenatal clinic. The small building, which housed both prenatal and pediatric clinics, was crowded with people. Three Midwives For Haiti students worked in a small room doing intake exams. Susan and the interpreter, plus the pregnant woman, would now make 6 in the room. I was happy to wait outside. Sitting on the ledge of a wall, we waited, offering Trader Joe’s dried mango slices to the women and children around us. Opening the door is so easy in Hinche. The people are warm and welcoming with the simplest act of kindness. Before long, we had mothers and children around us, they as curious as us to meet someone from another world. The assumption at first is that we are so different, our landscapes: world’s apart geographically, economically, culturally. But, easily, we find common ground and are laughing at ourselves. By the end, I am able to say in Creole: last year, Dina spoke better Creole than me, and this year, I speak better Creole than her. They erupt in laughter, agreeing and rejoicing that we both are trying to connect. Susan finally comes out of the clinic. She is already recognizing that the best place to find us is in the most boisterous crowd with children and women, laughing and pointing and generally having a ball.

What do you do in Haiti when it rains?

2011-08-01T18:50:00.000-07:00

You go out and wash your hair, of course!

Have we really been here only a few days? So much has happened. We weathered last night’s thunder and lightning storm, only to find that once it starts raining cats and dogs in Hinche, the kids start having a ball. The soccer field and baskeball courts were just as active, except that the mud soccer players now had to share the field with the kids shampooing their hair and others running around bare naked in the rain. The rainstorm occurred just around dusk, light waning, only to be lit up by the dramatic lightning overhead. Boys in the church pavillion were sliding on their bare butts as if the floor was a Slip ‘N Slide. Naked as jaybirds, they pushed off and slid sitting up, over the polished stone floor. This was livin’! Having a ball Haiti-style in the middle of hurricane season. The heaviness of the rain beckoned us to come and play, to experience nature in one of its magical incarnations. Before long, I found myself standing in the middle of the soccer field, rain drenching my clothes and hair. Dina joined me and we worked our way over the flooded field to the pavilion and watched the 20 or so boys, sliding on their bottoms. This was pure joy for them, experiencing no self-consciousness at all that they hadn’t a stitch of clothing on their bodies.

Today we went by jeep to the mobile clinic near a small church amid farming land about an hour by dirt road from Hinche. I say “an hour by dirt road” because it was probably only about 20 miles out. We only saw about 11 women, which is light for MFH, but it was great to be unhurried and practice my midwifery Creole live.

On our way out to the mobile clinic, we picked up Filomen and Marie Ange at the hospital. I got my first peek at Unicef’s cholera tents set up within the walls of the St. Therese hospital. I am sure I will learn more about that later, but early recon tells us that at first, the tents were full, then, as the epidemic came under more control, people started to clear out. There is a sense that there has been a second wave of outbreaks, perhaps even from poor sanitation at these tents.

I met Filomen and Marie Ange on our first trip here. When we saw them, we exchanged exclamations and hugs, so glad to see each other again. Not two minutes down the road did Filomen start singing our Haiti song that Dina made up last year. We joined in, emphatically, laughing and singing, remembering the words together and knowing that we were all immediately on the same page. We picked up Magdala to another round of hugs and rejoicing, blabbering away in Creole and feeling the effect of a little more language under my belt.

I am so happy to be here, with the midwives again. I know that they are working hard to continue the vision of midwifery in the Central plateau. The mobile clinic has expanded to 16 sights every month, an incredible feat.

Courtney spent the whole day at the Azile. Susan and I went back to the Midwives for Haiti house in Hinche in the afternoon to organize the stock room and bring in the supplies that we brought from the US. We drank beer and ate our stew and dumplings, content with a very full day of work in Haiti. Each day represents a lifetime of learning and appreciation for the people of Haiti—their joys, their suffering, their challenges, their successes.

Ayiti, m’kontan we ou anko! Haiti, I’m happy to see you again.

Nou La, Anko!

2011-07-31T17:51:00.000-07:00

After a long day of travel yesterday, we are “nou la, anko”! (“We are here, again”, for those who don’t speak Creole.) Dina, Susan, Courtney and I met up in Miami to begin the Haiti 2011 adventure. Susan and Courtney had travelled together overnight from San Francisco, Dina had arrived the night before, and I came from New York. Boarding the plane reminded me of how close Haiti is to the United States. Pow! In less than two hours we would be in Haiti.

Upon arrival in Haiti, the most chaotic part of our trip was sure to be the simple act of getting out of the Port Au Prince airport intact. With Dina’s and my newfound love for Haitian Creole, we were able to fend off those who would lead us astray and finally get picked up for the short ride to Matthew House 25.

Ah, Matthew House. We had only been there two short times before and yet it felt like our Haiti home. Nancy met us with open arms and quickly ensued to tell us updates of the boy with cancer who had lived in the tent city, Darling and baby Matthew, the mother who was in labor while we were here, and other families that we had known. The beautiful, 14 year old amputee that we had interviewed for our video, who was usually at the top of her class, was now having trouble at school. Nancy is worried that she needs psychological support. Hardly surprising after losing her leg and witnessing her brother’s death as a wall fell on them during the earthquake. The soccer field is now completely devoid of tents, cleaned up, walls freshly painted for a soccer tournament that would happen this evening.

Tey, the “president” of the Matthew House tent city, was still there. I showed them photos from last year and passed out photos to Nancy and Tey that I had brought as kado yo (gifts). Back in the states, I printed out 340 prints of photos I had taken the year prior. These would be my ice-breakers for the return trip. I also found my photo book in NY of the Children of Haiti that I had made for my nephews. I brought that along too to show the children, hoping that I would meet them all again.

Soon, the new pink jeep from Midwives for Haiti was here to pick us up. The PINK Jeep! A wonder of modern auto mechanics! 4 wheel drive, rugged all terrain wheels, benches in back like the usual Haitian transport, heavy duty roll bars, luggage rack on top that easily held Courtney’s 3 extra large, 70 and 80 pound bags, 2 extra large suitcases, and a few more large duffles. The area in back was designed to be large enough to carry a stretcher, converting the Jeep into MFH’s homemade village ambulance when needed. The “snorkel” is the muffler, diverted up and over the top of the vehicle, so that when, during the rainy season, Ronel needs to pass through deep water, the water wouldn’t back up into the muffler. The Jeep was donated and made in the US for Midwives for Haiti. Pink matches the color of the students’ scrubs in the hospital and is now, officially, the signature color of Midwives for Haiti.

The road to Hinche from Port Au Prince is mostly paved, such a pleasure! We stopped on our way out of PAP at the brother of our interpreter’s house to buy artwork, witnessing a slice of life on the outskirts of Port Au Prince. For most of the ride, Courtney and I rode in back, speaking every now and then with Peter, the young Haitian driver of our interpreter who was along for the ride. A few hours into the drive, as the terrain was getting more and more lush, we drove through a village that started to look familiar. As we passed through the main market area of town, I saw the familiar sign of Zanmi Lasante and asked the driver to stop. This is Paul Farmer’s model hospital that began as a center to treat tuberculosis and HIV and is now a sprawling wonderland with an art center, a nutrition program, a Women’s health center, dentistry, pediatrics, even a small glass enclosed room that exists as their NICU. We found an American physical therapist who had just arrived 10 days earlier to take us around. I ran back to the pink jeep and found my photos of people I had met there last year and hoped to find a few still there. As I entered the maternity ward, I was met by a familiar face!! It was Marlene, one of last year’s students from Midwives for Haiti!! She remembered me immediately. Having recently learned the Creole word for remember, I told her that I remembered her but did she remember me? She laughed, of course!, and quickly pantomimed playing the ukelele and our singing! She remembered Dina, our big party and the photo year books that I had sent them. I was so excited to see that she had a job in this amazing hospital. We talked excitedly, in my broken Creole. I wanted to know all about her job. Were they paying her well? Was it enough? Was she here on her own? She showed me around, 3 women in labor, 4 or 5 in the postpartum ward. This year, I wanted to go out and speak Creole with some of the midwives. I wanted to know how they were getting on, if they were working as midwives, how were they? Marlene said, “N’a parle en Hinche.” We will talk in Hinche. On August 4^th, there will be a continuing education session in Hinche that will bring all of the former midwives back to Midwives for Haiti. We’ll figure out when we can go out and continue our exchange of friendship and midwifery comraderie.

We also toured the pediatric unit where I gave out more photos. The most amazing thing this time was a 50 piece orchestra of kids from Port Au Prince that was practicing on a patio under a tent. The most beautiful, classical music with violins, cellos, 4 stand up basses, the works. So like Paul Farmer, that music and art and beauty are all pieces of healing. We loaded ourselves back into the pink jeep and headed out for our last hour of the drive to Hinche.

Maison Fortune was just as we had left it. Summertime, children everywhere, grabbing your hands are they meet you. We saw familiar faces and were thrilled to see Brother Mike. It struck me that, of course, I would remember them, my first Haiti trip burned into my memory. But how could they remember us, with all the volunteers that come through? It feels good that Haiti recognized us, just as we recognized Haiti.

Cudos to Courtney!

2011-07-28T15:57:00.001-07:00

Yay Courtney for bringing 3-100 pound bags of donated items to Haiti! We should arrive in Port Au Prince on Saturday morning if all goes as planned. Courtney has packed 100 pairs of shoes, 40 newborn blankets, formula and diapers for the orphans at the Azile, a volley ball net for the girls at Maison Fortune, over the counter meds, lots of toothbrushes, kid and baby clothes, a couple of hacky sacs and an Uno deck! Yee ha, you go girl, Courtney!

For those of you interested in details about the state of midwifery in Haiti, here is UNFPA's most recent report:

http://www.unfpa.org/sowmy/resources/docs/country_info/profile/en_Haiti_SoWMy_Profile.pdf

In the mean time, I say goodbye to my nephews:

Daniel

Matthew

Mark

Nicholas

as I prepare for the trip to Miami tomorrow.

2011-07-24T10:28:00.001-07:00

Testing the email to blog option from my iPhone in NY. This year we are going to try to blog live from Haiti using a tethering option instead of the data card. Had to purchase an international data plan. Still crossing my fingers that it will work!

Sent from my iPhone

Emmett's Arrival

2011-07-22T18:31:00.000-07:00

Rebecca and I are overjoyed to announce the birth of our son, Emmett Levi Harris. He came into the world at 3:59 AM on July 1, 2011, clocking in at 6 lbs 12 oz and 18 3/4 inches.

Rebecca starting laboring around noon on Thursday. We called our midwife, Maria, at around 4. When she arrived, she checked Rebecca, who was, to our surprise, already dilated to 9 cm. Expecting a quick birth, we got ready for the delivery. Once fully dilated, she began pushing. She was amazing. With perseverance you had to witness to believe, she pushed for three hours. But the baby was not descending. He was just stuck at "station 1," and no amount or walking, pushing, or position changes was moving him along. At the three-hour mark, we had a frank discussion and all agreed transfer was appropriate. We made the 5 minute drive to UCSF in Maria's car. Once we got there, Rebecca made it to the 15th floor, stopping to kneel on hands and knees several times along the way. The plan was to get her an epidural and some pitocin and hope for some passive descent before pushing again. After a three hour "rest," Rebecca started pushing again. By this point, the doctors were mentioning c-section as a possible option, and even as a possible outcome. They were keeping a close eye on Emmett's heart rate, and said it was OK for Rebecca to push as long as she could, so long as the baby was hanging in there.

It turns out that the problem was one of simple geometry. Emmett's head was turned to the right, rather than chin to chest. That meant that his head could not fit through Rebecca's pelvic bone, no matter how hard or how long she pushed. In other words, this was not going to be a home birth because Emmett had other plans.

Rebecca pushed for three more hours. Somehow she managed to get Emmett to station 2, which was far enough along to allow the doctors to offer an assisted delivery using a vacuum device. They placed the vacuum pump on the baby's head and Rebecca pushed like all hell. Our baby was delivered vaginally at 3:59am, just before the sun rose over San Francisco.

This was obviously not the birth plan we had in mind. But it didn't matter. We had a dream team of friends supporting Rebecca throughout the night. Maria was critical to help us through the hospital world, and to keep us focused on our goal: a vaginal birth. We refused some interventions (like the electrode clip on the baby's head) but decided on the assisted delivery as a last option to avoid a c-section. After it was all over, the doctor told Rebecca she had never seen a woman push that hard for that long, and said that Rebecca saved herself and our baby from a c-section.

It was a perfect birth.

Love to all,

Cody, Rebecca, & Emmett

The Birth of Finley Royalton Prassas by Calen

2011-07-22T18:26:00.000-07:00

My labor came with no warning, at least no warning signs that I recognized. The day prior, my partner Pilar, my mom Janfra and I took a day trip to Pescadero for lunch and we stopped in Pacifica on the way back to the city. In Pacifica, we took an hour and a half hike along the beach and to the top of the cliff overlooking the ocean. It was the warmest day that Pilar and I could remember experiencing in Pacifica, so the gentle breeze at the cliff’s edge was a welcomed, rejuvenating yet soothing caress. We screamed at the top of our lungs into the wind. I often like to do this at mountain tops or into strong winds because you cannot be heard and feel complete liberty to let go…something I struggle with and would soon need to do regardless of who could hear me. It is very cleansing. This was day 7 past our due date and earlier that day we had gone to St. Luke’s, our backup hospital, for a Non- Stress Test. Although everything looked great, talks of what to do in case induction was necessary had already begun. We started to get nervous, so by the time we were at our Midwife Maria’s office the next morning for a 9:30am appointment we were visibly anxious. Maria calmed us by reminding us that most first time deliveries occurred 8 days past due date. Currently we were exactly 8 days past our due date. So much of my pregnancy was text book…why should this piece be any different!? Maria also said that the next six days until we were at our two weeks post due date Dooms Day were a very long six days and anything could happen during that time.

Before the end of our appointment I told Maria that the slight cramping I had been feeling for weeks occasionally felt a little stronger, three times this had occurred to be exact; once the night before while sleeping, once early that morning, and once in her office. By the time we were walking to the car I felt it again. Driving home Pilar said something that really changed my attitude. She said “we lost sight of our goal; to have an amazing homebirth.” She was right, and that sealed my resolve to proceed with our original homebirth plan and put the whole non stress test and thoughts of induction at the hospital out of my mind. I didn’t have much time to think about it because within a half hour I was feeling regular contractions. I decided to vacuum the apartment and clean the bathroom- stopping only to have the contraction and then start cleaning again. At this point I was still convinced that this could be false labor so I told Pilar to continue working and wait to call Maria- we had just left her office merely an hour ago! I apparently convinced Pilar it was also false, or at least early labor because she suggested taking a walk. My mother said that I might not want to do that to which I replied “I am definitely taking a walk!” It had been part of our “plan,” to take a walk during early labor. After the next contraction I whispered to Pilar “we can’t take a walk.” Pilar knew then to call into work and let them know that they would not hear from her again that day.

The contractions were frequent enough that I started to keep track at 11am. They were every 4 minutes apart and lasted 45-60 seconds. At 12:30pm I ate a little greens and beans (Kale and cannellini beans) and we decided to call Maria. She said to call back when the contractions were 4 min apart for an entire hour. The contractions were already 4 minutes apart for the past hour, but we decided to wait another hour to be sure. An hour later Pilar called Maria to let her know that the contractions were every 3 minutes apart. I was moving about the apartment these initial hours trying out new spots to find my comfortable space. I found the chair my grandmother Sylvia made in the hallway at the time Maria walked in at 3:30pm. I remember her asking if we had set up this as a birthing station, we had not, and she said “see, that’s what happens!”

Five hours had gone by already but I remember it as a much shorter period of time. Maria checked me and I was at 5 cm. I remember feeling like I had worked too hard to only be “halfway…” as if you can really say that 5 cm is halfway. Maria stripped my membranes again- a midwife at St. Luke’s had done the same during our non stress test the day before. At St. Luke’s I was at 2 cm and my cervix was very soft. During my next contraction Maria “encouraged” my cervix to open and in a few moments I was at 6 cm. I decided to stay on the bed where Maria examined me for a few minutes longer. This was one of the very few times that I got an extra minute break in between contractions and I slept and woke to the next contraction having completely forgotten that I was even in labor. From then on I only went back to the bed for examinations and never to labor. Maria had told us that she would mostly hang back during labor unless she saw that we needed her. Of course she continually monitored me and the baby, but otherwise she only stepped in to make suggestions like getting into the shower or to say some encouraging words, but mostly she let Pilar and I work together. The best part about that is that Pilar and I actually felt safe doing that work because Maria not only prepared us for this day, but her experience and calm demeanour in the room during labor put us at total ease.

