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.

Labor:
· 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.

Delivery:
· 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.

Cesarean:
· 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. . .

Iza's Due Date

Today is February 24th, Iza's due date.

She has been with us for two weeks already and we can hardly remember life before her arrival.

Breast Feeding Update: She is still learning how to latch. Two weeks is a long time to study the art of the latch. At least it is a long time for a mama trying to coax a little one onto her breast. But we are hanging in there. And now that she has arrived (as of her due date), we are sure that a true latch is in her near future.

Last night Iza decided to "latch" and do her suck-suck swallow thing between midnight and one thirty. We set the mood by playing her birth soundtrack with heavy doses of Enya and George Winston. There was invigorating music. There were bare breasts. Bodily fluids. Moans. Pip squeaks. A belch. This morning we received a very kind email letting us know that our lactation party kept the neighbors awake. Seriously. I guess the music traveled via the air ducts in our turn-of-the-last-century condo. Yay! Iza is such a party girl. She has already had the neighbors complain about her milk antics! Things may get so rowdy they might have to call the Boston Police.

There is much to write about. Little time. Let me just say, thanks for the muffins. There is nothing more loving.

And thanks for the pep talks. New mantra: "I am the mama" and I will decide that my baby girl gets her mama's milk. Now we just have to convince baby Iza to forgo the china and drink straight from the fountain.

Team Izabella

It takes a team to bring a baby into the world....

Yes, I was the one pushing and yes we used no medical interventions. Her arrival was 100% natural. (Labor narrative with all its juicy details to follow, perhaps.) Yet let there be no mistake, we had plenty of assistance. Team Izabella 2008. And for the record, I fully support anyone who does use medical interventions. I have been there, I know the painful intensity--it empowers and humbles you.

And since the delivery, we have needed a whole battalion of helpers--lactation consultants, cheerleading friends, the nurse who generously gave us a handmade knitted cap when baby Iza's went missing as we tried to leave in freezing weather. Without Grandma, all would be lost. (Thank goodness we have even had an offer of a volunteer Grandma in the future when my mom will need to return to the land of Oz. Be careful what you offer!) Not to mention the 20 or people who have massaged my breasts in the past six days, none of whom have been my husband.

The smell of her soft skin. The silk of her hair. Her scrunched up face and her yellow baby poo. What more is there?

First attempt at blogging post-Iza arrival: I fired up the laptop and then couldn't resist a lean down and a gentle kiss on her exposed arm (she was born with a fist up next to her cheek and loves to have the hand near her face) and BAM my laptop crashed from my lap to the floor, inches from my state-of-the-art lactation machine. Hence: kisses trump keyboards in this new state of our affairs.

For those of you who know me: picture this: J.K. Kelley changing a little teeny diaper on a skirmiquin of a sweet baby girl, careful not to irritate her cord.

Still. How can I not blog my little girl's world? I have to give her something to be embarrassed about in about 13 years.

Izabella
born at 38 weeks and 1 day
born 2-08-2008
6 pounds 12 ounces
all spunk and spittle

By the way, still no crib or changing table. Yet we are sleeping, poopalooing, and doing just fine. My belly was plenty big after all that worry. And we do have our Bundle Me (thanks Ash!) and our Burberry diaper bag (thanks Jji!). We are in style and as soon as we figure out how to latch (or as L. calls it in ESL, "leach") we will be on the way. . .

38 Weeks

A typical pregnancy lasts between 38 and 42 weeks. You are assigned a due date at 40 weeks. Today the baby is 38 weeks. This means she could decide to arrive any day now. L's workplace has a betting pool with various dates ranging from Feb. 23 to March 1. We have had our fingers crossed for Feb. 29, leap day, just for the high jinks of it.

Things that are prepared for baby x's arrival:
diaper bag (tres chic! thanks to Jji)
car seat (not yet installed!)
co-sleeper/bassinet
supply of diapers, changing pad
baby clothes
my suitcase is packed
Boppy billow AND a My Breast Friend pillow
baby wash clothes
Bloom baby lounger
assorted slings
cotton balls
assorted infant care instruments--thermometer, nail clippers
assorted paperwork for the hospital

We have a doula. We have a pediatrician. We took the hospital tour. I am a regular at prenatal yoga. I swim.

Things that need to be prepared:
birthing soundtrack
crib
stroller
changing table
nursing foot stool
her name!

Things I obsess about:
1. furniture for the baby's room--we still have not purchased crib/changing table/storage but not for lack of my Internet searches. Hours. Still no combination of design/price/usefulness that satisfies. So, minimalism is the route we are going. So much for the "perfect" nursery.

