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Welcome Big Man Lucus 9lb 9oz 10min after arriving into our room for this planned hospital birth!

 No iv, no meds, nada!

A Family-Centered Cesarean: Taking Back Control of My Son's Birth

--I had to share this article, it is such a beautiful birth story showing that the an unexpected birth plan can still turn out the be a wonderful experience.

The article is from ImprovingBirth.org   

A Family-Centered Cesarean: Taking Back Control of My Son’s Birth

So, what happens if you are completely committed to “going natural” and things don’t work out? How do you deal with being told, “This baby is at risk. We need to deliver via cesarean”?  All that matters is a healthy baby – you just need to get over it…right?

Get over it? Just like that? Of course the ultimate goal is a healthy baby, and of course you are going to agree to the cesarean for the well-being of your child. But that doesn't mean it’s going to be easy to let go of the experience you've been envisioning for nine months, and it doesn't mean you don’t have the right to grieve that loss.

It can be extremely empowering to take back the birth experience – to decide where and in what position you will labor, to tell the delivery staff, “I will not lie on that bed and push my baby out, thank you very much,” and to place your baby on your bare chest immediately after he or she is born to nurse and begin your new life together. But once a cesarean enters the picture, the ability to maintain any power over your birth experience flies out the window…or does it?

Immediate skin-to-skin for Kelsey and her son Finn while still on the operating table as surgery finishes up. “He was silent, just stared at me, and then rooted around to nurse,” says mom. So precious!

My partner Sean and I had been planning a natural childbirth. We established our prenatal care with a midwifery practice, we took a six-week natural childbirth class, we attended a labor workshop, we read Ina May Gaskin’s Guide to Childbirth, we watched videos of water births, we hired a doula, we had a birth plan – we were set. Our due date came and went, but that’s pretty standard for first babies, so no one was worried. I had had a relatively easy pregnancy, the baby was healthy, I was healthy, so all seemed fine.

At 41 weeks I went in for a routine ultrasound just to make sure my fluid levels still looked good. I sat in the chair, the tech gooped up my belly with gel, and she placed the ultrasound probe on my skin.

“Oh, so I see we have a breech baby.”

“Huh? We don’t have a breech baby!”

“Yes, you do – see? This is the head right here.”

WHAT????!!!

I had just been to see my midwife the week before, and she didn’t think there was anything abnormal about the baby’s position. I immediately started to cry and asked, “What does this mean? Will I have to have a c-section?  Isn’t there some sort of turning procedure that can be done?” The ultrasound tech told me the obstetrician would come and talk to me and that, yes, if the baby wasn’t too big, they might be able to try the External Cephalic Version (ECV) turning procedure, but they could also just go ahead and schedule a cesarean for me since I was already at 41 weeks.

“I really don’t want a cesarean,” I told her. “We really want to have a natural childbirth. I’d really like to try to turn this baby.”

One happy mommy: Donita and Alejandra bonding after birth

Our baby was estimated to be 7 pounds 14 ounces (we later learned he was about a pound larger than this). Since they thought he was fewer than 8.5 pounds, the obstetrician said he could make an attempt at ECV.  He told me to go ahead and schedule the procedure for the next day. If the ECV attempt didn’t work, he told me, he would go ahead and deliver our baby via cesarean that same day.

I felt like I had been hit by a truck. It was just too much to process all at once – to find out that our baby was breech, to schedule an appointment for this weird medical procedure, and to swallow the idea that if the ECV didn’t work, I was going to have my baby surgically removed the next day. It seemed that not only were all of our plans flying out the window, but so was all of our power.

I scheduled the appointment and then went to see my midwife. I felt some relief when she told me that, as long as the baby was not showing signs of distress, I absolutely did not have to have a cesarean the next day if the ECV didn’t work. I was only one week past my due date; I had until the following Monday (two weeks past my due date) to try to get this baby to turn. I was so grateful to have that extra window. I felt like we got back a little bit of that power we had lost.