After this point I don’t remember much in the order that it occurred. I remember getting into the shower, into the birthing tub, out of the tub, back into the tub. I remember the tub being a little too warm during the contractions, so I stood up for many of them with just knees to feet covered with warm water. But what I remember most of all is the feeling of Pilar by my side during every contraction. As long as she was there stroking my arm, massaging me, and making me sip fluids, whatever it was, she was my anchor. She made me sip coconut water. I had never tried it before and I thought she was giving me the sweetest nectar on earth. Pilar’s hand resting on my body meant I was safe and I had the freedom to do what I needed to do without fear. I remember Pilar leaving my side only 3 - 4 times and ONLY between contractions. It was the only time that I felt fear and needed to talk myself down, breathing and telling myself she would be back before the next contraction. I remember hugging her and burying my face in her neck. I remember Pilar’s encouraging words; “you can do this,” “you are doing so great.” I also remember her supportive silence which was just as useful and amazingly comforting. Every time Maria would listen to the baby’s heartbeat Pilar would tell me how great the baby was doing…I came to find out later that Pilar really didn’t know if it sounded good or not but she told me it did anyway. Lucky for us the baby’s heartbeat remained steady. That was so reassuring because I focused on the fact that the baby was doing his job so I could do mine!

Sadly, I also remember my guilt but in a way my guilt was kind of sweet. I remember screaming “Fuck” once and then apologizing for it. Swear words became especially ugly to me during labor and I didn’t want them at the birth. I vividly remember Pilar being in the shower with me and I remember moving her out of the way so that I could lean against the back wall. She stepped out of the shower and never returned. I wanted her back in but I didn’t have the energy to tell her that. I only had the energy to tell her when something was not working. Two more occasions that come to mind was when I was rocking and Pilar was also trying to rock with me. Our rocking kept getting out of sync and I had to tell her not to rock me…that one broke my heart because all I wanted to do is tell her how much I love her and how much she was helping me through the entire process. But again, I had no energy for that. Last was when I was in the tub and she asked if she could come in. I didn’t answer because I was thinking about it. I DID want her in the tub, but I was conflicted because that would mean she would have to leave my focus point. I had my head buried in her neck and my arms draped over her shoulders. Could I give that up? I wanted her in both places.

I felt a lot of pressure in my pelvis all of a sudden and asked Maria about pushing. She checked me and I was only at 7 cm. I couldn’t believe that I was only 1 cm more. Through the next contraction Maria helped my cervix reach 8 cm. I was moving at about 1 cm per hour which is good, but in my head I couldn’t believe that so much work was done for what seemed liked little progress. Each time I was baffled that I hadn’t magically jumped to 9 or 10 cm. My labor never stalled. 9hrs at 3 minutes apart is about 180 contractions. Yes, I did the math. That is the true scientist in me. Maria said to me that I was moving into transition and that this next stage would be the most intense. For some reason I was completely ok with that. Maybe I expected it, or maybe I was just naïve because transition is most definitely intense and this is where I lost it a little bit. I never used a lot of the tools I learned through my readings, or that Pilar and I practiced during our Birth class save 2. #1) Pilar was my anchor, period. And #2) I continually told myself to breath low, keep my tone low and in my pelvis to keep those muscles soft and relaxed. Transition was when I particularly used these ideas, but what my body did was very different. I found myself moaning the word “ouch!” Ouch does not seem like a very positive word to focus on and I probably could have used another but the vowel sound in what I needed. Then I started screaming, high resonating screaming. I knew it was not constructive, I knew I would lose my voice, yet I felt like there was very little I could do about it. Maria stepped in at this point to very directly tell me that I needed to calm down and bring my tone back down. It was frustrating because I knew she was right but I felt like I was disappointing her and myself for not being able to do it. Another time I remember my body acting without my brain was in the tub. There were 3 - 4 contractions in a row when I was on my knees that I skated around the tub from side to side in spastic animal like movements. In my head I thought “What just happened? That was so strange.” Up until this point my movements had been spastic sometimes but all were deliberate. These new movements skipped the involvement of my brain all together. Maria checked me again and said that I was at 9 cm and told me to try not to push for a little while. I asked if pushing was easier than transition and she told me that it was just different and that people described it as better because it involved actively doing something. I would soon find out that pushing is not easier. For the next 20 or so minutes (I actually don’t know the real time, it just felt that long) the contractions were so intense that I started to think “I need help,” “I can’t do this.” I didn’t really want to say these things out loud because I didn’t want these feelings to be taken seriously...but I did say them because I knew someone would talk me out of it with encouraging words which I needed right then.

Then I said “I can’t help the feeling to push.” It was still just a feeling at this point because it was certainly not the involuntary pushing which my friend Rachel has equated to throwing up. Maria gave me permission to gently push during those contractions. Next I knew Pilar was in the tub with me…though I don’t remember her getting in. I was leaning back on her; she was holding my hips swaying me back and forth. It was some of the best pain relief I had felt in hours. Then I felt the overwhelming and completely involuntary sensations of pushing. It was not aided by me at first; it was more like I was just along for the ride. I quickly learned how to help it out a little. I finally found my low resonating groan again…more like a growl actually. Growling felt good. I tried to use the growls during the pushes to bear down and move our baby to the outside world. It felt so good to rest my ankles on the edge of the tub, but Maria wanted them inside so I could use the resistance during pushing. So for a few minutes there was a funny little dance of feet in tub, feet out of the tub. Maria then suggested that I move to the birthing stool to which I blatantly said “No,” but really I just needed a moment to think about it. I stood up and immediately had to stop. I had a huge pushing contraction while standing - then moved to the stool which was wedged between the birthing tub and our large dining room table. Sue Baelen, the other midwife who came in about 30 minutes before pushing got stuck behind me. She ended up soothing me from behind. Sue is like Mother Earth and I melted into her (her words) as she sent energy through my body from her hands. Pilar and Maria were in front of me. Maria directed Pilar to hold pressure on my perineum (I just realized, this was told to me after- this is not from my memory), to prevent tearing. I did tear, but elsewhere (labia), so Pilar did an excellent job! I think in all I pushed for about 30 minutes. Pushing is intense and no one ever told me it feels like birthing a baby through your rectum.

I then felt the dreaded “ring of fire.” It strangely kind of felt good to me. At least it meant that the head was crowning and that it would just be a few minutes more until we could meet our little one. Maria got the head and shoulder out (I presume) and Pilar caught the baby and brought it up to my chest. The three of us just snuggled. Maria said “don’t drop the baby.” I guess we looked shaky, but this made me laugh because I had no fear about dropping the baby, no fear about there being anything wrong at all…the endorphins were amazing! I didn’t even cry. Pilar cried which is very rare and kept telling me “I am so proud of you!” We just stared at the little face as the baby started to cry and use its lungs for the first time. His eyes were open and he was looking around. We just stared for 5 minutes before even looking to see if it was a boy or girl. It is a boy! We could not lift him too high because the umbilical cord was not very long. Pilar did lift him a little too high once and she said that I started to explain, as if I were a teacher, how everything was still attached. I find this very funny, but I don’t remember this conversation at all. I do vividly remember Pilar cutting the cord, however, and then delivering the placenta in one push. I would have liked to see the cord pulsing…but by 5 minutes it had certainly stopped. Sue brought my placenta over to us so that we could see how beautiful it was. She showed us the “tree of life” which describes the main veins running through the organ. She asked us what we planned to do with it and we hesitantly said that we wanted to cut it up and freeze it for smoothies. Sue didn’t flinch and offered to cut it up for us! It wasn’t until a few days later when we discovered the glass Pyrex container in the fridge. She perfectly wrapped each and every little piece in parchment paper so it would be easy to separate. Pilar said it was wrapped like a dream since she was the one who actually made me smoothies for 30 days straight!

The hormones made me feel ecstatic. You know when something is so wonderful it makes you cry? Well, this was so wonderful it was beyond happiness, it surpassed tears, and ended someplace in ecstasy. Pilar and I named this beautiful little boy Finley Royalton Prassas. The name came from looking at his face and was never actually on our list…but it just suited him. And finally we were three.

Homebirth up 20%!!

2011-07-06T04:02:00.001-07:00

Yippee! Read the latest AP article on SF Gate here!

Haiti Homework

2011-06-30T10:37:00.000-07:00

This is part of a short summary on Haiti by the UNFPA:

"Located in the heart of the Caribbean, Haiti faced many challenges prior to the devastating January 2010
earthquake, including political turmoil, natural disasters and food insecurity. With a population of 10 million, Haiti
is the poorest — and the only least developed — country in Latin America. Maternal mortality is declining, at
300 deaths per 100,000 live births in 2008, compared to 670 per 100,000 in 1990. The nursing-midwifery
workforce was decimated by the earthquake and significant emigration that followed and this has created a
major challenge. Only 26% of births are attended by skilled health personnel."

As Dina, Susan, Courtney and I prepare for our trip to Haiti, I will be offering up information about this incredible country. We leave on July 30 and will work with Midwives for Haiti for 2 weeks. I am excited to return, hoping to deepen my own appreciation of the power of midwifery in rural Haiti and hoping to reconnect with the midwives that we met last year. I am curious to hear about their year: successes, frustrations, goals for the future. Hearing that only 26% of births are attending by skilled personnel tells me that there is still lots of work to do.

Baby 1000!

2011-06-28T15:46:00.000-07:00

On Friday, May 27^th, 2011, with great joy and patience, I welcomed in the 1000^th baby into my practice. Audrey Opal arrived, asking us to honor the most important aspects of natural birth: patience, trust, wisdom and commitment. Audrey Opal was born at home, in the water to loving and welcoming mom and dad, Kristi and Bill. It was the perfect 1000^th birth!!

So, many have asked: Is that 1000 homebirths? What does 1000 births really mean? Really, what it means is that I have witnessed 1000 babies join us on the planet. 1000 babies I call “my own.” Not all of them have been homebirths, because, as we know, not all planned homebirths happen at home. And, not all of them have been natural or vaginal births. Again, even with the best of plans, not all births happen the way we intend. But, I can say with all confidence, that all of them have been amazing, incredible experiences. Perhaps more appropriate would be to say that I have accompanied 1000 women along their birth journeys. I have witnessed incredible strength, courage, compassion, challenge, testing, and will power. Birth is hard. It challenges us to the very core. Yet, embraced with integrity and sensitivity, it is an empowering, transformative journey. Birth has the power to teach us what it is like to be a woman, to become mothers, to experience life to its fullest capacity. When birth does not give us what we want, we have to work through disappointment, pain, frustration. We need to dig deeper to the core of ourselves to understand the lessons of birth, in whatever form they come. We grow and learn. We are humbled. Birth is empowering. Birth is hard. Our babies are amazing.

Here are some more numbers that you might be interested in:

I have caught:

7 triptychs (three babies for one family)

3 sets of twins at home

21 VBACs (attended) with 13 HBACs (Homebirths after CSEC)

3 Face presentations

I don't know how many were boys and how many were girls, anyone want to volunteer to count?

Maternal mortality rate in the US per 100,000 births : 13

Maternal mortality rate in Haiti per 100,000 births: 632

As many of you know, I traveled to Haiti last year with a program called Midwives For Haiti. I even have a YouTube channel. Go to You Tube and search sfmidwife. You will find the micro-documentaries that Dina made about Haiti. Dina and I and another CNM, Susan Leibel, will be traveling to Haiti again this year. We will be there the first two weeks of August. Dina and I are hoping to make this a yearly trip so that we can build continuity, rapport and camaraderie with the student midwives and graduates. In order to make this a sustainable mission for us, we are dedicated to fundraising to cover expenses. I have already raised $5700 of the $11,000 that this year's trip will cost for the three of us. I know that many of you have asked me how you can help with this project. So.... here's how. You can donate by sending your checks to me at: 206 27th St., San Francisco, 94131.

You can make your check out to me, or, if you would like your donation to be tax-deductible, you can write the check out to Midwives for Haiti, putting Maria Iorillo in the memo line. Still send the check to me and I will send them all together to Midwives for Haiti. It is quite eye-opening to see how much good can be done with just a few thousand dollars. Your donations will fund two midwives and 1 videographer to travel to Haiti for 2 weeks. Last year Ami and I both brought 50 pounds worth of medicines, supplies and baby clothes which were used immediately and much appreciated.

I am also collecting the white, mesh panties that are given to women to wear after birth. If you have any new, extra ones from your birth experience and was wondering what to do with them, now is the moment. These simple panties help to convey a sense of dignity to the Haitian mothers who often times only have a few torn clothes to use after the birth. You can also donate cotton onesies, baby hats or sox. Most other baby items are too bulky to travel with. Together we can make a difference for Haitian mothers and their babies. Thank you for being a part of this project with me.

Of course, donating your baby supplies means we get to see each other! Just call me for a time that we can get together.

Ganden’s Timely Arrival

2011-06-23T21:55:00.000-07:00

There were two things I wanted to accomplish before the arrival of our “little man.” 1) finish painting and decorating his room and 2) see the ocean.

This sounds reasonable enough, but at 35 weeks we learned that “reasonable” was all a matter of your frame of reference when I went into early-term labor. I had been having flu symptoms for three days and had developed a hearty cough so I think my body just went into immune system overdrive and sent a system-wide “Eject!” command to my babe.

At that point we owned a car seat (but it wasn’t installed), the baby’s room reaked of primer and fresh drywall mud, and in our denial about the contractions I had been feeling 7 minutes apart for 10+ hours we arrived at the hospital without even packing a bag. So it was a reality check to both of us when the doctor said that I was 2 cm dilated, 75% effaced, and that it was highly possible that the baby would arrive in the next day or two. “The train has left the station,” she said. As we processed this news our midwife Maria came to the hospital as we came to grips with the idea that our baby was coming earlier than expected. Then slowly after a few hours at the hospital the contractions slowed and then stopped. We were told we could go home until they started again.

Once we arrived home my husband immediately drew me a bath and poured me a glass of wine, both on doctor’s orders. He then installed the car seat base, assembled the bassinet, and stayed up until the wee hours of the morning painting the trim of the room (even though we knew the baby wouldn’t sleep in there for months). I knew I had chosen homebirth for a reason that was as much physical and mental—even though we were treated wonderfully at St. Lukes, my body sensed I was in a hospital and shut down my labor! My mantra became “37 weeks, 37 weeks” because my pregnancy had to last two more weeks for me to be able to have the home birth we had planned for.

We made it. At 37 weeks I told my baby that he was welcome to come whenever he wanted. At 37 weeks and 1 day my husband and I finished his room. At 37 weeks and 2 days we drove up to Muir Beach so that I could see the ocean. I had been visualizing waves in my labor preparation, imagining them washing over me and then fading away like a contraction, so I had been yearning to close my eyes and listen to the ocean and breathe the salty air so that I could imprint it on my senses to call on in time of need. It was a crisp, clear day and Dave and I went on a short walk and then sat on a log together and soaked in the sea. On our way home I suggested that we stop for lunch in Sausalito—I had been wanting to try a restaurant called ‘Fish.’ Apparently many others had the same idea because we had to wait in line for 45 minutes just to order our food. But I was super excited about the crab roll, so it seemed worth it. After we ordered there weren’t any tables free, so we pulled two stools up to the bar and sat happily watching the food being prepared. Suddenly, there was a pop, followed by a whoosh, and I said to my husband, “I just felt a pop and now I feel like I’m peeing my pants.” We both looked down and clear liquid was streaming down the stool and pooling on the floor below. It was a moment of wonder and shock; we looked at each other incredulous, laughing. It was 2:00pm. The three teenage girls sitting at the bar next to us looked over and asked (in a Southern drawl), “Are y’all going to have a baby today?” Then they took our picture. Dave’s immediately reaction was to rush out of the restaurant, but I was like, “hell, no. I just waited 45 minutes to order my food, I’m hungry, and I’m going to eat this crab roll before I have this baby.” So he ran back to the register and asked them to package everything to go. We waited another 10 minutes and then I wrapped his windbreaker around me like a diaper and we hobbled out of the restaurant.

Once in the car my first call was to Maria, our midwife. She had just arrived home from another birth and told me that contractions may not gear up for another 24 hours so I should go home and relax and call her when they were 5 minutes apart. My second call was to Natural Resources because we weren’t scheduled to pick up the birth tub for another week and I really wanted to labor in the tub. They offered to try and find a tub for us and would call me back shortly. My first contraction happened as we were driving on the Golden Gate Bridge.