2. My Belly. In particular, size. I measured too small. All is fine. But I can't imagine that a little person of 6 pounds has enough room in there. And so,

3. Her movement. I miss the big decisive tango moves. Things are more subtle now. I worry. I admit that I prod her a bit to get her to dance. It makes me feel better to see her undulate.

Any day now. . .

In the meantime, I'm off to prenatal yoga. Really, a sight to see.

"Babies Buying Babies"

Check out this segment from the radio program This American Life. While the entire program is entertaining, it was the third act of the Jan. 18, 2008 episode #347 Matchmakers that I thought was worth passing along. It makes you think. Dolls may not talk (most of them), but they say a lot about us.

You can listen to the entire program for free (or download it for 99 cents). The "Babies Buying Babies" segment starts at about minute 40.

http://www.thislife.org/Radio_Episode.aspx?episode=347

Segment Description from Website:

Elna Baker reads her story about the time she worked at the giant toy store, FAO Schwartz. Her job was to sell these lifelike “newborns” which were displayed in a “nursery” inside the store. When the toys become the hot new present, they begin to fly off the shelves. When the white babies sell out, white parents are faced with a choice: will they go for an Asian, Latino, or African-American baby instead? What happens is so disturbing that Elna has a hard time even telling it. (16 minutes)

Primary Decision

I'll admit it. I am still undecided. I am one of "those" people interviewed in the street on the eve of a primary vote who claim indecision.

Although I am sure I am the last to hear of the Washington Post "Choose your Candidate" quiz, I'll pass it along here. I found my results informative, but not shocking. It takes time, but it is worth it. Even if you are already "decided."

http://www.washingtonpost.com/wp-srv/politics/interactives/candidatequiz/

Date Night? Cheap Trip to Transylvania

Music with Film
Film
Transylvania
8:10 pm
Thursday, January 31, 2008
Remis Auditorium

Transylvania by Tony Gatlif (France, 2006, 103 min.). In this picaresque gypsy musical road movie, Zingarina (Asia Argento), rebellious, young, and pregnant, travels to Transylvania with her best friend to search for the man she loves. She met him in France, but one day he left without a word of explanation. With her friend Marie, who jealously watches over her, Zingarina throws her body and soul into a romantic quest in a fascinating land. But when she finds her former lover in the midst of a pagan festival, he brutally rejects her. Mad with anguish, she flees Marie, who reminds her of her past, and meets Tchangalo, a kindred spirit without borders or ties. In French with English subtitles.


MFA members, seniors, and students $8; general admission $9.

Buy Tickets: http://www.mfa.org/calendar/event.asp?eventkey=31782&date=1/31/2008

The Road by Cormac McCarthy

When he woke in the woods in the dark and the cold of the night he'd reach out to touch the child sleeping beside him.

Then they set out along the blacktop in the gunmetal light, shuffling through the ash, each the other's world entire.

gryke
grike: CREVICE, CRACK; especially : an opening in rock widened by natural forces (as weathering or solution)

Grimacing at the day. He pulled the boy closer. Just remember that the things you put into your head there forever, he said. You might want to think about that.
_____You forget some things, dont you?
_____Yes. You forget what you want to remember and you remember what you want to forget.


vestibular
vestibular: of, relating to, mediating, constituting, or affecting the vestibular sense
vestibular sense: : a sense mediated by end organs in the vestibule of the internal ear that contain otoliths and are stimulated by the pull of gravity and by the starting and stopping of rectilinear head movements; broadly : LABYRINTHINE SENSE

He rose and stood tottering in that cold autistic dark with his arms outheld for balance while the vestibular calculations in his skull cranked out their reckonings.

The grainy air. The taste of it never left your mouth. They stood in the rain like farm animals.

Look around you. Ever is a long time. But the boy knew what he knew. That ever is no time at all.

Can you do it? When the time comes? Can you?

Make a list. Recite a litany. Remember.

Dark of the invisible moon. The nights now only slightly less black. By day the banished sun circles the earth like a grieving mother with a lamp.

No lists of things to be done. The day providential to itself. The hour. There is no later. All things of grace and beauty such that one holds them to one's heart have a common provenance in pain. Their birth in grief and ashes. So, he whispered to the sleeping boy. I have you.

rachitic
of, relating to, or affected by rickets

siwash
Etymology: Chinook Jargon, from French sauvage savage, from Middle French -- more at SAVAGE

This is my child, he said. I wash a dead man's brains out of his hair. That is my job. Then he wrapped him in the blanket and carried him to the fire.

All of this like some ancient anointing. So be it. Evoke the forms. Where you've nothing else construct ceremonies out of the air and breathe upon them.