We went to the hospital the next morning at 6:30 am, and after waiting 3.5 hours, the ECV was performed. It was excruciatingly painful, and, unfortunately, it didn’t work. They monitored the baby for two hours after the procedure was attempted, and we were cleared to go home. We were very disappointed the procedure didn’t work, but we were grateful to have a little extra time to try some other turning techniques.

With careful planning and support of their care team, this family had a gentle, joyful, family-centered cesarean at Baystate Franklin Medical in Greenfield, Massachusetts.  Mama waited until labor began to go into surgery; after birth, she got her wet baby skin-to-skin on her chest, and the obstetrician even
milked the baby’s cord to send her home with the placenta!
Credit: Marissa Potter at www.BellyfullBirth.com

And try we did. Over the course of the next four days, I had two “Turn-Baby-Turn” Massages; four visits to the chiropractor for the Webster Technique adjustment (video here); lots of forward-leaning inversions; and a crazy set-up that involved an ironing board propped on an incline against the couch, me lying on the ironing board with my head at the floor and feet up at the top of the board, a bag of frozen blueberries at the top of my belly, a heating pad at the bottom of my belly, and a flashlight shining and music playing between my legs.

On Friday, we went in for another ultrasound and learned that, despite all of our efforts, our baby was still breech.  Reluctantly, we scheduled the cesarean for Monday morning.

At this point, I reached out to other women I knew who had planned a natural birth but ended up needing to deliver via cesarean.  I asked for their advice – what did they do (or what did they wish had been done) to make their birth experience more in line with what they had hoped for?

I am so glad I asked. I learned that, even with a cesarean, it is possible to retain some control over the birth experience. One friend in particular, who had to have an emergency cesarean after planning a natural homebirth (twice), really helped us identify certain requests that we could make, requests that gave us a taste of those aspects of the natural birth that were most important to us. She also sent me this article, which is about strategies to make cesareans more woman-centered.

On Saturday morning (two days before the cesarean was scheduled), my water broke and I went into labor. We went to the hospital, and, thanks to the bagel I had eaten a half hour before, I had to wait for six hours for the cesarean.

From the U.K.: baby went right to mom’s chest and had delayed cord clamping, as well.

I felt like it was such a blessing to get to experience natural labor for those six hours!Laboring is good for the baby, and it was good for me emotionally. While they were preparing me for surgery, I met with the obstetrician and the anesthesiologist and made a few requests for my cesarean.  They agreed to all of my requests, and I had a much more fulfilling birth experience because of those few little things. Here’s what I asked for:

1. I asked them to drop the surgical curtain down a little bit and to and hold our baby up after they pulled him out so I could see him immediately after he was born. I couldn’t see the actual surgery (thankfully!), but I was able to see our son in the first seconds of his life.
2. I requested that they put our baby on my chest in the operating room while they were sewing me back up. They did have to wrap him up in blankets before they could put him on my chest because they keep the operating room so cold (to prevent bacterial growth), but at least I was able to see him and touch him and kiss him before they took him to be weighed and measured.
3. I asked, in addition to my partner, to have my midwife in the operating room with me (which I was glad to learn was standard operating procedure). I gave my midwife a camera and asked her to take pictures of the cesarean. This was wonderful – the pictures were amazing, and having the documentation of our baby’s first moments outside of the womb helped me to connect to the birth experience and begin to feel like our experience was a real birth.
4. I requested that my partner be able to stay with our baby through all of the post-birth measurements and procedures.
5. I requested that I be allowed to breastfeed our baby as soon as possible. He was brought to me in the recovery room within an hour of his birth.
6. I requested that my doula be permitted to sit with me in the recovery room so that I had someone to keep me company while I waited for my partner and our baby to return from the nursery.

While my partner and I weren’t able to have the birth experience we had been envisioning, our son’s birth was still special. I think the reason it didn’t end up being a traumatic experience for us was because we were able to retain some power over the process. In many cases, there is the opportunity to make requests of the surgical team, but we often don’t realize we are “allowed” to ask.

ASK.

Our thanks to Shannon in Lexington, Kentucky, for contributing this story!

Why is Rhogam (Rh immune globulin) necessary?