Once home, we quickly sat down and ate our food—I savored the crab roll, and part of a chocolate chip cookie. It was 3:30pm and Natural Resources called to say that they found a tub, so my husband left to pick it up (which involved squeezing it into our Mini Cooper so tightly that he couldn’t move the stick shift out of second gear) and I called my parents to update them on my labor. During the conversation with my Dad I had to continually pause to breathe through the contractions, a signal that labor was progressing. At that point my contractions were between 3 and 5 minutes apart, so I called Maria again and she said she’d be over in an hour. When my water broke we debated if our little man would be a Sunday or Monday baby, and now I felt pretty confident that the baby was coming that night.

As the contractions grew stronger I moved from lying across the exercise ball in the living room, to folding myself forward over the kitchen counter. I was listening to my hypnobirthing mp3s and focusing on my breath. I felt strong and prepared. Dave was heroically scrambling to find a way to connect the hose to the sink to fill the tub (no time for dry runs!). Since my water had already broken I knew that I couldn’t get in the tub as early as I had hoped, and I wasn’t fully confident that we were going to get it set up and filled in time, so Maria suggested that I take a shower. Ahh, the shower, my happy labor place. The warm water felt amazing on my skin, I was alone with my contractions, and my voice reverberating within the enclosed space in a way that allowed me both focus and release. I remember Maria saying that I needed to do whatever made the contractions come on stronger, so I switched between squatting, placing a leg up on the shower bar, and rocking my pelvis back and forth. I remember stroking my belly from right to left and singing, “this is the way you go” as a way of trying to coax the little to guy to turn the appropriate direction to avoid back labor. I also remember saying at the end of each contraction: “bring it on baby, bring it on.” And he did. Maria and Dave would periodically check-in, and I heard my mom arrive, but most of the time I was moaning through contractions and keeping my eyes closed. I was so happy in the shower that I lost track of time and inadvertently used up all the hot water just as Dave was able to get the hose connected between sink and birth tub. Oops. So the boiling of water began! One of my clearest memories from my labor is the cycle of Dave being around to apply counter pressure to my lower back during a contraction and then the second it was over he would whisper in my ear, “ok sweetie, now I have to go and boil more water!” and then he would disappear until my noises would signal another contraction. Dave jokes that he felt like he was attending a birth in the 1800s because we were at home, had a stack of our own clean towels and sheets ready and waiting, and were boiling water.

After I finally left the shower, Maria recommended that I move to the bed. We had recently purchased a padded stool for the cat to use as a step to get up on the bed—I kneeled on it with my body draped forward over my yoga bolster placed on the bed. Once again my eyes were closed and I just tried to relax into the contractions as they grew stronger and stronger and more challenging to bear calming—my hypnobirthing practice was being tested. After one contraction I looked up and saw that it was 9:15pm. I remembered reading somewhere that you should cover up the clocks so that you’re not tracking how much time labor is taking, so I walked over and covered it with a shirt (which now seems a bit ridiculous). I was keeping my eyes squeezed closed both during and after then so my memories are all sounds. After one particularly strong contraction subsided, both Maria and Dave started to leave the room as another huge contraction immediately rolled through me. I remember screeching, “somebody stay and help me!!!!” at the top of my lungs. I was still kneeling draped over the bed hunched over my yoga bolster and the contractions were at their strongest yet. For the few moments between them Maria was telling me to blow out the tension. The baby’s heart rate was still strong and steady. Soon, Maria told me that after the next contraction I should stand up and try to go to the bathroom. I remember waiting for the contraction to subside and as it started to lessen another one would immediately ramp back up, so at that point I think I screamed, “they won’t stop!!” Eventually there was a small break, so Dave supported me as I hobbled over to the next room and the second I sat down on the toilet my body completely took over, I became possessed. My whole abdomen felt heavy, and I started making grunting noises. In my head I was thinking “this baby needs to come out now!” but I’m not sure if I was able to convey that in words or not. Maria ran over and asked if I was pushing, I’m pretty sure I said, “I can’t help it.” Since my water broke before contractions began I still had never been checked for dilation. With one touch Maria said the baby was coming and that I should move back to the bed. That’s when my mind awarded me a moment of clarity. I remember thinking, “Dave has spent nearly all of my labor filling the tub, and I sure as hell am going to use it!!” So with that, I left everyone behind and strutted down the hall into the nursery (I wanted my boy to be born in his own room), threw my robe on the floor, and stepped into the tub. Dave and Maria followed.

I started squatting, as that’s how I had seen it done in all the birth videos, but Maria told Dave to get into the tub as well and support me like a chair so that I could scoop my pelvis upward. Then the “animal” body kicked in, I surrendered. Sounds were coming out of my body that I was not in control of, nor even knew how I possessed. I remember Maria saying, “Jaime, you need to stop screaming. Make low, grunting, animal noises.” Then Dave started making them in my ear so that I could mimic them. Next thing I knew I was being told to reach down and feel the head. All I could think was, “this baby needs to come out now.” He had politely waited to hit the 37 week mark and now was rushing, ready. I only pushed a few times. I had Dave pinned between me and the side of the tub, the back of my head pushing into his face and shoulder. During the pushes Maria was reaching into the water and I could feel a tug—later I found out that the cord was wrapped around his neck twice and she was untangling my babe. I was imagining water and expecting to feel the “ring of fire” but only felt splitting. Only later did I learn that my little man burst through on his way into the world, my body either didn’t have the time or the ability to stretch around him. With one big push his head was out, with the next push out flew his body. It was 10:30pm; 8.5 hours after my water broke. Maria scooped him up and handed him to me. He was so slippery and I felt so awkward, still balancing on my husband’s lap, trying to keep the little guy warm without dropping him. As he was born Sue, the second midwife, had let herself into the house—the ending speed of my delivery must have taken even my midwives by surprise. I called for my mom, who had been waiting, praying, in the next room. She ran in with the camera and shot the most amazing photos that so perfectly captured the moments after his birth: Dave and I in the tub holding Ganden, Dave cutting the cord, both of us in mouth-gaping awe. Just after the birth I remember thinking that I didn’t feel the euphoria that seems to so often appear on women’s faces in the birth videos just after they give birth, all I remember feeling was discomfort. But then I saw the photos and was surprised at how glowing I look—I was radiating joy, love, power. I was mighty.

Two truths were confirmed for me through my birth experience: the wisdom of the body and the power of the mind. It’s a delicate dance between these two because birth is about surrendering to sensation and allowing the instincts of the body to take over while harnessing the power that the mind has over the body. By thinking ‘relaxxxx’ (another of my mantras) and focusing the mind on a particular body part, that body part responds to the command. And relaxing into contractions is far less painful and more productive than fighting them. I mentally understood that going in, and physically felt its truth after a mere few contractions.

Body and baby engage in unknown communications to determine the proper timing for delivery. While a bit earlier than expected, my little boy knew he was strong enough to enter the world. He waited for us to finish his room so that he could be born in calming space fashioned with love. He waited for me to see the ocean so that I could imprint the sounds of the waves within my mind. Perhaps the sounds and smells of the ocean were his beckoning call, a prompt for my bag of waters to rupture, a shared signal to both of us that our minds and bodies were ready to turn inside out.

Ganden, may your laughter always reach up to heaven, my sweet little boy.

What happens after delivery is so often skipped in birth stories. After birthing the placenta I returned to my bed and was able to spend some quality time with my new baby and my husband. We cuddled and practiced nursing. I remember being in awe, but also being completely distracted by pain and continued contractions. After an hour or so Maria said that I had to go to St. Lukes for a repair since I had a fourth degree tear. When people ask me if I have any advice for women regarding birth I say, “embrace discomfort.” I felt mentally, physically, and emotionally ready for the challenge of birth, but a bit under prepared for what would come afterward. I certainly didn’t want to leave my brand new baby at home to go to the hospital. Once at St. Luke’s I had to adamantly refuse the IV pain medications—I had made it this far naturally and other than local anesthetic was planning on staying natural. While laying on the table I had to repeat ‘relax, reeeelllaaaxxxx’, again and again because I was still racked with labor strength contractions but needed to lie still for the delicate suturing that was going on. But in the end I was able to return home and back to bed where my husband and little boy were lying skin-to-skin.

Thanks to Sue Baelen who took such good care of my little boy and my husband while I was away. And much thanks to Maria who caught my little boy and helped make our desire for a homebirth as close to our dreams as was possible. And thanks to my Mom and Dad who both gave Dave and I the space to share the birth experience together, and was very present and supportive during key important moments. And most of all, thanks to my husband who was with me every step of the way (especially when racing to carry pots of boiling water across the house to fill the birthing tub) and who even managed to stomach cutting the cord. I am truly blessed. I was prepared for the first few weeks as a mother to be challenging, but was not prepared for how gentle, joyful, and blissful they could be as we nested at home as a new family. The homebirth experience was wonderful in that it allowed me to “do my thing” during labor and delivery, but what was even more wonderful was the care and I support I felt after the delivery. Dave was there every step of the way (who knew breastfeeding could be a 2 person job?) and I felt like there was a team of people helping me to be successful as a mother, and for that I will always be grateful.

Sasha's Birth by Jamie Rosenfels

2011-06-22T18:09:00.000-07:00

Sasha is Finley Mae's Mom of the previous birth story. Sasha was born at home herself and here is HER mom's story.

Sasha was my 5th baby who was born at home, and my first experience with midwives. Our first child, Jaia, was born at home in Arvada, Colorado in February 1971, with a “cool doc” who had attended medical school in the East, but then began to think holistically and was attending home births. His name was Richard Moskowitz. He lived in Boulder, but was at a birth in the mountain town of Ward when I went into labor. Ward was an hour away and there were no cell phones; the folks who were having their birth didn’t even have a landline. He arrived merely 20 minutes before she was born.

Our next 3 births were at home, with my husband Robert and myself handling the delivery. After the birth of our 4th child I started practicing midwifery, attending births of friends and then other families in eastern Iowa. We moved to a wooden A-frame on 10 acres of land two months before Sasha’s birth. At the time she was born, Nov. 9th, 1980, I had two midwife partners who were also my best friends, Carla and Neva. Since my births had gotten progressively shorter (17 hours, 4 1/2, 2 1/2, and 1 hour and 45 minutes). Carla decided she and her husband would erect a tipi in our field so she wouldn’t miss the birth!

As the clock turned midnight I had a big rush, then another. I awakened Robert and took an invigorating, yet calming shower. He got Carla out of the tipi and called Neva and her husband Dennis, who was a doctor. I had gone to the birth of their son the previous year and Dennis was going to photograph our birth. I had also attended the birth of Carla and Roger’s son 7 months before. It was one extended happy home birth family. My brother, Chuck, also came over to witness and photograph the birth.

I relaxed on a big mattress in the loft of our A-frame. I checked my dilation before anyone had arrived. It was a gooey 5 centimeters. Robert woke up our four other children who were nine, six, four, and two years old. We still have photographs of them; including the two year old waking up drowsily, and sucking his thumb. Their expressions show curiosity, anticipation, but certainly no fear. I remember laughing as I lovingly watched our four kids taking in the sights and sounds of the birth.

It was the first birth where Robert and I did the smoochie-lovie scenario described in Ina May’s Spiritual Midwifery. I was in labor daze so I don’t remember much. I know Neva and Carla were vying for whom would catch our baby. It was decided that they would both catch. It was all so short: probably 25 contractions and very little pain. The labor and birth lasted one hour and 12 minutes. It was such a glorious feeling, and one of relief to have my big beautiful baby lying on my belly and chest, nuzzled to my breast. She weighed 10 pounds, four ounces; a baby sister for her big sister, who named her Sasha. After everyone was snuggled back in bed, we all slept until mid-morning. My family came the next day, plus a few friends who brought food for us. Sasha was adored by her family, which was now seven strong!

Invest in Midwives

2011-06-22T16:52:00.000-07:00

U.N. Report Calls for Investment in Midwives To Reduce Maternal, Infant Mortality

June 22, 2011 — More investment in midwifery could save millions of infants and hundreds of thousands of women who die annually because of a lack of access to skilled health care during childbirth, according to a United Nations Population Fund report released Monday, Reuters reports.

The report -- the U.N.'s first study on midwives -- found that 358,000 women and 3.6 million infants die annually because of largely preventable complications during pregnancy, childbirth and the postnatal period. About another three million infants are stillborn, the report found. The report surveyed 58 countries, studying the equivalent of about 60% of all births and 91% of maternal deaths worldwide.

Countries need a minimum of six skilled birth attendants for every 1,000 births to achieve 95% of needed coverage, the report concluded. A total of 38 countries need more midwives, 22 of which need to double their midwifery workforce by 2015. Seven countries need to at least triple or quadruple their workforce, while nine countries need to increase the number of midwives by between six and 15 times (Kelland, Reuters, 6/20).

Dozens of aid, development and educational institutions endorsed the report and asked governments and philanthropists to invest in midwives, the AP/Washington Times reports. Vincent Fauveau, a physician who worked on the study, said that midwives can provide a solution for countries with shortages of doctors and nurses. Midwives also can provide contraceptive counseling and services, he said. War, poverty and hunger threaten women and children in many parts of the developing world, he explained, adding that "a long-term strategy" and many investments are needed to save lives (Bryson,AP/Washington Times, 6/20).

Sasha's Birth of Finley Mae Soleil By Sean

2011-05-31T20:23:00.000-07:00

Finley Mae Soleil Gillon has arrived! She was born at home, in the water, on Friday, May 6th at 7:00am. She weighed 8 lbs., 9 oz. and was 20.5 inches long. Sasha's labor lasted 7.5 hours and she was inspiring throughout.

Sasha's water broke at 11:30 pm on Thursday night while we were laying in bed... she heard and felt a "pop". We got up and she moved to the shower, where we looked at each other incredulously. It's not happening, is it? Within an hour the dull aches turned into intense contractions. Her mom, a former midwife who had arrived earlier that evening from Iowa, and I put hot wash clothes on her back for a couple of hours as the rushes strengthened. We hurried around getting ready in between... I ran around like a maniac trying to sort out the tub and everything else. It was happening so fast.

By about 2:00 am, Sasha laid down on the floor in the living room, moaning "open" through rushes and falling asleep in between. I laid next to her and, along with friends, comforted her as we fell in and out of sleep. When she stood up near 5:30, happy to see the first signs of sunlight, she was nearly fully dilated. Realizing she was farther along in labor than anticipated, we called our midwife, Maria Iorillo, who was incredible. She arrived shortly after to find us in the birth tub. Several intense, thrilling, overwhelming pushes later, a posterior head emerged... that was a surprise. The shoulders and body quickly followed. I pulled our baby up to Sasha's chest and we snuggled. What an amazing feeling. We soon found that she was a she and I cut the cord.

Finley and Sasha are both healthy and we're deeply enjoying our first days together.

Love,

Sasha, Sean, and Finley Mae

Look for next blog post that will tell you all about the placenta!!

Number 993 - Welcome Na'Imah Iman

2011-05-23T17:02:00.000-07:00

As I sit here staring at this little human that was in my belly just seven days ago, it is hard to believe this all really happened. I am blown away by my homebirth experience and am so proud to have had a successful birth in my own home surrounded by the people I love most.

Our birth story, for me, starts earlier than most I think because somehow I just knew it was coming. Tuesday April 19^th I was 38.5 weeks into my pregnancy, I started seeing a little bloody discharge and having period like cramps that had started days prior to that all of which excited me but I knew that it could still take weeks before I met my little one. The following day I had my appointment with Maria, I arrived early and so I decided to take a walk around the neighborhood, something I hadn’t been doing due to all of my pubic bone pain throughout the pregnancy but I was determined to meet my baby as soon as possible. Maria and I discussed the discharge with no alarm except Maria did say that she wasn’t sure if the baby is going to wait until my Mom got here on the 25^th, so that also excited me. I then got my chiropractic adjustment from Kristine and was on my merry way. When I got home the discharge and cramps continued to increase but no rhythm to the cramps just noticeable and annoying. At around 9pm when I was about to lay down for bed I got up to pee and noticed a brighter and larger amount of blood when I wiped which alarmed me so I called Maria. She let me know that it still sounded like mucous plug to her and I should try to sleep because I might be woken up in the middle of the night with contractions. So now I am really excited and falling asleep felt like it would be impossible, it was like the first day of school all over again. At 10pm I felt a noticeable change in the cramps they were not tightening across the top of my belly but down low and slightly more intense. I eventually fell asleep around 11pm only to wake up at 1am with more of the same cramps. I laid in bed until 3:30am trying to fall back to sleep but I started to become hungry. I got up to eat which shifted something because then I felt them a little stronger and more frequent, every 3-5 minutes lasting about 30 seconds in length. I decided around 4am to text my doula Stacy Vogan and give her the update. She recommended I take a bath and try to relax. I decided the bathtub was too filthy so I scrubbed it clean then decided I was too hot to take a bath so I went and tried to lay down some more. Around 5am my still sleeping husband, Walid, woke up to his alarm and I told him to call in to work because my labor had definitely begun. My surprised and half asleep husband said “babe! Why didn’t tell me last night” I explained I wanted him to sleep as long as he could. We continued to lie in bed and relax, I got another hour of sleep from 7am-8am and woke up starving, I had the most insane craving for McDonalds breakfast so I sent my husband out. After he returned and my best friend Bianca came over I left the bed and tried to watch a funny movie to distract myself. That lasted about a half hour before I decided all the chatter of the movie was annoying me so I had them shut it off. At some point during this time I managed to shower and shave my legs but I cannot recall the time. My friend Susanne had also arrived, she was my photographer and as much as I was feeling like I didn’t want an audience I knew I wanted documentation. We also set up Skype so that my Mom can feel present.

