Lessons from my birth

Watch more at http://www.ustream.tv/channel/your-birth-coach

I wanted to share some of the things that could be learned from my birth video.

Labor is an active process

A woman in labor is not a passive vessel through which a baby emerges.  Labor is an active dance between mom and baby.  Mom needs to move her baby through her body which requires freedom of mobility.  You will notice in early labor that I wasn’t comfortable having contractions sitting down and needed to stand and rock my pelvis to make it the most comfortable.  In active labor I needed more support.  I would hang off of my husband and rock, in what would look like a slow dance.  When I hit transition I felt the need to really hang off my husband as I felt like I needed to let my bottom be heavy.  This was the point where I had an overwhelming desire to get in the tub.  The water allowed for a lot of relief of the intensity of contractions and freedom of movement.  You will see that I moved freely from leaning forward to squatting and back.

Support is important

You will notice that I had amazing support from my husband and friends who were calm and responsive to my needs through the entire process.  My midwives would have come in early labor to support me if I had wanted them there.  Some women want their midwives to be present from early on in labor and the midwives are happy to oblige.  I personally prefer to labor on my own and have them there only for the actual birth.  In this case labor progressed faster than I anticipated at the end and my midwives did not arrive until after the birth.  This was not intended to be an unattended birth.  I was not concerned that they hadn’t arrived but knowing they were on their way was comforting.

Labor does not need to follow a textbook

The textbook way of labor progression starts with the first stage of labor. This stage goes from early labor to active labor to transition.  In early labor contractions typically start farther apart, 10 to 20 minutes apart, and are short only lasting 30 to 60 seconds long.

In active labor contractions are closer together 3 to 5 minutes apart lasting 60 to 90 seconds.  Transition is marked by contractions that are close together 1 to 3 minutes lasting 90 to 120 seconds, with possible multiple peaks.  From there you move into the second stage or pushing.

My labor started at 5 pm with contractions that were 2 minutes apart only lasting 10-20 seconds, this would be considered early labor since contractions did not last long and were not intense, and I was able to talk through them.  By midnight contractions moved to 7 minutes apart lasting 5-10 seconds with less intensity.  From midnight to 2 am contractions were not frequent, regular, or strong.  At 2 am contractions were suddenly every 2 minutes lasting 45 seconds, this would be active labor as contractions were more intense and it was harder to talk through them.  This lasted for about 45 minutes when I entered transition.  Transition lasted about 15 minutes.  Second stage or pushing lasted 18 minutes from the first early sensations of pushing.

Labor can slow down and pick up again naturally without pitocin

Depending on the care provider when my contractions failed to progress around midnight it may have been recommended to speed things up with pitocin.  This happened also with my first labor where contractions slowed/stopped for 2 hours after early labor.  Instead of trying to push things along with medications, in both cases I laid down to rest during that 2 hour latent period and in both cases my babies have been born very soon after getting up.  In this case he was born 1 hour and 20 minutes after getting up from resting, with my first it went straight from no contractions to 20 minutes of pushing before birth, my husband thought I was asleep for the 2 hours before I started pushing with my first birth.

A posterior baby can turn around in labor

With both my first birth and this current birth my children were in a posterior position at the end of early labor.  This is likely what had caused labor to slow in both cases.  Babies can reposition themselves in labor with or without waters broken.  With my first birth this happened 53 hours after my waters had broken and with this birth my waters were still intact.  To encourage the baby to turn I had my husband who is a chiropractor do Webster’s In Utero Constraint technique.  This is a chiropractic technique most famous for turning breech babies but can be used for any uterine constraint that interferes with optimal baby positioning.  After getting my chiropractic adjustment, I went into a knee chest position (on my knees with my chest down below my pelvis, like child’s pose in yoga) to help the get the baby’s head out of my pelvis so it could have more mobility to reposition itself.  I also laid on my right side and stroked my belly in the direction I needed the baby to move.  These are all tips and techniques that your midwive or doula would have for you in labor.  In both of these cases I felt the baby move itself into position and labor started back up very quickly.