When a woman comes in for her initial prenatal visit some of her blood is taken in order to run tests. A “type and screen” are part of these tests and what that means is that we want to know the woman’s blood type (A, B, AB, O), Rh factor (positive or negative) and if there are any antibodies present in her blood. This information is important because women who are Rh Negative will more than likely need to receive Rhogam. Let’s say that your blood type is A Negative. The next step would be to find out your partner’s blood type. If he is Rh Negative and you don’t have any antibodies in your blood, then you do not need Rhogam. But if he is Rh Positive then you will need to receive Rhogam at around 28 weeks of your pregnancy. Then when your baby is born we would have to test his or her blood as well. If your baby is Rh Negative you will not need Rhogam after delivery, but if he or she is Rh Positive, then you will need Rhogam after delivery.

Let’s try to understand the science behind this process. Our bodies are programmed to fight off unwanted viruses, bacteria, fungi, and other threats to our system. We achieve this by building antibodies that recognize an intruder that made us sick; the next time it tries to attack, our body’s defenses will detect it and fight it off. If a mother is Rh Negative and her baby is Rh Positive there is a risk that the fetal blood will enter mom’s circulation and mom’s body will think that it needs to respond as if there is an intruder.

Giving Rhogam allows baby’s blood to bind to it so that mom’s blood does not see any threat and does not make antibodies against Rh Positive babies.  Rhogam is effective for about 12 weeks and that’s why mom should receive another dose after delivery if the baby is RH positive. Moms should receive another dose of Rhogam after a miscarriage, accidents to the abdomen, or other instances when there is a risk of baby’s blood mixing with mom’s blood. Rh Negative moms will need to receive Rhogam with every pregnancy if the baby’s father is Rh Positive.

If a woman develops Rh Positive antibodies she will have a high risk of miscarriage. If a baby is exposed to these antibodies there is a high risk for a pre-term delivery, severe anemia that requires a blood transfusion, and sadly even death. That is why Rhogam is a simple enough solution to a potentially big problem.

Written by: Sabely (Student Midwife)

Tree of Life's Newest Bloom

Welcome earthside baby boy Jacob ... All 11lbs 3oz and 23.75 inches of him! Congrats to an amazing family Michele, Ryan and all his big brothers. Peacefully born at home in water and into his mamas arms.

Thoughts of a senior student

Thoughts of a senior student-
by Michelle Isla, SM

I feel so excited to be at the tail end of my formal midwifery studies.  In some ways it feels as though it was just yesterday that I entered midwifery school and in other ways it feels like a million years ago!  So much emotional growth has taken place.  It’s what inevitably occurs when one embarks on such an intimate and intense journey.  I can finally see the light at the end of the tunnel.   I’m just a few short months from finishing this phase of the journey and embarking on a new beginning… the beginning of an inspiring career, economic stability for my family, and the beginning of my informal midwifery education.  The level of responsibility suddenly increases times a thousand!  It’s certainly quite a different experience to practice under someone’s guidance than to be the sole responsible midwife at a birth.  I feel prepared in many ways yet at times overwhelmed by the responsibility.  I trust the feeling will balance itself out in time. 

I’ve been so blessed to be a part of the Tree of Life family.  I came into the practice as a junior student and have gained an incredible amount of experience since then.  I’m filled with appreciation for Kaleen who agreed to take me on as a student when she already had one student and was focusing on her growing practice.  I’m sure she was hesitant to add anything extra to her daily time investment and thought process yet for some reason she agreed and I will forever be grateful for the kindness that was extended in that decision.  Who knew this would also open the flood gates of students at Tree of Life!  There are now six of us students with another one coming on later this year!  Thankfully some of us are on our way out and the others will have those same wonderful learning experiences.  I look forward to hearing their stories and offering them gentle advice on their journey.  We will all share in the experience that the journey is nothing like what we had imagined.  In many ways it is much sweeter yet much more intense than we ever thought.