At around 10am we started timing contractions they were coming every 4-5 minutes and lasting 45 seconds. I would let them know it was coming then my husband would rush over and squeeze my hips and I would try to breath. At that point I really thought I needed my doula, I was feeling slightly inadequate and was needing more support. My doula arrived to the house around 1pm and as soon as I saw her I burst into tears, partly so relieved to see her and partly just from the pain and exhaustion.

She was wonderful, reminding me of all that we have practiced and what I already knew I could do. Taking deep breaths and as Stacy would say “going deep” with my moaning. I was also feeling hungry and having zero desire to eat anything that I had to chew. Bianca made me a protein smoothie and we continued to labor. Shortly after that I decided to get into the birthing tub.

The tub was amazing, I felt lighter and calmer. My husband got in with me and pushed on my hips with every contraction, he was so wonderful, reliable and completely supportive. Maria arrived around 2pm we think. My contractions at that point were feeling very intense, I would feel it coming, it would last about one minute to a minute and a half, then as it subsided another one would come up right behind it without a break but only lasting about 20-30 seconds and then I would get my much needed break. My moans were surprisingly louder than I had expected them to be.

I am typically a very quiet person and expected a lovely silent homebirth as I had seen in so many homebirth videos, not so in my case and I was later told I sounded sort of like a lamb. I also remember clearly saying the words “no” and “ouchy” and I only cursed a few times (also surprising). What’s even more interesting about that is that I once read somewhere that research had shown newborns have the same intonation as their mothers when they cry and I swear some of the sounds she makes were the exact sounds I made while I birthed her.

We were still waiting on my antibiotics to come via courier, since I had tested positive for GBS, once they arrived around 4pm we then needed to warm them up a bit. Around 5pm they were ready to go I had to leave my warm and cozy tub, which felt impossible. I could hardly walk at that point and made it about 10 steps before I felt another contraction coming. It was then that I saw a slight gush of water coming down my legs with a little bit of blood. I remember being confused if my water had broke or if I was still just wet from the tub but it continued to come and then I could care less as the contraction came on stronger. I bent over a table and called for the hip squeeze again and so we decided to do the antibiotics right there. I would sit on the exercise ball in between contractions to rest but I had to remain on that antibiotic and at that table for an hour.

After we were done with the antibiotics I felt very aware of the audience in my home and had an intense need to be alone with my husband so we went and begun laboring in our bedroom with the door closed. Every now and then Maria would pop in to check the baby’s heart rate, my blood pressure or my dilation; baby was always strong and steady. I sort of dreaded when Maria came in the room only because it meant a check of some sort or more antibiotics and my contractions felt so insane that I thought I couldn’t bare anything else. After laboring on the bed for awhile Maria checked my dilation again and I was only at 7 and feeling like there was no way that could be possible after all this work. She suggested we try sitting on the toilet as a different position to help things along and so we did. The contractions got worse on the toilet, stronger and longer. They also made me feel like I needed to push, push what I am not sure, what it really felt like was that I badly needed to poop. I would bare down on my husband’s hips and hold on until they passed, I was not liking the toilet at all so we moved back to the bed. Eventually I wanted to try the tub again in hopes that I would be getting close to pushing and we could birth there. At some point someone said I might be ready to push in a couple hours….I remember feeling very aware of time and knowing that these contractions were coming every 30-45 seconds apart from each other it seemed just daunting that I will be doing this for a couple more hours at the least. After we were in the tub for awhile Maria checked the baby’s heart rate again and she said that the heart beat was decelerating so I may need to leave the tub. She suggested I shift to my side and see if baby likes that better and thankfully she did, heart rate regulated and all was well. Eventually, we needed to do antibiotics again so we needed to leave the tub. Walking was near impossible and it took my husband and my doula to get me back to the bedroom contracting along the way. We labored there for what we think was about 45 minutes to an hour then Maria gave me a check again and said that I was at about 9 ½ and there was just a little bit left, then she said “I think you can start pushing and the pushing will clear that space”, she also said that she was calling her second midwife and she left the room. My doula Stacy said “did you hear what she said”, and I said “yeah, she’s leaving me” and she said “no she gave you the green light to start pushing”, for some reason I thought that the second midwife was coming to replace Maria. Maria then came and asked me if I wanted to make my way back to the tub for birthing. I had always wanted to birth in the tub but I just could not imagine making my way back across the house. So the pushing began right there in my bedroom. It felt amazing to try to get rid of that rectal pressure, although it was as if I got it out half way and it would be sucked back in..…highly dissatisfying. At one point I felt that my husband, who I was leaning on, had fallen asleep (which in retrospect I cannot imagine how because my moaning had definitely increased). I tried pushing on my back, pushing on all fours then Maria said “I have the birthing stool if you want to try that”. Again, feeling like I didn’t want to move anymore I also was willing to do anything to meet my baby. I decided to go for it, with my husband behind me supportive as ever and after just a couple pushes Maria checked the baby’s heart rate again and said “so Krissi, it’s probably best he baby come out as soon as possible” and I remember feeling an animalistic instinct to push and keep pushing like never before and then I heard “ok, there’s the head” which surprised me because I didn’t feel that happen but with the next push I felt an incredible burn and on Friday April 22^nd at 3:10am there she was on my belly.

I looked at her in complete amazement. She was so alert and just fantastic, she needed a little oxygen but throughout the whole process I never worried about her and had complete faith in Maria and my baby.

I can’t describe how happy I was to meet her and in complete denial that I actually pulled it off. I felt alarmingly refreshed and energetic and I was home in my bed with someone so perfect. We stayed up for the next 3-4 hours before falling asleep for about 3 hours and awake again with excitement. I am still in disbelief and as any one of my friends would tell you, I have a very low tolerance for pain but my determination and a little bit of stubborn (or as Maria wouId call it tenacity), I did it, without a single thought of an epidural, we did together, a perfect rhythm between baby and mama and an incredible birthing team. I am so thankful for Maria and Stacy and my amazing homebirth experience; I loved every moment of it and wouldn’t have wanted it any other way.

Maia's Blessed Birth Or: How I had a Homebirth at Kaiser

2011-05-05T15:38:00.000-07:00

by Gillian Bowley

My family is together in our bedroom on the second daybreak of our daughter’s life. Daddy is holding Maia in bed, and Cindy Lou is looking on at the strange scene from her doggie bed in the corner. And I am in awe of the many blessings we have received as we brought Maia into this world. I don’t want to forget a thing about her birth.

After the birth, our midwife Maria said eloquently, “In a hospital, they are focused on a healthy baby and a healthy mama. And we midwives are focused on that, too, but we add healthy process. Because most of the time, without a healthy process, you don’t have a healthy baby or a healthy mama.”

Our process began on Sunday, April 17. Brian and I spent the day quietly together. Things had been feeling hectic and separate and impatient for me. I felt like the baby might be coming soon, but I needed to connect. We went on an urban hike, letting the location of bakeries determine our route. We walked a hilly course of about 6 miles around the city, stopping at bakeries along the way. Sesame tofu salad at Mission Pie, vanilla wafers at Dianda’s, a strawberry tartlet at Destination Bakery in Glen Park, a chocolate chip cookie at Noe Valley bakery, and then back home to Sharon Street. I was totally exhausted, but not feeling any closer to labor. I went to bed with the same feeling I’d had for a couple of weeks: ”Maybe tonight…?”

That night, at 3am, I woke up from what felt like regular surges, but I let Brian sleep. A note about “contractions.” I wasn’t sure what I was feeling, since the sensation was similar to the menstrual cramp achiness that I’d been having for weeks. And really, the contractions I experienced during labor, whether light or profoundly deep, were more like surges of energy. I know the biological explanation of contractions, but to me it was a life force surge. I wish I could say that this helped to ground me or center me during my labor. It did not. It’s more in retrospect that I understand my experience of surges.

Around 4am I decided to do some timing, and sure enough these surges were about 10 minutes apart and lasted 30 seconds each. Brian’s alarm rang at 6am, and I let him know that we were going to have our baby soon. I was incredibly excited and curious.

We decided to keep our 8am appointment with our midwife Maria rather than call her. I must explain about Maria. The more we have learned and experienced about pregnancy, birth, and babies, the more in awe I become at Maria’s incredible depth of knowledge and skill in caring for mamas and babies in a deeply caring, spiritual, and individualized way. She took incredibly good care of my family, but more to come on that subject.

To get to Maria’s office, we took the J-Church muni train. I had a couple of surges on the train, but was able to breathe through them and sway my hips in the seat. When we arrived I excitedly announced that I was in labor. She checked my vitals and sent us home, advising us to go about our business and have a regular day, though I couldn’t imagine how to do that. I was really excited about being in labor, and I was so curious to find out what would come next. We went to a café, stopped by a market for some supplies, and instead of waiting for the train home, we walked the quick mile through a foggy Dolores Park. Things felt perfect.

My mom came over to our house at around 10:00, and we decided that she and Brian were going to take Cindy Lou out for a walk while I rested. Just before they left, I had a surge, so I stood up and leaned over on the table, and, Pop!, my water broke. The sound and sensation of the pop were so surprising that I yelped and cracked up. I could not stop laughing, which of course pushed out more liquid, which made me laugh harder. Brian and Mom decided to skip the walk. I was having a great time! I called a dear friend in Virginia, and was still able to talk reasonably through my contractions. I sent a few text messages about my water breaking, and got some encouraging responses back. This was really happening. My baby would be born on Monday April 18^th—full moon, foggy San Francisco, Passover—perfect.

Around noon, the surges intensified and I had to move and moan through them. The work was starting. Brian stood by me and helped me through each one as we moved through the house. We worked on the exercise ball next to the bed, on the toilet, over the couch. Brian timed the contractions, and while it was clear they were building, I knew we weren’t anywhere near the 4-1-1 mark: contractions 4 minutes apart, one minute duration, for at least an hour. My mom and Brian were really eager to contact Maria, so at 1pm Brian called to give her an update and let her know that my water broke. She was excited and encouraged us to keep going and call her back when we reached the 4-1-1 mark.

My surges built to about 3 minutes apart, but were a bit inconsistent, as occasionally I’d have a 5 or 6-minute interval. They were also short at 35-45 seconds. They were, however, consistently strong: I had to moan and move through them. I got impatient around 5 or 6, and at 6:30pm (still Monday) Brian called Maria to report our progress. Even though we hadn’t gotten to 4-1-1, she decided to come over.

I was relieved when Maria arrived at about 7pm, because I felt like I’d been working hard to get labor moving by trying all sorts of positions, movements and moaning. I was getting tired and I was curious to know how dilated I was, and how close I was to having our baby! She checked me, and we learned that I was 3 ½ centimeters dilated. This was pretty discouraging to me, and was definitely a low moment. I’d felt so prepared for many things, but I didn’t know anything about bringing labor on. I’d just assumed it would happen naturally. I was tired and out of ideas. We all needed a break. Brian’s parents brought food over, and my mom and Brian ate while Maria set up. I was not at all interested in eating, although I was hungry. I managed to eat a banana.

The night is a bit of a blur. It was a long night, but we continued to try everything: positions, walking, bouncing, swaying, atmosphere (music, candles), herbal drinks, and homeopathic remedies. I called on my many mantras to help me: My body and my baby know what to do; My body is opening like a flower; KNOW; TRUST; and meditation techniques and yogic breathing and positions (juicy hips) to open, open, open. I talked to my baby, and told him or her that it was time, it was ok to come. I asked him or her what I needed to do.

At about 3am, the 24 hour mark, Maria suggested I get in the tub for a change of pace. My surges were very intense at this point, but the timing continued to be variable. I was getting really tired, so the tub idea sounded great to me. Being in the tub gave immediate relief to my tired, sore body. Brian sat by and timed my contractions. I was surprised by the power of the surges I had while in the tub. They gripped my body, and I floated around to find positions and moans that would help move the energy through my body, and most importantly help the baby move down. Some of these surges were long: about a minute and a half or longer. The energy gripping my body was unbearable to me, but I stayed in the tub because I thought that maybe these contractions would take me to the next level of labor. Still, it was hard work, and I told Brian I didn’t know if I could do it. I felt despair: fear, hunger, exhaustion, and no baby in sight. When would this end? Brian was encouraging and loving and he is the reason why I was able to keep going.

In the morning, 12 hours after my first internal exam, Maria wanted to check my dilation. So, at about 7am on Tuesday, I was eager to see how much I progressed. I was 5 cm dilated. What??? All that work, all night long, and I had only opened 1 1/2cm? What was happening here? We talked a lot about what could be holding me back, and what I could do to progress in my labor. But first, Maria suggested this would be a good time to take a break so that I could build my strength up to keep going. This sounded great to me. We found a place for me to rest in a rocking chair, because when I lay down in bed, the contractions were too intense for resting. In the rocking chair, I was able to rest for about 3 hours. My contractions were coming every 6-10 minutes, and they were between 30-40 seconds, and they felt strong. I had to moan and move through them. I also had to train myself to stay in the chair when they were done. I had the urge to walk around, and especially to go to the bathroom, but I knew I didn’t actually need to go, and that giving in to the urge to move around would not give me rest.

The resting was extremely helpful, and I was ready to ramp things up. Come on active labor, let’s move this baby! We had exhausted all homeopathic and herbal remedies; they just didn’t seem to be working. We had a new plan: castor oil! I would use the laxative to contract my intestines in the hope that it would encourage my uterus. Yes, this would work. I took the castor oil, continued to rest, and waited for the oil to work its magic.

At some point close to lunchtime, Maria noticed that the baby’s heart rate was decelerating during contractions, which is normal during active labor. But I was no where near active labor. Baby heart rate decelerations during early labor are reason for concern. The castor oil needed to work.

I’ve lost track of time, but maybe around 1pm the castor oil kicked in. I was re-energized: I had rested and I felt like this would do the trick. I got back into positions and tried new ones, but still no progress. It was clear after all the castor oil moved through me that it did not do the trick. I still felt it was possible for these contractions to build to active labor, so when Maria suggested acupuncture, I was very excited because I knew my body responds well to acupuncture treatments. We quickly found an acupuncturist, Linda, who was able to see me in 45 minutes, at 3:15. At 36 hours of labor, we piled into Maria’s car and drove a mile down Church Street to see Linda. Before we got there, Maria asked, “What do you think?” I replied, “I think I’m going to get this treatment, it’s going to put me into active labor, and we’re going to have a baby by the end of the day.” I was still smiling.

The drive was bizarre: I felt like I was watching a movie, or watching someone else’s dream. The block and a half walk from the car to the office felt long, and I had a contraction along the way. Linda treated me as I sat on a stool and was face-down on a large pile of pillows. The treatment had an immediate effect, and it was not only due to the cupping and needles. Linda encouraged me to call on my guides, to talk to my baby, and she asked what was blocking me. I thought for a long while, and I said that I thought that the baby needed my permission. When she asked me what I meant, I said I didn’t know. Brian was in the room and he said, Yes, the baby needs my permission too! It was deeply emotional, and I literally felt the baby move down as some of this emotional energy was cleared. Linda and Maria left me and Brian alone together in the room. I was still being treated, but Brian and I talked to each other and our baby, and made a plan for when we got back to the house.