Vaginal exams are not necessary in labor

Vaginal exams do not need to be done routinely during prenatal visits or in labor.  You will notice that at no point during this labor did I have any vaginal exams.  My midwives offered to come and check but I was not interested.  Through 3 pregnancies and births I have had only one vaginal exam which occurred 52 hours after my waters broke with my first child.  At that point I felt like the information may be valuable and I wanted to know my progress (which was none).  Some women like to know how dilated they are but this information is only so relevant.  As I have experienced you can go from 3 cm to birth in 2 hours or some women could be 6 cm dilated for weeks.  During active labor it is expected of you to progress 1 cm per hour, even though the average first time mom is more likely to progress at 1 cm every 3 hours.  Every labor will progress differently and introducing timelines increases the likelihood of interventions that may not be necessary.  If mom and baby are doing fine, my opinion is let labor progress at it’s own pace as this will lead to less interventions and trauma for mom and baby.  Drawbacks for vaginal exams include introducing sources of infection, even with sterile gloves, and can also interfere with mom’s rhythm.  They are often uncomfortable for mom and force her to lie down during labor which can be quite painful.  Also the cervix is a sphincter that can open and close.  You can actually move backwards in dilation due to stress.  vaginal exams themselves can cause this.

Once the baby’s head is out there is no rush

Once a baby’s head is born many practitioners like to speed up the end on labor by pulling the rest of the baby out.  This introduces extreme forces into a delicate newborn spine and nervous system and should be avoided.  Birth trauma caused by these forces often goes undetected and has been correlated with sudden infant death syndrome.  This is also the main reason all newborns should be checked by a pediatric chiropractor shortly after birth.  Maintaining the integrity of the nervous system is essential for optimal function.

Once a baby’s head is born it will naturally reposition itself to align it’s shoulders with the widest part of the mother’s pelvis.  This realignment, that the baby is programmed to do with no assistance, takes a minute or two.  Once the shoulders are aligned the rest of the baby’s body will slip out without any pulling necessary.  There are cases where a baby may need some assistance but that is not the norm.  Cases of shoulder dystocia (shoulder getting stuck) can often be taken care of with repositioning mom so the baby can manoeuvre itself around her pelvic bones.

Baby can be under water safely

You will notice in my birth that baby’s head was out and under the water for 2 minutes.  The baby does not take a breath when only it’s head is out nor does it need to.  The baby is receiving all it’s oxygen from the umbilical cord.  The baby will not take a breath until its face reaches the surface.  Even then there is not a rush for it to take a breath instantly.  Again it is still receiving all the oxygen it needs from the umbilical cord, as long as the cord is still intact.  The first APGAR scores are taken at 1 minute and it is desirable that the baby is breathing on it’s own by that time.

Not all babies need suctioning

Ideally medical interventions will only be used when clinically needed but many interventions are done routinely in hospitals on all babies whether or not they are clinically necessary.  Suctioning is done routinely in hospitals but is not necessary for all babies.  None of my babies have babies have needed suctioning at birth.  Coming through the birth canal squeezes much of the fluid out of the lungs and often babies can clear the remainder on their own.

Delayed cord cutting allows baby to get it’s full blood supply back from the placenta

You will notice there was no rush to cut the cord.  This is done immediately in hospitals out of routine and to speed things up at the end of the birth.  When a baby passes through the birth canal up to 1/3 of it’s blood supply it squeezed out of its body into the placenta. It takes time for this blood to return back to the baby.  If the cord is clamped and cut immediately, the baby is losing out on 1/3 of it’s blood and will have to make up this loss in the first few days of life.  There are a host of immune cells, stems cells, and red blood cells for carrying oxygen that are in that blood that baby is supposed to be getting back at birth.  Early cord clamping also makes it more critical that baby is breathing on it’s own right after birth and increases the need for resuscitation.

You will notice that even 10 minutes after my baby’s birth the cord was still pulsing and filled with blood that was being delivered to my baby.  It took 30 minutes for the placenta to be born and we did not cut the cord until after this time.

Mom and baby were never separated

At no point after the birth were my baby and I separated.  Initial bonding after birth is important for all mammals.  All other mammals will reject their babies if they are not together immediately after birth.  It is best for mom and baby that the baby be placed skin to skin on mom immediately.  Most procedures that need to be done after birth can be done with baby on or beside mom.

If there are more lessons that can be learned from this video that I have missed please leave a comment with your impressions.