As for me, you will continue to see me in clinic although not attending as many births.  It feels strange to even think of it.  I’m going to feel so deprived of that incredible birth energy we’re all addicted to!  I’ll be eagerly looking forward to the next birth.  For now, it’s time to learn a bit more about the administrative part of running a midwifery business while the other students are attending births and gaining that experience.  I will be finished with midwifery school early August and sitting for the state board examination later that month.  After that…the sky’s the limit!  One thing I know for sure is that I’ll be practicing midwifery!

Hi everyone, its Jaclyn.  Since I've been spending a lot of time in Initial prenatal appointments with Kaleen, I hear time and time again about nutrition and exercise during pregnancy.  I hear a lot of great things about moms eating well and making better choices about their diets, but I do hear a lot of myths about exercise during pregnancy, especially running.  I decided to get to the bottom of this is in an effort to better inform our clients about fitness.  See you in the office!

Running During Pregnancy

 

Thinking about hanging up your sneakers in the best interest of your pregnancy? Think again! New recommendations from ACOG, The American Congress of Obstetricians and Gynecologists, advises that continuing with a consistent running regiment is not only a safe fitness option, but also the most well rounded option.  Both Gynecologists and Midwives agree that woman who participated in running and jogging on a regular basis before pregnancy, can continue to maintain the same activity for the remainder of their pregnancy.  Women who were not running or jogging before pregnancy are not encouraged to start once they become pregnant, but they do suggest 30 minutes of physical activity and exercise daily. 

For women desiring an un-medicated, natural childbirth, the benefits of running are prodigious.  In addition to reducing lower back pain, preventing excessive weight gain, improving sleep quality, and promoting muscle tone, running has also been seen to reduce the risk of developing Gestational Diabetes.  As we know, diabetes during pregnancy carries an increased risk of developing Macrosomia, or a large baby, as well as a greater incidence of developing Type II Diabetes after pregnancy.  This same risk carries over to the fetus.  Additionally, there is a strong correlation between Gestational Diabetes and high blood pressure, and preeclampsia.  Furthermore, there is evidence that running and regular exercise during pregnancy can reduce insulin resistance in women already suffering from Diabetes. 

A daily running goal can also promote mental health and emotional well-being.  Being in a positive state of mind can certainly improve your birthing environment, also having the “me time” associated with running can help you to process fears and anxieties surrounding your birth.  There is a trend within the running community that these women tend to have better physical stamina and muscle strength, which helps their ability to cope better in labor.  This also aids in their return to fitness after the birth of their children. 

If you aren’t already a runner, don’t worry, there are a number of activities that you can participate in during pregnancy.  Walking, swimming, biking, and aerobics are all fun activities that promote the same health benefits as running.  Just with running, make sure that you look for warning signs that your activity level is too high, these include; vaginal bleeding, dizziness, increased shortness of breath, chest pain, headache, and uterine contractions.  If you are currently running, you can continue until your body tells you to slow down.  Make sure to be aware of where you run and that it is a safe environment free of hazards.  Run inside, on a treadmill when the weather is inclement and take your pace slower if needed.  Remember, listen to your body and keep on pounding that pavement!

Tiffany here--

Wow the last 2 weeks have just flown by with all the events and new patients that have come to Tree of Life, but I would not want it any other way.

Tree of Life attended 3 birth events during the month of March and had the wonderful opportunity to meet some potential new clients and got to reconnect with other natural minded birth ladies. The Voluisa County Birth Network and the Central Florida Birth Network did such an amazing job hosting 2 of the events we attended. The other event we had the opportunity to attend was the Seminole County Health Department's Annual Baby Shower. It was a great success with several women in attendance. I loved having the change to share Tree of Life with so many women and have the chance to share with women that birth does not have to fit into our society's view of birth, it can be whatever the birth mother desires it to be. 

Now that these 3 events are behind us the new focus is the Tree of Life Family Reunion. This is a very excited time for Tree of Life to see our past clients that have delivered with Tree of Life and also a time for us to celebrate another successful year for Tree of Life. So much has happened in the last year, one major milestone was the opening of the new Tree of Life Birth Center in DeLand, FL. 

It is such a blessing to work for such an amazing midwife and to be able to be surrounded by so many fantastic women here at Tree of Life.