I haven’t written many details about Brian’s involvement, but he was right next to me every second of this process. He waited for my cues, he rubbed, pushed, pressed, and supported my body, or when I decided I did NOT want that, he stopped. He whispered encouraging, loving words, and he timed my contractions while supporting me through them. When we returned from the acupuncturist, with me deeper in contractions, we went into the “labor cave” (our bedroom), and sat together. There were new rules: I did not want to hear any chatting in the house, and Brian and I would not chat. We would sit in meditation, and I would do everything I could think of to progress labor. The acupuncture moved the baby and deepened the surges, and I believed that focusing more on the labor would get us to the active labor part.

Brian timed my contractions in the cave. Over an hour or so, there was no change. Maria continued to check the baby’s heart rate during these contractions. The deceleration was still there. No change in either baby or mama. Maria did an internal exam around 5:30. I had been laboring for about 38 hours, and she told me that I was 5 ½ cm dilated. I knew what was coming. It was time to consider transport to the hospital.

Oh, the deepness of the disappointment I felt at this moment. How could this be happening? What was wrong with me? What was wrong with my body, with my baby? What else could I do? I did not want to transport, but I know that if I stayed at home, there was the real possibility that my labor would not progress quickly enough and we would put the baby in danger, not to mention the fact that I was so exhausted that if I labored for another whole night, I might not have the energy to push at the end.

I turned to Brian. He was so strong. We talked about the cards exercise from our childbirth class. We’d had 6 cards, and on each card we wrote a wish for our birth. On the back of each card, we wrote the opposite of that wish, for example: short, productive labor on one side had long, slow labor written on the back. Our instructor Jane had us lay them out, and one by one, we chose a card to turn over. It was a very useful exercise in which we had to ask ourselves which aspects of our birth were we willing to give up, and what might happen if we had to give them up? It was clear that it was time to turn over the have birth at home card so that we wouldn’t have to compromise the others, especially healthy mama, healthy baby.

Tears came, certainly, but I felt that this decision was just the next step on our journey together. The three of us, and my mom as silent backup, had worked together to consider each step of my labor. I felt very confident with the plan: we were going to Kaiser to get, as Maria put it, “a whiff of pitocin” (labor-inducing drug), have the baby, and then get out of there AMA (against medical advice). It was just the next step in my homebirth.

Upon arrival at Kaiser’s labor & delivery floor, Maria found a nurse who is her client! She was going off duty at that time, but she set up with a nurse, Juliana, who was very respectful of my priorities and preferences. Juliana was on our team, and was incredibly patient, kind and encouraging. Perhaps most important, she communicated with the rest of the staff my preferences, and reminded them often how I wanted it done.

As I was getting set up, I looked at Maria and laughed. What else could I do but give in and laugh? I just couldn’t believe that after all we had done, all the months of thoughtful preparation and the hours and hours of labor, here I was in a beeping hospital room, surrounded by blue caps and masks, and hooked up to monitors and IVs. But for some reason, I wasn’t sad, I wasn’t disappointed. I guess I knew this was what it was going to take for me to meet my baby, and I was so ready.

Maria was right: all I need was a whiff of pitocin, administered at about 9pm, and I felt like I was pushing the baby out from the first contraction. The OB had checked me upon arrival, and I was 6cm, but I felt like this baby was coming soon. The surges were gripping, but it was a great feeling: finally, progress! This baby was coming. I didn’t have time to get used to this new level of contractions, and I felt a little confused by the rush. My body was shocked and holding against the surges, but Maria reminded me to moan deep and low, and to relax my legs and bottom, which I kept gripping. I knelt facing the back of the hospital bed, and as each contraction came, first I threw my hips against Brian, and then I figured out how to hold on to the back of the hospital bed and squat. I felt like I was pushing at the end of my surges. I heard Juliana say, that sounds like pushing! I didn’t know if I should do that yet, but Maria told me to just go with whatever was happening, and Juliana was very encouraging and told me to “do my thing.”

I know that I was in active labor for 3 hours, but it seemed about 40 minutes. Towards the end the OB came in and shouted, “wait, wait you’re having a baby!” I was too deep in labor to actually laugh at this, but I knew it was totally absurd. She insisted that I labor on my back: what a vision! I was confused at this point, not having my wits about me to protest. Maria helped get me into a position, and I started pushing. WOW, the incredible power that I felt. It was amazing. This baby was coming. But still, that laughter in the back of my head: was I really lying down on my back with a bunch of OBs in scrubs yelling “Push, PUSH!?” Yes, that is how the last few minutes of my homebirth went. And suddenly, I looked down, and there was my baby’s beautiful, perfect head, screaming. What an incredible sight. I continued to push, and just a few minutes later my husband placed our baby on my chest, and let me know that we had a girl.

I am unable to describe the bliss, gratitude, and wonder that filled those moments. I was aware of some activity around me, but mostly it was just me and my baby, my husband Brian elated by my side. In the next moment, I looked at Maria, and her face had the same look of excitement that I felt. It was like were we silently saying to each other, what an awesome birth!

And so, Maia Ambry Cavagnolo was born at a Kaiser homebirth at 12:14am on Wednesday, April 20, 2011.

Healthy mama, healthy baby, and I would add: very healthy process.

Maia Ambry is here - A Perfect Birth

2011-05-02T08:31:00.000-07:00

Here's Brian's story:

Perhaps word has already reached you that I am now a daddy. But I thought you might want to see a photo and some stats for the record. Maia Ambry Cavagnolo was born on 20 April 2011 at 12:14am. She weighed in at 5lbs 8oz and was 19" long. Gillian's contractions started at around 3am on 18 April and ramped up throughout the day.

Plan A was to have the baby at home. So after some breakfast and a walk we got comfortable and the contractions started setting in. Gillian's mom came over to help out, and our awesome midwife Maria joined the party at about 7pm that evening. Gillian labored through the night like a rock star (or perhaps a miner?), but contractions weren't coming as close as we needed them. Over the course of the next day we tried all of the midwife tricks for stepping the labor up a notch, but we just continued to cruise. Finally, we decided to head to the hospital for some pitocin, everybody's favorite labor-inducing hormone, in order to finish the job before complete exhaustion set in. Also, the baby's heart rate was dipping with each contraction. While this is not completely abnormal in the late stages of labor, it's an unsettling sign in the early stages. So off we went to Kaiser for Plan B.

At Kaiser, a client of Maria's was one of the nurses on duty! She was just about to get off work to go on maternity leave. But she hooked us up with Juliana, a friend of hers who was completely down with the home birth track and who has earned a special thank-you note for her awesomeness. After getting the pitocin dripping, Gillian's contractions got pretty strong pretty quick. She did a fantastic job! It was not long before it came time to push. With a bit of coaching from Maria, and some experiments with position, the zeroth birthday was imminent. I glanced at the clock between each contraction, waiting with anticipation to see if my baby would be born on boring-old April 19th, or famous 4/20. Gillian, was not watching the clock. She was digging deep during contractions, and then fending off the pesky interventions of the young and impatient resident OB. After about 3 or 4 solid pushes, out popped the baby! One of my important ceremonial duties was to announce the sex of the baby. "It's a girl, right?", I said. Needing some assurance because everybody was convinced she would be a boy for some reason. Hooray! We all celebrated.

We spent the night at the hospital, SUPER exhausted. After my parents came by to meet the baby, I crashed so hard that I can't even report on what happened until the next day. I don't even remember whether I slept on the bed or on the floor. I can only imagine how exhausted Gillian was. The next day at around 5pm, after a bunch of tests, we managed to escape from the hospital to come home for Maia's first family dinner. We've spent the last few days learning all sorts of stuff about feeding, pooping, cleaning, and sleeping. I'll spare you those details:)

Birth of the Bean

2011-01-18T19:38:00.000-08:00

Here is the amazing story of the one who is/was known as "The Bean." As told by her father Isaac. Click here.

A Father's Perspective - The Birth of Julius

2011-01-17T21:57:00.000-08:00

Hi everybody, Janis here (Shaniqua's husband).

The nutshell story is that our son, Julius John Stipins, was born a week ago today. He is very healthy, Shaniqua is recovering well, and we're getting settled into a decent rhythm at home. It's perfectly fine to stop reading now. :-)

We have hesitated until now to send you all a birth story. For casual acquaintances and distant relatives, it's fine to send out a "Hey, it's a boy!" email, omitting the difficult and frightening parts. For our fellow travelers from the birth class, though, we didn't feel right giving you a sanitized version of the story. At the same time, we haven't been in a good enough place to feel like sharing the truth with anybody until now. So here it is, and hopefully it will be helpful in some way to some of you.

First of all: Shaniqua never went into labor naturally. We had considered and planned for many different eventualities, but this was not among them. I don't even remember it being mentioned in our class as a thing that happens, although possibly I wasn't paying attention. Our midwife, Maria Iorillo, says that she sees about two cases a year of a woman going until week 42 without going into labor. Shaniqua had plenty of Braxton-Hicks contractions, but still had not gone into labor by Dec 29, which was two weeks past our "due date". (A phrase worthy of irony-quotes, to be sure.)

Here is some information that we probably knew at some point, but did not have at the top of our heads when it became relevant:

- At least with our midwife, once the pregnancy extends to 41 weeks, it is recommended to get two non-invasive tests done at a hospital. The first is a non-stress test, which makes sure that the baby's heart rate is not crashing, and that he is moving often enough to indicate good health. The second is an amniotic fluid index, which makes sure that the baby has enough fluid around him in the uterus. These tests need to be repeated every few days starting with week 41. The idea is that the pregnancy can continue safely if the tests look good; otherwise induction is recommended. Our tests looked excellent on Dec 22, 24, and 27.

- We had established care at St Luke's and at UCSF. St Luke's is closer to us, and so we went there for the first two test dates. However, St Luke's will not induce labor past 41 weeks 4 days, so our test on Dec 27 was performed at UCSF, which is better equipped for neonatal intensive care.

Nobody likes a pregnancy to extend past 42 weeks, regardless of how good the test results look. If it is fair to call 40 weeks the "due date", it's probably fair to call 42 weeks the "induction date". This is a perfectly reasonable thing; it's just not something we were really conscious of until we zipped past week 41 with no labor.

Here is one of my opinions that I mentioned in class, but which bears repeating:

- If you accompany someone you care about into a hospital, prepare to be an advocate for that person. Question everything until you are satisfied that you understand what is happening, and do not feel obliged to accept someone's recommendations. Everyone who comes into your room has an agenda --- not a malicious one, but one which may not be aligned with your own goals. For a simple example, after each of the three testing sessions, we had to fend of a different well-meaning hospital employee hellbent on performing a cervical sweep. They each had to be turned down multiple times before finally accepting Shaniqua's decision. (Our midwife is not a fan of sweeps in most situations, including the situation we were in.)

Anyway, back to the birth story. With our midwife's guidance, we made the decision to check into UCSF for an induction on Dec 29. The appointment was made for 8pm, with the understanding that the first step of labor induction would be a drug called Cervidil, which is designed to ripen the cervix gradually, over a period of 12 hours or so. The idea was that Shaniqua would check into the hospital, they would give her this medication, she would get a good night's rest, and then on the morning of Dec 30 they could begin further induction if necessary (read: Pitocin).

That's not how it happened.

By the time Shaniqua had been checked in to the admittedly nice Labor Room 3, and her cervix had been roughly examined twice (and likely swept, in her estimation), and the Cervidil was inserted... it was 2am. OK, fine; she and I would get some sleep there, and we'd see what the morning would bring.

Forty-five minutes later, Shaniqua started having real, painful contractions. She had one real, painful contraction every 60 seconds from 3am until 11am, when the force of the contractions caused her body to eject the Cervidil. This is during the time that she had planned to be resting, based on what we had been told by the doctors. The doctors were surprised at how effective the Cervidil was, which was little comfort to Shaniqua.

Even though this is the non-sanitized version of our birth story, I am going to fast forward through the labor now, if for no other reason than that I lack the ability to communicate the profundity of what transpired in Labor Room 3 that night and day and night. Some day I will try to write it into a worthy story. For now, this is the email I sent to friends and relatives on 12/31/2010:

------------------------------

Hi everybody,

This is Janis writing from Shaniqua's email account, announcing that our son, Julius John Stipins, was born today at 7:42am at UCSF hospital. For those keeping records, he is 9lbs 8oz and 23" long. He's also very cute, due to looking a lot like his mom. :-)

We were planning a home birth, but Shaniqua still hadn't gone into labor two weeks after the due date. So we went in to the hospital on the evening of Dec 29, so that they could give Shaniqua something to induce labor. It worked surprisingly well, and by 3am Dec 30 Shaniqua was in labor. She labored for 28 hours, making incredible progress, and astonishing the doctors, the nurses, our midwife, her mom, and me.

Let me interject here that I am not claiming that any one way of giving birth is right, or wrong, or better than another. But I will tell you Shaniqua's way, which will surprise none of you who know her: she labored for 28 hours, on her own, refusing assistance from any doctors or nurses, and keeping her own counsel about every step she took with her baby. She made astonishing progress, the likes of which our doctors, nurses, and midwife had never seen, to say nothing of her awed husband. She breathed; she walked; she bounced on the fitness ball; she spent time in the tub. She did not take so much as a Tylenol for 23 hours, and then she only took something because she felt she needed to sleep for a bit. Still, as time went on, her vital signs got a little worse, and it became clear that it would be medically necessary to deliver by C-section, and she accepted that (probably because she knew she had done 120% of what any normal person could expect to do). Even so, 27 hours in, she still refused assistance in getting in or out of bed. In a nutshell, Shaniqua was able to bring Julius into the world exactly how she wanted to, if not how we originally planned. Having that kind of say was what we wanted out of a home birth in the first place, so it was a big success after all.

Anyway, the procedure went perfectly, and right now baby and mama are recovering together nicely in the hospital. I'm home, sending a few announcement emails before taking a shower, sleeping a bit, and heading back in.

If any of you feel compelled to offer congratulations, please give at least 99% of them just to Shaniqua. I'm looking forward to being one of two great parents that Julius has, but the successes up until today belong to her.

-Janis

------------------------------

For this more specialized audience, I will give some of the technical details that I omitted from the included email:

- Shaniqua was 0cm dilated at 2am.

- She was 5cm dilated when her water broke at 1:30pm.

- She was 7cm dilated at 9pm, and did not dilate further than that, despite the addition of Pitocin from 1am-5am on 12/31.

Some more details:

- Shaniqua had severe preeclampsia and HELP syndrome.

- Her blood tests showed rapidly declining liver and kidney function, and her platelet count had dropped by 50% between checking in to the hospital and 9pm the next day.

- At 7:30pm her blood pressure was 190/105.

- At 7:35pm, her husband cleared all medical personnel out of the room so that she could work in peace with Maria and Nova.

- At 9pm, her blood pressure was 120/80.

For this more specialized audience, I will give some of the spiritual details that I omitted from the included email:

- Shaniqua told me, afterward, that she knew in her gut weeks ago that this baby would come via C-section. She feared for the child's loss of the oxytocin rush he was supposed to get as he passed through the birth canal, and she decided that she would labor naturally as long as humanly possible, so that her child would have the benefit of as much oxytocin as she could generate. I do not have sufficient words to comment further on this point.

- I personally had never witnessed nor imagined anything as powerful and profound as Shaniqua's labor. I worked with her through much of it, and advocated fiercely for her as well as I could so that the doctors would leave her to labor the way that she needed to; but the part that transformed me was between 10pm and 1am:

Shaniqua lay in the hospital bed, nonverbal, deep in her labor. She was having powerful contractions, strong enough to alter radically the shape of her belly, every few minutes. Shaniqua experienced these contractions as perfectly as any woman could hope to: she was fully present in each second of time, falling immediately into rest as each one passed, meeting the next one head on and riding it as it surged, moaning, breathing, shaping, visualizing, but never wasting one moment looking forward or backward, never stopping to reflect on the magnitude of the previous surge, never fearing the start of the next.

Meanwhile, Maria sat by the bed in a glider chair, her hands folded over her belly, sleeping between surges, and waking to coach Shaniqua through each. I can see the scene still, with Maria's face lit by the glow of the computer monitors in the dark room, an expression of perfect calm and understanding as she watched over Shaniqua, guiding her through the creation of our family.

I watched from a few feet away, attempting to rest on a couch, but unable to let my consciousness slip from the scene before me. Here were two archetypes of womanhood, walking the boundary between life and death, night and day, one life and two. One of the women had never made this journey before, but went on fearless and confident and undaunted, trusting herself never to misstep; the other had guided many along similar paths, knew exactly what guidance to offer and when, and knew also that success or failure, life or death, was ultimately beyond her control. Together they worked, while I watched; and I like to think that I learned something about life and death and womanhood from being there.