_____We're going to be okay, arent we Papa?
_____Yes. We are.
_____And nothing bad is going to happen to us.
_____That's right.
_____Because we're carrying the fire.
_____Yes. Because we're carrying the fire.

catamite
Etymology: Latin catamitus, from Catamitus Ganymede, cupbearer of the gods, from Etruscan Catmite, from Greek Ganymds
: a boy kept for purposes of sexual perversion

kerf
groove

cochere
Etymology: French porte cochère, literally coach door
1 archaic : a passageway through a building or screen-wall designed to let vehicles pass from the street to an interior courtyard
2 : CARRIAGE PORCH

Can you do it? When the time comes? When the time comes there will be no time.

The chary dawn, the cold illucid world.

intestate
Etymology: Middle English, from Latin intestatus, from in- 1in- + testatus, past participle of testari to be a witness, make a will, from testis witness -- more at TESTAMENT
1 : having made no valid will
2 : not bequeathed or devised : not disposed of by will

He thought each memory recalled must do some violence to its origins. As in a party game. Say the word and pass it on. So be sparing. What you alter in the remembering has yet a reality, known or not.

He could not reconstruct for the child's pleasure the world he'd lost without constructing the loss as well and he thought perhaps the child had known this better than he.

If they saw different worlds what they knew was the same.

knurl
1 : a small protuberance, excrescence, or knob
2 : one of a series of small ridges or beads on a metal surface to aid in gripping

mae west
Etymology: Mae West died 1980 American actress noted for her full figure
Date: 1940
: an inflatable life jacket in the form of a collar extending down the chest that was worn by fliers in World War II

_____You're not the one who has to worry about everything.
_____The boy said something but he couldnt understand him. What? he said.
_____He looked up, his wet and grimy face. Yes I am, he said. I am the one.

150 Pounds No Less

The last thing I expected was to develop a complex about my belly being too small.

I am 36 weeks plus 3 days into the 40 weeks of a typical pregnancy. Two weeks ago I lost a few pounds and my belly measured a few inches below the expected range. Low grade panic developed.

I attempted to eat more despite near constant heartburn and the low groan of a belch always ready to erupt. (It is pregnancy, people. Worse bodily discomfort to come. I can't promise to spare you from the gore if you want to bask in the maternal joy.) I swear my stomach is the size of a lima bean and who knows where my intestines are located these days.

Still, I ate: often, and with a renewed sense of urgency for feeding the little one. On Friday morning I am proud to report that we tipped the midwife's scale at a healthy 150 pounds. It was a relief to see that number on the scale.

As my weight has increased over the course of the pregnancy, I have been amazed to watch the ever increasing digits balance on the scale. I was expected to gain somewhere between 28 - 40 pounds (according to one estimate) and I am just about there. Here is the breakdown in weight gain as estimated by www.babycenter.com based on my pre-pregnancy height and weight:

Maternal weight
Uterus: 2.82
Breasts: 1.17
Blood: 3.64 (Almost four pounds of blood!)
Water: 4.89
Fat: 9.74

Baby weight
Fetus: 7.5
Placenta: 1.89
Amniotic Fluid: 2.32

Total: 33.97 pounds

Still I worry that my belly is below par for the top of the ninth. Those near and dear to me assure me daily that my belly is HUGE, and so BIG, and plain BEAUTIFUL. I take deep breathes and stick it out as far as I can when I am not trying to waddle down the stairs or tie my shoes.

This weekend I corralled the family to a photography studio for a family portrait. I will attempt to keep a photographic record of the baby's life. (Thus far in my many years I have compiled exactly ONE photo album.) When better to start for baby X than with a few shots of her mama's Big, Huge, Amazing belly? I hope to hang the images in the baby's room to welcome her. Well, not to welcome her exactly. I am sure she will probably arrive before I manage to get the photographs ready for display.

Here is a fun, slightly sad fact: I noticed that my first instinct in front the camera was to cock one contrapposto hip and suck in the abdomen. Fat chance!

The baby is due Feb. 24th.

Free Cycle (got it? need it?)

Check out this idea:

Freecycle: A Web of Free, Unwanted Things by Ted Robbins

www.freecycle.org

Yesterday I posted an offer of two desk chairs that we no longer need.
Today seven people have expressed an interest.

One more way to purge. In general I like the idea of supporting Salvation Army and Good Will, who use the proceeds from donations sold in their shops to fund their job training and other social justice work. On the other hand, I've had these chairs for ages because it was too low priority to get them down to the car and across town to donate.

(Works all across the country. Check out the website for a network near you.)