Thursday, February 28, 2008

Natural Childbirth: Assembling Team Iza and the Birth Plan

We made our baby in South Bend, Indiana. Her arrival was scheduled after our move to Boston, Massachusetts. I would need to find the right midwife and and hospital in a city filled with an overwhelming array of top notch medical facilities. I was overwhelmed. In the end, I would not change a thing about my labor and delivery. Newton-Wellesley hospital was the perfect setting for Iza's natural birth.

I knew I wanted a natural childbirth and I knew I wanted a midwife. (How did I know these things? That deserves another blog entry of its own.) While I was open to a home birth or a birthing center, my husband was less sure. So, how to determine which midwife is the best for me in a city where I don't know a soul? (Or at least the souls I do know are not in the birthing phase of life.) As a well-schooled student of Eve Ensler, I simply asked women about their experiences. As I walked the streets of Boston in my apartment search back in the Spring of last year, it occurred to me that I was passing women with their infants happily strolling along. The experts were right in front of me. And how they loved to talk. I gathered a few stories and a few names seemed to repeat. This is how I found Elizabeth "Biddy" Fein at Harvard Vanguard. One of her happy moms assured me that she was excellent. I scheduled an appointment soon after we moved to Boston.

At first I thought that my choice of midwife limited me to a delivery at Brigham and Woman's hospital. I toured their facilities and was impressed by their professionalism. Biddy let me know at my next appointment that she also attended births at Newton-Wellesley hospital. Honestly, having another option was almost unwelcome. I just wanted a place to give birth, not more decisions to make. Nevertheless I scheduled a tour at Newton-Wellesley just to make the comparison. It was a BLINK decision. It was clear to me that Newton-Wellesley was the better place for a natural birth. Not only were the rooms and the fresh muffins each morning impressive, but they also assign one nurse to each patient and have a reputation for being open and welcoming to moms who want to labor and deliver without medical interventions. Don't get me wrong, this is no Ina May Gaskin retreat. While they are open to natural childbirth, it is still not the norm. The nurse assigned to me was pleased to witness my natural birth because it is a rarity.

Not expecting my husband to coach us through labor (who can remember all those labor signs and aids?), I also hired a doula. As is the case with most hospital midwifery practices, you are assigned to a midwife for your prenatal care. The midwife who attends the birth, however, is determined by whoever is on call when you go into labor. Thus you cannot know in advance which midwife will be present. It was important to me to have a doula present because she would be the one person (besides my husband) who knew me and knew my birth choices. I wanted a familiar face. I found Tara Kenny through a recommendation from Isis Maternity. I interviewed a few doulas, but felt most comfortable with Tara. I highly recommend her services (and can put you in touch if you leave a comment). Tara is actually a midwife who is building her practice here in the Boston area. I was lucky to have her expertise.

I imagined that Tara would assist my labor in my home and help me to determine when to go to the hospital. She would bring all the tricks of the trade--her experience and skills as well as the birthing ball. She would tell me when and how to breathe. As it turned out, Tara would meet us at the hospital--more on that later. Tara helped me write my birth plan (see below), detailing my preferences for labor and delivery. The birth plan was sent ahead to the hospital and given to the midwife and nurse on duty. They knew my choices and honored them.

Put my picture on the natural childbirth brochure. Put Iza's picture on the cover of the Newton-Wellesley hospital's informational packet for parents looking for a natural childbirth. My midwife, Dianne Reynolds, was amazing. The nurses were outstanding. If you live in this area and want to have a natural childbirth, but are a bit hesitant about a home birth of a birthing center, go with Newton-Wellesley. That's my vote.

My birth plan:

The Birth of My Child

My goal is to deliver a healthy baby. I would like to have a gentle and natural birth and would like support to begin breast feeding. In addition to my midwife, my husband and my doula will be present.

· I prefer the use of intermittent, external fetal monitoring.
· I am aware of the medications available and will ask for them if I need or want them.
· I plan to move and bathe as needed during labor.
· I prefer not to have an IV unless it becomes medically necessary.
· I prefer to allow my waters to break without assistance.
· I would like to avoid the use of pitocin or other medical inducements.

· I would like the option to use a mirror during delivery.
· If there is difficulty during pushing, I would like to use gravity or pelvic positioning and be given more time as long as baby and mother are healthy.
· I prefer no episiotomy cuts, but would like the use of perineal support/compresses.

Following Delivery:
· I would like the baby placed on my chest immediately and allowed to find the breast, allowing as much time as needed.
· The baby’s bath, exams, and vitamin K shot should be delayed until after the baby has had a chance to feed for the first time, allowing as much time as needed.
· I prefer to refuse the prophylactic eye drops.
· I prefer that the cord be allowed to stop pulsing or at least that it not be cut until I am ready to consent. My husband or my doula will cut the cord.
· I prefer that my baby receive only breast milk and request that the hospital not give the baby any formula or provide a pacifier.
· I would like to be consulted in all decisions regarding the baby.

· If a cesarean becomes absolutely necessary, my husband and/or my doula will accompany me.
· If the baby is not in distress, then the baby should be given to my support person immediately after birth.

Thank you for your consideration regarding my wishes for a healthy and happy birth!


Next installment:

the blog-appropriate narrative of Iza's birth. . .


Khageman said...

I am in awe! Such a well written, well informed birth plan. You have included things I didn't even know about until my doula training. And it sounds like your preparation paid off with a wonderful birth experience and a healthy, beautiful baby.

S.E.Minegar said...

Your birth plan is remarkable. It sounds like you really did your homework. J.K.Kelley, you are an educational experience!

Thanks for sharing this special moment.


Megan said...

I love Newton 2 year old Vann was born there and I had a great experience. However, I am much more educated now and have had a change of heart on how I want my second to be born. I definitely get the feeling my Dr. and the nurses wouldn't be that supportive of a natural birth. I was thinking of changing hospitals but my due date is in December so I don't have that much time. I would love the contact info for your support team...this was great for me to read and very inspiring. Thanks so much!

J.K.Kelley said...

Tara Kenny, my doula, can be reached at:

Have you considered a midwife instead of a doctor? For Biddy Fein's info, click on the link in the entry above.

Do you have a birth plan?

Good luck! If you would like to email me, you can reach me at:
hutchkelley5 at