- Our birth story definitely has a touch of bad-to-worse, at least when you consider that our original goal was to have a vaginal birth at home. Had Shaniqua broken down and cried; had she bemoaned her fate; had she indulged even once in the slightest form of self-pity or fear or frustration, I would not have thought one iota less of her as a person. But she did none of those things. She spent every bit of her energy on laboring with her child, letting nothing distract her, nothing dissuade her from reaching the finish line on her own. Her determination and focus inspired me through the whole experience, and saved me from falling into negativity and fear of my own. I was in awe of her, and I remain so.

OK, end birth story.

I'm running out of energy here --- my fault for writing so much --- so let me just give a brief outline of what happened from the birth until today.

- C-section babies don't get the amniotic fluid squeezed out of them by passing through the birth canal. This means that when Julius was measured at 9 lbs 8 oz, he was weighted down by at least three bellyfuls of fluid that he vomited up the first night. This was not "spitting up", he covered Shaniqua's chest with fluid each time. He also blew out four diapers with meconium in the first 24 hours. Together with the fact that Shaniqua and Julius were plumped up with three boluses of saline from the labor, the kid dropped 9.8% of his weight by the next morning.

- Despite the fact that this weight loss was entirely understandable, the hospital has a policy of watching closely any baby that loses 10% of his birth weight. We got watched carefully. Whee.

- Breast milk comes in later after a C-section than it does after a vaginal delivery.

- Kid was "underweight". Mom was waiting for breast milk. Not a good situation.

- We met some very kind people in the hospital, but also some very clueless and frustrating ones. Shaniqua was in the middle of processing a tiny fraction of what she had gone through during the labor, when a 26-year-old OB doc fresh out of med school comes in to do rounds. She'd never met Shaniqua before, but when Shaniqua made the mistake of crying in front of this doc, next thing we know... social worker knocking on the door! Whee.

- Think very carefully about whether having her mom around for the labor is what you want to do. I spent a nontrivial fraction of my energy during the labor in a battle of wills with my mother in law, who was convinced I was killing her daughter by preventing unwanted medical interventions. In the grand scheme of things, it wasn't an important conflict; but some moms don't really want to see their daughters go through this kind of experience.

- We finally got out of the hospital on the night of Tuesday, Jan 4. We only managed this by feeding the kid some formula to boost his weight enough for the hospital to let us go. Feeding formula to the kid was an extremely emotionally charged decision.

- Sleep is very, very important. Not just a little important. Postpartum stress/exhaustion/emotions can look a lot like postpartum depression or psychosis after severe sleep deprivation. Moms: please eat and sleep as well as you can, for everybody's sake. Dads: same advice.

- After meeting with Maria on Wednesday, we got on a schedule intended to help Shaniqua's milk come in, while getting the kid's weight back up a bit. It worked on both counts: Julius gained back 15 oz in less than 48 hours (!), and as of today Shaniqua is starting on-demand breastfeeding, which was her original intent.

Anyway, I'm gonna go ahead and stop now. :-) Please forgive my meandering attempt to capture some of our birth experience to share with you all.

-Janis

Midwifery: A Smart Investment in Haiti

2011-01-17T16:48:00.000-08:00

This post from the Huffington Post talks about the need and reward for training midwives in Haiti.

Anna's Birth of Alexa

2011-01-03T17:33:00.000-08:00

On the morning of July 17th at around 6am, I started feeling what I thought were contractions. They were mild, like the cramps I get during my period. I was so happy to feel them as I knew that we were going to meet our baby soon!!! My husband, Tuyen, was very excited but also a little worried as Maria had told us that he would be the main person during my labor. I had no fear, however, and believed in my partner wholeheartedly. The birth was the most amazing and memorable experience of my life. The biggest role in my amazing delivery was played by my husband. He was always by my side as I went through my tough labor and provided inspiration when I didn’t have the strength to go on.

After sharing the news that my labor had started with Tuyen, I went back to sleep because I wanted to conserve my energy. My sister-in-law had given birth three months prior and she told us that her biggest mistake was that she spent so much of her energy counting her contractions during the early parts of her labor that she was exhausted by the end. We took that advice to heart and I rested as much as I could early on, which ended up helping tremendously. I awoke from my nap at 10am. My contractions were getting a little stronger, but still very manageable like heavy period cramps. My husband called Maria to let her know that my labor had begun. He had set up the birth tub a couple of days before and cracked some coconuts for me so we were ready for our delivery. I wanted to go and get some food at a restaurant but my husband suggested that he go get some takeout instead. J

By 6pm my contractions had started getting a little stronger and we started our dance. When the contractions started, I would run to my husband and put my arms around his neck. He would embrace me and we would sway slowly back and forth while breathing deeply and vocalizing loudly together as we exhaled. We did this until the contraction passed and the pain subsided. He used his iPhone to time the length and frequency of my contractions. We were supposed to call Maria again when my contractions were less than four minutes apart, lasted at least a minute, and repeated for at least an hour. My contractions were never very consistent as it progressed however: sometimes they would be last for a minute-and-a-half but they would be five minutes apart and other times they would be 3 ½ minutes apart but last less than a minute. By 11pm, my contractions were long enough and getting close enough together that Tuyen decided to call Maria and let her know. Maria asked our doula, Nova, to come join us.

We repeated our dance during each contraction for the next few hours. I also got in the shower for several minutes to help with the pain. Nova came around 2am and started observing our progress. We continued our dance as my contractions got more painful and lengthy. By 3am, my contractions were getting really strong and I was vocalizing very loudly. Nova timed the contractions and told Tuyen that she had called Maria and that Maria was on her way. Maria got to our place at around 4am. We went to our spare bedroom and Maria examined me. She told me I was doing great and that I was already 5cm dilated. Oh, this news was even more painful than my contractions! At that point I could not believe that I went through 22 hours of labor and was only 5cm dilated! I thought I was getting close to being able to push. I went back to my dance with my husband, but mentally I was crushed. I couldn’t believe that I was only halfway through the dilation process and that the harder half was still left to come!

Maria suggested that I take a break from pain by getting in the birth tub as hot water slows down the contractions and lessens the pain. I did so and my pain eased a bit but I didn’t feel comfortable in the tub as I wanted to embrace my husband during the contractions. I got out of the tub after about ten minutes and walked around the apartment naked and in pain like a wild animal. The pain was getting so strong that it forced me to get on all fours. I lost my husband at that point and continued to labor on my own on the bathroom floor. I screamed that I couldn’t do this anymore. My contractions started overlapping with each other and there was no break from the pain. In my head I was ready for anything that would kill the pain, even if it was a bullet to the head. I started saying that I couldn’t do it. My husband and Nova kept telling me that I could do it and that I was doing it.

I was in the bathroom at this point and I decided I needed to get back into the birth tub to try to ease my pain. On the way to the tub, we passed through the kitchen. I stopped at the sink and threw up from the pain. This caused my water to break. When it rains, it pours…J. My thought turned back to the birth tub. I tried walking to it, but since my water broke it was slippery and I did not make it very far. I finally got to within a couple of feet of the birth tub but I was in too much pain to actually get into it. Nova told me to talk to my baby as it would take my mind off of the pain. I started crying… “Baaaaabbby! Please come out! Why won’t you come out?!?” I kneeled on the ground and help myself just trying to get through the pain.

Soon after, at around 6am, Maria decided to check me again. She needed to get me back into the spare bedroom for the examination but the room was all the way on the opposite side of our apartment. My husband picked me up from behind and dragged me to the bed as I was unable to walk anymore. Maria checked me and said that I was fully dilated! She said I could start pushing when my contractions came. Maria and Nova prepared hot compresses for me and guided me through the pushing process. When I was pushing, I bit my pillow very hard and pulled the sheets off my bed. I was so ready to see my baby that I pushed her out in about 15 minutes. Maria placed Alexa on me and I felt her gentle and warm body on my belly. Our love was born!!!

Maria said it was amazing because, for first time moms, the pushing usually takes a couple of hours. It happened so quickly that our second midwife didn’t get to our place until after Alexa was born. Maria and Nova were amazing and super-supportive during the whole birth process. Although it was extremely painful, I couldn’t be happier with how the whole labor turned out.

Mother of Many

2010-12-06T14:28:00.000-08:00

This great little animated piece is in honor of the hospital-based midwife and natural childbirth. Enjoy it here: Mother of Many

Emmy's Amazing Birth

2010-11-16T10:29:00.000-08:00

I read so many birth stories while I was pregnant. I selected only the ones that were beneficial to my projection of what it would be like. A lot of them came from Ina may gaskin's 'spiritual midwifery' where they would describe each contractions as a “rush” and would describe how psychedelic it was and how tuned in everybody present at the birth was to the energy of the birth. I’m happy to say that my experience of the birth met the expectations that I created for myself through reading birth stories that vibe with that.

I had a feeling the baby would come earlier than the due date. I thought it was possibly wishful thinking, but I was ready, and the baby felt ready. I didn't want him to come too early, though, because I had a huge desire to go swimming with my mom and my big belly, before becoming 3 generations. My mom flew in, we went swimming, and the contractions began as I was drying off. I was surprised at how much it felt like constipation. At first I wasn't exactly sure. Part of me couldn't really believe it, especially because it was the day before my own birthday and I never imagined we'd share a birthday!

I went to the studio where the tub had been set up next to a mattress, and spent time experiencing waves of stomach discomfort. My mom helped for a while by rubbing my back, but soon i had to stand up because my back was feeling stiff. Walking around relieved the pressure. I thought about all the women who i was sharing this experience with, women i'd seen in videos, women in ancient tribes, my ancestors, and all the women around the world in the process of birthing at that very moment.

Maria, my midwife, told me to call her when the contractions were 4 minutes apart and lasting for one minute for an hour. Time seemed to fly by during contractions. I would tell my mom that it felt like 20 seconds, but it would turn out to be over a minute long. Every contraction, my mantra was 'yes, thank you.' I'm grateful that contractions start off small and build gradually. It gives plenty of time to integrate, and to feel that my body would do all the work and I just had to get out of the way.

Maria came. I was having rushes outside of the tub, because I had heard that if you get in before you're at 5cm, you might go back to being smaller. I was holding onto the tub, looking at the water, and really, really looking forward to getting in. After Maria checked how far I'd been dilated, at 4.5cm, i asked if i could go in and Maria said, 'of course.' Getting in the tub was followed by an immediate 'ahh~' and i was so grateful for the tub. The pressure on my back was pretty much eliminated. Later on it would return when it got more intense, but i found then that stretching my thigh muscles and butt muscles helped, and stretching was so much easier in the water than it would have been on land.

The baby's dad started composing soundscapes around 6pm. The way the yoga studio is set up is that the floors have transducers in them so you can feel the low frequency sound vibration through the floor. he was playing a lower volume than usual so that he could hear me and stay tuned in to the birth. It was good that he was playing music because not only did it keep him occupied with something important to do, but it assisted me on a level which i wasn't consciously aware of. Later when i would watch the video, I noticed that the sounds I made were in tune with the music he was playing. The lights were low and the people present (My mom, Maria, and Summer, the doula/apprentice midwife) were napping and hanging around. I found out later that they were taking detailed notes and were actually doing stuff, but at the time i was happy being in the zone and not having any interventions and distractions. I focused on meditating on and expressing gratitude, to my body, to my baby, to the earth, to the universe, to everyone who made the birth as it was possible. Although it was intense, I wasn’t experiencing the sensations as pain. I was committed to not experiencing the sensation of Pain from before the birthing process began. I remember thinking that it felt exactly as it should, and considering that my DNA contains a memory of the birthing experience from all the generations before me. I was thinking, 'even though i haven't experienced birthing in this lifetime, all of this is very familiar."

At around 6cm, i started to get the urge to push. I'm not sure why my body wanted to push if I wasn't supposed to push! I can't figure that out. It contradicts my belief that my body inherently knows what to do! Nevertheless, I trusted Maria and Summer's advice not to push, and they explained to me my cervix would get inflamed and swollen if I did. The energy would build up from my stomach and, similar to the reflex you get when you're dry heaving, where it comes from your stomach and into your head and out from your mouth, i was overcome with a slight urge to push, that built from the stomach and into my head and out from... my mouth if i breathed through it or in the form of pushing if i didn't. Summer stayed close by and would remind me, anytime it seemed like i was pushing. I found that using acu-points on my face and scalp helped release the energy as well. As it got to the intensity of being almost-there, i found that moving myself around the tub with my arms helped distract me from the urge to push as well. I toning to the point that I was losing my voice, but it really helped transmute the sensation. Sometimes I would hear myself and it would sound like a baby crying. I was doing deep grunts and high pitched squeels and lots and lots of Oming. Om, Yes, Thank you. Ohmmmm. Whenever I noticed my thoughts wanting to go negative, I would say “Babyyy~ I’m looking forward to meeting youuu!!” and I would usually find myself laughing or crying tears of joy. I began to get pretty tired at around 7cm, and in between contractions I would go into such an intense state of relaxation that I was drooling. Luckily I wasn't worried about what I looked like.

Opening up took pretty much an hour per centimeter, and at 9.5cm dilation my cervix wasn’t completely open but the baby was descending and Maria got in there to try to lift my cervix around the babe's head while i pushed and the baby tried to descend. The baby's heartrate dipped during a contraction, and so Maria said that she'd like me to leave the tub just in case she had to resuscitate him. I was slightly bummed that the baby wouldn't be born into the water, but eager to get the baby out and wrap it up, as this was all very exhausting and i was ready to rest for more than the time between contractions would allow me! leading up to the birth i processed the possibility that the birth may not proceed as planned. I didn't want to be disappointed in any way, so i had to accept that i may have to go to the hospital, i may end up having to get a c-section, i may ask for an epidural if i'm in the hospital, et cetera. So getting out of the tub and birthing the baby did not seem like such a deviation that warranted disappointment.

I pushed once on the mattress lying sideways but wasn't really into that. Maria invited me onto the birthing stool. Somebody said something along the lines of "he should be out in 20 minutes." and i thought, whaaat? 20 minutes? then i remembered how quickly time had been flying, and how i'd been in active labor for about 10 hours now, and so the initial feeling that 20 minutes was too much became excitement that 20 minutes was a breeze. So i pushed and worked on pushing, and then i more or less pooped him out! Maria kept reminding me to 'push down here' which, though it seems obvious, wasn't, since i don't practice pushng on a regular basis like I practice breathing.

The sensation of the head coming down did not feel like I thought it would. I thought it would be more vaginal, but the sensation was incredibly rectal. I also thought the shoulders and body would be easier after the head opened me up and that it would just slide out, but I had to push the body out too. After the baby came out, he was put in my hands and was a floppy, wet creature. Maria was rubbing him with a towel, stimulating him, and he cried. The crying overwhelmed me because I didn't want him to cry. I wanted the birth to be so peaceful that he would come out breathing peacefully. While I held the baby, i was told to push out the placenta. I was of the mindset that the placenta would eventually come whether i pushed or not and so I wanted to chill. I was on the stool, holding a wet, floppy crying baby, trying to adjust, but i was eventually convinced to give a few pushes to get the placenta out. Baby was left intact until later in the morning. He was born at 4:16am on my birthday, July 22nd... our birthday!

I lay in bed the rest of the day. the cord had been cut. I had been thinking i would do a “lotus birth” and leave the placenta attached until it fell off naturally, but lying there with the placenta, and the cord no longer transferring anything, lifeless, placid, white, with blood clots lining the cord, I asked the baby if it was okay to cut it. He didn’t react to my handling the cord, so I told Maria kind of sheepishly that i changed my mind about the lotus birth. She clamped it, and ceremoniously offered sephen and i the scissors to cut it. I had just birthed the baby so ceremony seemed silly, but i noticed that for stephen it felt significant.

I wasn’t able to sleep that day. I was physically tired but my mind was awake and alert. I wasn’t overcome and flooded with love like i expected, but I didn't beat myself up about it because i was tired and i was pretty certain of my ability to love the baby. I experienced strong feelings of love during the labor, but after the baby was out, i was tired. Awake, and alert, but spiritually, emotionally drained from all that work. I looked at this baby that the universe had placed into my care, and thought about how cute he was. My heart didn't melt into breastmilk like i imagined it would feel like. The sucking felt like nipple clamps were being pulled by a sadist, and i was the masochist who was enjoying it thanks to the lovely hormones of oxytocin guaranteeing the survival of the babe. But oxytocin doesn't feel like the heart-melting love that i think of when i think of love.

I'm writing this now 4 hours before he turns 5 days old, and I'm happy to say that I'm falling in love. Yesterday I separated from him for 15 minutes while I took a shower, and I missed him incredibly and couldn't wait to see him again. Later he stared transfixed at the shadows of my hands on the wall as I made shadow puppets of angels, birds, hearts, circles, and mudras. Today I saw the beginnings of a smile in the form of a series of quick grins, some of them lopsided and some of them fully delighted. His emotionally expressive dreamlife is the source of my neck pain, and my arms are sore from carrying him all the time when I could probably put him down. My body feels great, and i'm lying on my stomach, beginning to strengthen my stomach and back again, and enjoying my body's flexibility. I imitate my baby's dramatic back bends and neck curls and arm movements and find my bones and joints cracking much more than they did before. I can't wait to see my chiropractor again for the best adjustment ever. I am in total awe of my body and have never felt so good about myself, my body, and my body's abilities. I watched my body change, and now there is this helpless, basic little creature whose entire days consist of sleeping, resting, feeding, and processing body functions. And i am completely in awe of life-force that will grow this child into a laughing, smiling, thinking, running, jumping boy... and then a climbing, dancing, kayaking, swimming, diving, creative man.

I've embraced polyphasic sleeping and find myself having so much time, and awaiting for the baby to wake up so I can breastfeed him again and interact with him more than just watching his dream-expressions. He is so incredibly cute. He has the same mouth that my sister had as a baby. When his eyes are closed he looks like a little asian baby, but when he opens his eyes, he has big, dark blue eyes that retain the cat-like, almond-shaped quality of asian eyes and the size of alien eyes. Every day is going to be different, and time is going to fly even faster now. Pretty soon he'll be taller than me and he'll teach me things I didn't know. For now I'm letting him know that he's here, he's safe, and good things are coming his way.

To see more incredible photos from this birth, click here.

US Birthing methods on the Huffington Post

2010-11-15T10:04:00.000-08:00

http://www.huffingtonpost.com/tabby-biddle/women-speak-out-about-wha_b_781205.html?ref=fb&src=sp#sb=370053,b=facebook

The Natural Induction Bender

2010-11-04T20:09:00.000-07:00

By Carolyn Goossen

One week past my due date, I experienced an internal shift from zen mama to mildly nervous nail biter. The baby was still squirming and stretching in my belly the same way he had been for the past few months, and I was still peeing every hour or so. “When is this baby gonna pop already?” I kept asking myself.

The next morning (day 8 post-due date) I went to an antenatal test appointment at my back-up hospital, St. Lukes, where my nervousness transformed into a more acute state of anxiety.

In general, the medical community is in agreement that most healthy women are very capable of having a natural birth until 42 weeks of pregnancy. Starting at 42 weeks, however, experts agree that there are increased health risks to the baby and to the mother, which is why many hospitals and midwives advise women to have their labor induced at that point.

At my back-up hospital St. Lukes, however, some recently published research about the optimum birth time period has led the hospital to officially change their policy. They no longer induce a woman at 42 weeks. The deadline to have your baby induced is now 41.5 weeks- or 11 days post-due date. If a woman wanted to be induced, they would only provide induction up until 11 days post-due date. If the woman chose to bypass this date, then she could no longer request an induction at St. Luke’s and would have to have their birth elsewhere.

The antenatal test showed that the baby was fine, but the nurse-midwife told me that my amniotic fluid was on the “low end” of the scale. She then explained the new hospital policy to me. She stressed that the policy was developed in the best interest of the baby, but that I could always go to another hospital at 42 weeks for an induction, should I not want to get induced at 11 days post due date.

This information left me feeling agitated. I hated the idea of getting induced, and staying in the hospital, but then I also wondered if I was self-indulgent for wanting to have a home birth when there were potential risks involved. Knowing I had less than optimal fluid in me didn’t help either.

So, with some trepidation, I agreed to schedule a hospital induction in three days time- the 11 day deadline- at the latest possible time permitted- 7pm.

On the way home, I tried to convince myself and my partner that I didn’t really mind going in for a hospital induction, although I was already beginning to dread it.

The fact was, I really did not want to be induced. Yet I was starting to panic and started doubting myself and my body. What if 42 weeks passed and the baby still hadn’t arrived? What about at 43 weeks? What would be my options then? My mind started racing, and a powerful surge of maternal guilt overcame me- guilt for wanting to stick to my original home birth plan.

I had booked a midwife appointment that same afternoon, so I headed over there. During that meeting, I explained my nervousness and my resignation about getting induced should labor not begin by 7pm on the 11^th date post- due date. My midwife, Maria, said it was entirely up to me, but reminded me that I was a “good birther”, and urged me to trust in my body’s ability to birth. My first child, Ella Zhao, now 6 years old, arrived 10 days after her due date after all, and I had her at home without complications or tearing, after 14 hours of healthy labor. I nodded my head in agreement and took a deep breath- I had for so long looked upon my first birth as a “lucky” experience- not as a product of my body’s innate ability to birth. It was time for me to reframe that first birth in my mind.

She urged me not to make any final decisions at this point, especially considering my desire to have a home birth. Worst case scenerio, she said, she would help me induce my labor by having me drink a castor oil milkshake on the 11^th day mark. And we could always go to another hospital for an induction at 42 weeks, should it come to that.

I left that appointment feeling like I still had options. I felt much more secure. And I felt determined to do whatever I could to get this baby out! I went home and embarked on a natural induction bender.

By poking around on the internet (man, the Internet is great in moments like this!), I found a huge amount of information on natural birth induction methods, including what herbs to take (chilis, oregano, basil), what acupressure points to press, what kind of foot massage to get, and other natural induction tips such as having plentiful sex, orgasms, nipple tweaking sessions, and strenuous walks.

That night I started with the herbs, (had a massive bowl of spaghetti with meat balls), the acupressure points, the orgasms and the nipple tweaking. I also made an acupuncture appointment for the next day, and a foot massage appointment for the day after that.

I also spent an hour’s time reading about women’s success with natural induction. I was particularly interested in the first-person narratives of women who gave birth at least 10 days after their due date. I discovered dozens of accounts by British women who had had successful homebirths between 10 and 20 days- some even more- after their due date.

The next day (day 9 post due date), I went for a hike with my mother and daughter, had an acupuncture treatment, ate a juicy burger with extra chili, and just tried to relax and enjoy myself as I poked my acupressure points and tweaked my nipples.

The following day (day 10post-due date), I ran some errands, chugged some nasty Chinese herbs the acupuncturist had given me, and treated myself to a glorious foot massage at a dimly lit massage parlor whose other clients all consisted of middle aged men.

That night, my daughter went to sleep over at her grandparent’s house, and I was laying on the couch topless, watching the HBO series Rome and tweaking my nipples (not a bad Saturday night all considering). Out of the blue, I started to get cramps. Real menstrual-type cramps! I called to my partner and we gave my nipples ample attention together. It was midnight at this point, and with every tweak and suck my cramps came on stronger. He suggested that we go to bed and start again in the morning, since I should ideally get some sleep before heading into labor. (With my daughter, labor went through the night, and it was indeed exhausting not to have slept at all.)

I agreed, and went to the bathroom to start getting ready for bed. Then all of a sudden, at about 12:15am, the wave of a contraction took over my body from the middle of my back stretching both up into my neck and down into the core of my belly. BAM! It was on. There was no early labor really- it went straight into intense contractions with very little in-between relaxing time. We called my midwife, and she said to call her again once my contractions were at least 4 minutes apart. We called her again 15 minutes later and by 1:15am or so, my midwife arrived. She set up her things, looked at me, smiled, and told me that it was time to push.

My baby was born at 2:15am, after 45 minutes of pushing. I admit I was surprised by the intensity of the pain, even though it was my second time around. But, as with my last labor, just at the point where I didn’t think I could do it any longer, that I was somehow physically incapable, the baby arrived. Bruno Tai Ming was born at 8 lbs 5 ounces, lovely and healthy and covered in goo.

My entire labor was less than 2.5 hours total. Most likely, this is due to the fact that this was my second child. But I like to think that my natural induction bender helped nature along.

Welcome Diane Ondine!

2010-10-28T20:53:00.000-07:00

For those who have been following Women in Charge, we are going to come back now to homebirths in the US. Here is Francine's story of the birth of her second daughter, Diane Ondine:

When we woke up on Friday June 11th, a hummingbird stayed behind our window during long seconds, staring at us and announcing the wonderful day to come…

We had a homebirth 2 years before with Maria as our midwife who delivered our daughter Elia and we had explained to her about the birth for a couple of months : the water-tub, the groaning/screaming sounds mama will make, the baby who will come out of mama’s belly…

It was the same schedule as 2 years ago : an appointment with Maria in the morning, non-stress screening at UCSF at noon, and the contractions began there… I was on my own and drove back home feeling happy, very grounded and “in charge”, looking at the clock in the car and mentally writing down how far apart the contractions were coming, at that time they were ten minutes apart.
It had turned into the sunniest day we had had all year in San Francisco. I came back home, cooked some Miso soup, got a snack ready for Elia, swept the floor and pushed the table and chairs away from the center of the room so we would have room for the birth tub.
I called Maria to let her know the baby was on his/her way, called my husband Bryce for him to pick up our daughter at the nannies’ and come home. I then called our friend Kristin who was the one who would be looking after Elia during the birth.

Everybody arrived in between 5.30pm and 6pm, right when I entered in real labor with stronger and closer contractions. Elia asked me to put some butter on her cracker and I had to stop at some point to let the contraction pass, she imitated me bending over, moving her hips and groaning and said “no that mama, I want butter cracker!”
That was so nice and sweet to have her around: she was holding my hand when I was in the water and later she wanted me to hear her belly with Maria’s stethoscope.

The ambiance was very sweet, warm and intimate. We lit candles and once again the midwives team was discreet, I loved that. I can feel Maria’s presence, I knew her focus and strength was all there but she did not step into my/our intimacy at all.

My water-bag never broke and our baby was born in the water and the sack (caul) at 10.03pm. Elia was falling asleep in the bedroom with our friend Kristin and as soon as she heard the baby crying, she came to us. She was a little bit concerned with the crying and the baby suddenly there and the rest of the activity. Bryce put her back to bed after a little while and she fell asleep.
I think I asked at least 2 times if it was a girl or a boy and nobody answered me! Now I realize that Maria’s job was to check if the baby was healthy and breathing correctly and the gender was not the priority of the first minutes!
And she was a girl : 7.2lb and 21inches long, with dark hair and long fingers. Our little Diane Ondine.

We had her first name picked up but wanted to be sure it was the right one so she was called ”baby sister” for the first 48 hours of her life - guess who chose this name?!
And then we picked up her middle name related to the way she was born : in French, Ondine means ‘Spirit of the water”, or water fairy.

We are so impressed by Elia, how she handled this big event and welcomed her sister, that was a great experience for her and she still talks about it : “baby cried, Maria Babies (that the nickname she gave to our midwife) with the light, mama in the water…”

Elia’s first words when she saw Diane in the morning after the birth were “pretty, pretty!”

I can only wish every woman have a so nice and happy birth as we did…

From Illysa Foster

2010-09-12T07:37:00.000-07:00

I have disallowed comments due to a plethora of spam/pharmaceutical industry comments. So I want to add some here:

Thank you, Maria, for sharing your long days and nights in Haiti with the public. Having been there myself just six weeks before, I found tremendous solace in your stories of triumph and loss. Hooray for you, Ami and Dina for bridging the divide of language and culture to see the lovely midwives of Haiti for who they are-women in service of other women and their families. I hear hope in your voice that rises in me as I remember the joy in working with bright students there and in seeing the beauty of Haitians-those with the most authentic smiles one can have the honor of witnessing. Thanks for sharing the pain, too. That resonates deeply, as well.

Blessings to you and your work,

Illysa Foster

Haitian Women Need Mesh Panties

2010-09-09T19:06:00.000-07:00

I never cared too much for the white mesh panties that every American woman adorns after giving birth, whether having given birth in a hospital or at home. The Haitian midwives have nicknamed them "sexy coulottes." I have a newfound love for these American throw-aways.

The Midwives for Haiti program is stocked with the weekly supplies brought in by the American volunteer midwives. Ami and I brought head lamps, wrist watches, rain ponchos, fetoscopes, baby clothes and blankets, 100 units of pitocin, 3 bottles of misoprostol, suture material, and the miscellaneous supplies donated by midwives -- cord clamps, gauze, syringes, tape.

There will always be demand for these items. Yet, this is the bare-bones minimum.

What I really wanted to give the women giving birth was a simple, clean pair of mesh panties and a single Kotex pad. Whenever we found these items in the storage room, we brought them to the hospital and gave them out. The women always received them as a gift. I saw it as a moment of dignity. Finally getting up off of the birthing table, to be able to feel clean and complete was a simple dignity that only one who has given birth can describe. The cushioned GYN tables of the Hinche hospital are only minimally cleaned after each birth. There are no pillows or sheets. Often I saw the mother resting her head on the metal rail at the head of the bed in between contractions.

The cloth that the mother brings for the birth is soiled quickly from the normal fluids of a baby being born. Blood stains her skirt that she has drawn up to have the baby. Sometimes, if she's lucky, a sister will come in after the birth with a clean set of clothes for the mother and the baby. Cotton cloths, usually from a torn sheet, are placed in her underwear to absorb the lochia of postpartum.

The simple, bright white of a clean mesh pantie and Kotex felt like a luxury each time it was placed. I especially wanted to give them to the mothers who lost their babies. I felt that they were leaving with nothing. I desperately wanted to give them something to express our compassion, to honor their work.

The other thing we gave out was water. While we were organizing the storage room, I found a bag of water. It was a black shoulder bag filled with approximately 15 small, plastic sacs of water. Upon seeing them, I could tell that this is how they sell clean water in the market. A commodity. When I inquired about the water, I was told they weren't being given out because then everyone would want them. I packed them up to bring to the hospital.

Whenever Ami and I were working, we made an impromptu policy that each woman in labor would receive a sack of water. In the heat and the relentless work of labor, the water was gulped with gratitude. Before we left Hinche, Ami and I bought two large plastic bags of water sacks from the market and left them in the Maternity ward. It was our final gift.

Paul Farmer's guiding premise is to care for the poor with dignity and commitment. If a TB patient was living under a leaky roof, well, of course, they wouldn't get better. Therefore, a prescription for a roof repair was written and carried through by Haitian carpenters.

In birth, women need respect and dignity as well as anti-hemorrhagic drugs. They need clean mesh panties and Kotex. They need water, not only to prevent dehydration, but to honor their hard work. As a woman would shuffle out of the maternity ward, adorned in her new mesh undies like her American sisters, I would feel the tiniest glimmer of relief -- we had given back.

Matthew House 25

2010-09-09T10:05:00.001-07:00

Here is the You Tube link to Dina's piece on Matthew House 25.

http://www.youtube.com/watch?v=4375uau3Xr0

Journal Entry: September 4, 2010

2010-09-05T08:41:00.000-07:00

I rarely slept later than 4:30am in Haiti. With the heat and the roosters and the dogs barking, by 4:30am, I was done for the night. Most of Haiti wakes up by 5 anyway. If I went outside by 5:30am, there was always a soccer game in full swing. The equatorial light was bright by this hour and the day had begun.

The roosters. I didn't tell you about the roosters. There are roosters everywhere in Haiti and they call back and forth to each other all night long. Sometimes there's a lull and you fall into a deep sleep, only to be abruptly awakened by a cock-a-doodle-do that seems to come from about 3 feet from your head. 3 or 4 more roosters will call in response, each one more and more distant.

I would wake up at this hour under our mosquito net and contemplate getting up. The heat was already heavy and the best thing was to just get up and sit on the porch. Some mornings I would get up and write on the computer, other times I would just get ready for the day.

Today was no different. For our last night in Haiti, we slept on the roof of Matthew House 25 in a tent. It seemed quite appropriate given the thousands of families in tents all over PAP.

Yesterday we took our small, 6-seater plane from Hinche to Port Au Prince. While waiting on the dirt and rock airstrip for our plane to arrive, Esther ran up for one final good bye. She was dressed for work and I was utterly thrilled to see her wearing my Birkenstock clogs that I had given her at the party the night before. I had wanted to give a few things away, but when the party started rockin', I forgot. At the end of the evening, Esther pulled my aside and asked me about the clogs. I was so glad that she mentioned it. They fit her perfectly and will be so much more comfortable that the thin and worn plastic sandals that most people wear.

I gave Magdala a dress. Here in Port Au Prince, I gave my sneakers to the boy I promised them to, Paolo. I gave the amputee who "saved" me when I was giving the kids lollipops and got swarmed, an umbrella. I gave the 14 year old amputee girl a flashlight as well as the young mom with the 5 month old with malaria. We gave onesies, a G diaper cover, and body wipes to Roseman, the woman who was in labor in the tent city on the first day we arrived. She labored all night, a 7th baby, with progressing beyond 7 cm.

We ended up transferring her which really meant: 1) she went to the nearest maternity hospital and the gates were closed for the night so she couldn't get in; 2) she went to another hospital where they refused her care because she wasn't registered there; 3) she came back to Matthew House while a young, well-connected medical student called around to find a place that would take her. She made calls to Sean Penn's camp, while I re-evaluated how we could take her back. Maybe if she birthed in Matthew house instead of her tent, if she had a bad hemorrhage, we would be better able to see what was going on. And 4) she was finally allowed to go to a Red Cross hospital in a "sketchy" part of town. A driver brought her there. She labored all night and didn't progress. In the morning, she was given pitocin and delivered a healthy baby boy.

Seeing the baby at 9 days old, he seemed small to me, under 6 pounds. He also seemed hot and lethargic. The mother said that he was nursing well. A medical doctor from the US had checked him out today in the tent city, said he was fine and gave him vaccinations.

As we were saying our goodbyes in the tent city, Darling, Matthew's young mother, began chanting Ami/Zamni (zamni means friend in Haitian Creole). We vocal boom boxed our Kijon ou ye and "the rain/comes down." It was a spontaneous outpouring of celebration in our meeting. Bennis, a young boy, loved our "How are you?" song. As we were leaving, he continually asked me for a soccer ball. I joked with him, showing him that I didn't have a soccer ball in the small purse that I was wearing. In the end, I ran and got him a baseball cap.

The rest of the clothes donations were left at Matthew House for Tey to distribute as needed. I am wondering if I will ever see these people again. Dina, Ami and I all fell in love with Haiti. I told Esther that I would come back next year. Yes, I would like to come back. I would like to continue the exchange that we began. At the end of our party, SheLove said that we were their favorite midwives even from day one. We asked her why and she said the we had given them the most love. Yes, I felt that. The love flowed both ways. We bonded through our hard work, our grief, our joy, our long, hot nights together, our vision for women and their babies. Midwives are the same throughout the world. We give of ourselves to be with women in their most vulnerable moments. We believe there is power in birth. We believe that women should be treated with honor and respect and that these simple gifts will provide lasting effects on a mother's ability to do her job well. Kindness, love, respect are all for free. Even the lowest resourced areas can give these away to any mother.

Brother Michael at the Maison Fortune often would ask in the evening circle, "What has Haiti given you today?" It is a question to punctuate the fact that we, as Americans, as foreigners, are receiving, more than giving ourselves while we are here. Haiti has given me a glimpse into the harsh realities of global midwifery. Haiti has shown me hope through the smiles of the children. Haiti has given me an opportunity to witness the strength of women, midwives, who go back to work, day after day, not knowing whether the day will be weighted heavy with joy or grief.

Thank you.

2010-09-04T17:00:00.001-07:00

I'm back in the US. Stuck in Miami International Airport without a computer. Will blog tomorrow.

Last Night in the Hospital in Hinche and A Party

2010-09-03T04:54:00.000-07:00

Ami and I deliver a stillborn baby each on our last night in the Hinche hospital.

Sonise is the first. She is young. She says she’s 20 but I still think these women may be younger than they say they are. She is pre-eclamptic. She’s received Mag Sulfate but her baby is already dead. She doesn’t believe it when she’s told the news. We put the Doppler to her belly and can not find a heart beat.

She pushes for awhile in the usual Haiti-style — on her back. It’s taking a long time and she’s quite uncomfortable. She asks if she can get up and use her bucket. I say that she can be in whatever position she would like.

She ends up squatting by the side of the bed and pushes the baby out on the floor. We quickly grab a blue surgical sheet to place on the floor underneath her. It’s really the first birth we’ve seen that is not on the GYN table. The placenta is born easily a few moments later. We move the mom back up to the table. Now, the 39 week baby is on the floor and the mother is looking down at her. Ami and I have developed a pattern of wiping off the baby and half wrapping the baby up, swaddle style, in a blue paper towel. Sonise wants to see and hold her daughter. Her sister is with her and is arguing loudly that she shouldn’t hold the baby. For a moment, there is chaos as the sister is protesting and Ami and I are insisting that this mother can process whatever way she needs too. Adeline, the midwife, is also arguing against holding the baby. We win the argument and Sonise holds her baby girl for a long time. It really seems like a rarity for someone here to bond with their stillborn baby. Sonise takes her time. It is good. Denial, anger, she’s blaming another hospital for the death of her baby. I know that she is going through the appropriate steps and I wait patiently for the grief.

I tell Sonise, “No, it is not the other hospital’s fault. These things happen and it is so sad.” Sonise insists that she wants to take a photo of the baby. After some difficulty, she gets 3 photos of the child on her cell phone. She seems happy with that. She wants to dress the baby. Again, the arguing ensues from her sister. Again, Ami and I support this woman’s choices. This is all she has of this baby. She puts a small hat and white cotton dress on the baby. She doesn’t seem put off or repulsed by that fact that her baby is dead.

Another photo. We tell Sonise that we will always remember her and her baby. She will always remember her baby. Sonise names her Daphne.

Ami’s stillbirth is in the over-flow postpartum room because the mother stayed there too long and now the baby is coming. We move some supplies down the hall to where they are. The woman is resting her head in her husband’s lap, not unlike many of our births in the states. The dark brown amniotic fluid of death is becoming all too familiar to me. The small, macerated baby girl is born soon. The mother and father only look at her for a short while and do not hold the baby. It is all very sad. This is our first birth with a father in attendance.

The rest of the night at St. Therese is unusually quiet, interrupted only once with the prayerful singing in the postpartum ward as Sonise and her family grieve for the lost baby. I am happy that she is processing this death in a very conscious and real way. Both of the babies tonite had been the mother’s first. We have another woman in labor tonite —it is her fourth. None of her babies have been born alive. We are hoping this one will be different.

                     ***************


I want you to leave Hinche with a story of life and hope. It is the story about our fete, our party.

I didn’t even have time to blog yesterday because Ami and I planned a big party at the Maison for the midwives. Midway through the week in Hinche I thought that it would be a good idea for future teams of midwives to have an American party to get to know the Haitian midwives. I knew that Ami and I were connecting so well with them, we laughed and joked in Creole at the end of each shift. We took photos together. We processed the death of our mother that had died on a deep level, together. Our relationship with them was strong and loving. I was afraid that many of the other teams were missing this true exchange. Thus, maybe a party would help them break the ice.

But then the next day I realized, I want to have a party for them. Ami was immediately game. We asked Brother Michael at the orphanage if he would ask the cook to make food for us. We wanted fried plantains and the crispy, fried potatoes sticks, hot dogs. We wanted the cook to buy avocados and eggs at the market so that we could make deviled eggs and guacamole. Ami, Dina and I would go to the market the next day and buy Haitian caramels and limes. We ordered up 6 cokes, 6 Sprites and 12 beers. Jean Louis’ brother would get that for us. Jean Louis is the founder and head of the orphanage. Everyone was amazed and excited that we were throwing a party. No one had ever done this before at the orphanage. We invited all the student midwives and the graduates that we had been working with. They all said they would come and seemed truly excited about it.

Yesterday was the party. After our night in the hospital, we came home and cleaned up a bit. Then we left at 8am to go on the mobile clinic. We drove 45 minutes out of Hinche and then walked for 25 minutes until we reached a small building that looked like a typical Haitian school. Dirt floor, wooden benches. This is where we would see the women and three were already waiting. By the end of the morning, Magdala and Philomen, as well as two student midwives, had seen around 25 women. Ami and I mostly observed, tired from the night before. We got home around 1:30pm and the party was at 3. We scurried around trying to find a CD player, worrying that the drinks hadn’t arrived yet. They would have to be put on ice in a cooler. The cook had made an amazing spread for the party — besides what we had ordered, she had made a beet salad, a pasta salad, the spicy cole slaw that we often ate, and popcorn. POPCORN!! We were so psyched!! The kitchen table was full of food. I got to work making the deviled eggs. I even showed the cook how to pipe in the filling by cutting a corner off of a zip-lock bag, filling the bag and oilá, you’ve got a pastry bag. I made her taste one, she liked it.

The drinks came at a little after three. On Jean Louis’ recommendation, we changed the order to a case of Cokes, a case of Sprite and a case of beer. He told us that with what we had ordered at first, that wasn’t a Haitian party. We were expecting 20 people. Our driver, Ronel, was meeting everyone at the hospital and would drive them to the Maison. At about 3:10pm, the thunder rolled in and it began to rain. At 3:15pm, the truck load of midwives showed up, all of them crowded into the back of the truck, now with 6 or 7 umbrellas providing shelter. We were delighted!

The midwives arrived, dressed to the nines — make-up and jewelry. We had told them to not come in scrubs, this was a party! One woman came in a long, lavender dress that looked like a maid-of-honor gown in the US. She was gorgeous. Everyone was excited and happy. I had a slide show running on the laptop of the pictures of our time with them. They were immediately drawn in, laughing and hooting when they would see themselves in the show. I offered drinks all around. The food was devoured in no time. Small plates piled high with all of the offerings. I saw many people going back for seconds. We had even found a bag of Oreos that had been left behind by some other midwives. I told them in Creole that I made the deviled eggs and the Ami made the guacamole, but the cook had made everything else. I also told them that I am Italian, so I really like it when they ate a lot. Everyone loved the food and drinks.

Now, Dina, of course, had been playing ukelele all week. On our first night in the Maison, we heard some kids playing the ukeleles, so Dina tuned them and played one off and on all week. She wrote a song in Haitian Creole that we now sang to the midwives. The song was made up of all the simple and common phrases that we had been using all week. Here’s the translation in English (of course we sang in Haitian Creole):

How are you?
How are you?
I don’t know.
How are you?

Not now.

How are you?

Not now.

How are you?

Not worse.

How are you?

We are here.

How are you?

I’m fine and you.

Oh, we are chillin’.

(Maria’s solo)
        Don’t cry because we are going.
        Don’t cry because we are going.
        Don’t cry because we are going.

Everybody……….
(repeat from the top.)

The response was obvious, immediately. Everyone was hooting and hollering and joining in the chorus. They loved watching the crazy Americans, singing their silly song with Dina on the ukelele. They clapped and cheered when we told them that Dina wrote the song herself. We laughed together, truly joyous and grateful for meeting each other. The Haitian midwives got together and sang us a song back. It was a beautiful song of thanks. I couldn’t understand the words, but I understood the sentiment and “Merci.”

After more chatting and socializing, exchanging emails and telephone numbers, the midwives piled back into the truck and said goodbye. The rain had only lasted about 10 minutes, so the truck was dry. I watched them leave from the second story porch, trying to capture one last photo. Esther, Genette, Adeline, Fedeline, Bien Aime, Marthonie, Anise, Monide, Magdala. Would I remember them all?

I will remember them in my heart. I will remember Haiti.

Nou La

2010-09-01T05:36:00.000-07:00

Haitians have another response to "how are you?" that reflects their resilience and optimism. Kijon ou ye? How are you? Nou la. We are here. We are here reflects their affirmation that they are still alive, here today, that is good. I have noticed that death is talked about without emotion. My father died. The baby died at nine months. Death is as hard a fact around here as life. We have already seen two funeral processions — the first was through the center of Hinche. Hundreds of uniformed men and women slow-stepped in time while a band played. Their was one line of people on each side of the street. At first we thought it was a church parade, but then it became clear that there was a hearse at the very back of the line. There were uniformed men and women first, and then children, all dressed in white. The band was next, followed by the hearse and the family. It felt very much like a New Orleans jazz procession. Ami says it is called a Second Line. The hearse driver was tapping his hand out the the car window in time with the music. The second procession was much less ornate. We simply saw a band of people carrying an ornate coffin down the street. There was no crying or talking. They were just doing what they needed to do. One night in the hospital, when there was a lull in births, I took a walk around the courtyard to get out of the stuffy, clawing heat of the labor ward. I started to hear a loud commotion and someone yelling loudly. It was a woman’s voice and I thought it was a new woman in the throes of labor. I went towards the sound to see what was going on. As I approached, a woman was wailing, “Mama, mama.” Over and over, interspersed with sounds of grief and heart-break. I would occasionally understand a few words in Creole, like please and leave. Mostly she just cried Mama over and over. This is the second time I had heard the keening in as many times as I had been at the hospital. The grief was so clear and pure, a total consumption of this woman’s body. They were people gathered around her, but no one tried to stop her process. She occasionally would spread her arms wide, bearing her soul in her willingness to bargain her mother’s life back. I stood with the group, watching the woman. It didn’t seem rude or disrespectful, on the contrary. It seemed that the more people who gathered around, the more this woman was honored and held in her space of sorrow. Sure enough, not long into this, the same men who had carried out our pregnant woman on the stretcher came trotting along with a small body wrapped in a white body covering. A Ford Explorer had pulled up that had all the seats taken out of the back. They put the whole stretcher into the truck and then the men got into the truck as well. I can only assume that they were bringing the body to a funeral home, or home. The next stop on it’s journey. The rest of the family were able to load the keening woman into the front seat of an old pick-up truck. Her keening quieted to a soft focus stare. The family climbed into the back of the truck and drove after the Ford Explorer. The hospital was quiet again.

Ami and I have settled into a routine of going to the hospital every other night to help out. The students were not there on the weekend, which made it a little different. Still, we connected with the midwives and shared with them more as peers. On Friday night, we went over for about 5 hours and I delivered a baby because they wanted to see how I did it. A healthy baby girl. At the end, I asked if I had lived up to the Haitian standard. We all smile and joke after a long night at the hospital, relieved and tired. On Monday night, the students were there, Josette and Marie Denise. I am so impressed with their skill and professionalism. They are almost done with their year long training program and I am confident that they will do well. Josette and I dealt with two second degree tears together. She is a girl after my own heart. Her suturing is meticulous and precise. We did the suturing together on the second mom because the sulcus tear was deep. She asked me if I would do the deep part and then she would take over. So we did it together. I also showed her a few new ways to hold her needle holder “to make her life easier.” She totally got it and I was so comforted to know that these women will be sutured well. I continually reminded them that where there is a question about access to clean water, it is very important that the tear is completely closed to avoid infection. Josette and I were two peas in a pod, figuring out our suturing job. I love being a perfectionist about suturing and obviously she did too. At the end, I told her I loved her in French. She smiled back and said, “I love you, too,” in English.

The same night we had a ninth timer and a second timer. All healthy baby girls. Active management of third stage has contained the onslaught of postpartum hemorrhage. So many women here are having there 6th, 7th, 9th babies.

I also tried out a new technique that I was so excited about. We found a whole bunch of clear plastic bags with drawstrings in the storage room. They looked like bags that may have been used in the US to hold women’s belongings while in labor or maybe the freebies that women leave the hospital with. Basically, here in Hinche, we have what we have and if we don’t use the stuff, it just sits in the storage closet. So I had an idea. We are going to use the bags to set underneath the mothers to collect the blood, amniotic fluid, everything including the placenta during and after the birth. Then we can take away the bag, the same way that they do it in US hospitals with the big, blue cone shaped drapes that collect and measure blood. I felt that using these bags would keep the women’s cloth cleaner, keep the beds cleaner, make the midwives' lives and the cleaning lady’s life easier. But most of all, it would allow the women more dignity in birth. By not having to sit in the puddle of their own blood and body fluids, the mother’s would feel cleaner and more dignified. It’s the little things.

So we tried the technique on the three women that delivered that night. All the midwives were thrilled with how it worked. They noticed that the table was cleaner, there was less mess to deal with afterwards. They were happy and I asked them to show the other midwives our new plan too. I told them to use up all the bags that we had and that we would try to get more. I felt happy with a good night in the Hinche hospital.

We walked home in the morning. By 5:30am, the sun was up and the day had begun. Families were here to see their loved ones in the hospital. We had brought Cokes with us the night before, for the midwives and SheLove, our interpreter. They don’t drink coffee here, mostly running on adrenaline and allowing some of the midwives to sleep, on the floor. Two midwives slept on the countertops. I was nursing the last Coke as we left the hospital. We passed the vendors setting up, one woman asked me for the Coke. “Blanc.” White girl. She motioned for the hand out. I gave her the Coke and said, “Bon jour.”

Nou La. We are here.

A morning at the waterfall

2010-08-31T06:11:00.000-07:00