Disclaimer: I am behind. My household was torn between a head cold and a wicked stomach flu last week, which made getting anything jotted down remarkably difficult, and the impending holidays have seen my evenings and weekends eaten by shopping, preparation, baking, and social engagements. I appreciate your continued patience and understanding.
Week four: induction, cesarean, and a coyote circle.
Induction is neat, isn’t it? There’s a possibility that, for whatever reason (and there are so very many), you can elect to start the process that will result in you meeting your little person. Induction may increase your chances of an epidural, the use of forceps, or a resulting cesarean birth, but it can also be the actual best case scenario and the absolute right thing to do in a birth story.
This week we chatted about various induction techniques available: the “stretch and sweep” (not technically considered induction, medically speaking), cervidil, synthetic oxytocin (pitocin), and rupturing of the membranes. Alternatively, we chatted about possible alternatives: waiting (for the baby to initiate labour*), The Labour/Midwife Cocktail, castor oil, sex, nipple stimulation, acupuncture and/or acupressure, red raspberry leaf tea, and light exercise (walking, most notably). With all of these options (induction and natural/”waiting”), benefits and side-effects were considered, presented and discussed.
Beyond the absolute real-life application of certain things we learn in Birthing From Within prenatal class, the presentation of topics, “what ifs,” and “what might happen ifs” is my favourite part. It’s reasonable, respectful and non-judgmental. What we are asked, as a class, is to be informed. In my life, Informed Choice has become so paramount. You can make any choice you feel necessary in your story (provided everyone involved, including yourself, is safe and healthy and of sound mind), as long as you have been informed, across the board. In birth, that is most typically epidurals or other pain relief/management techniques, cesarean birth (generally elective in this case), circumcision, etc.
We then touched quickly on birth wishes – careful not to call them plans, as that leaves very little room for change (and labour is rarely predictable). We discussed immediate skin-to-skin contact where possible (and with a partner where it may not be possible with Mom right away, such as in the case of a cesarean birth), newborn checks and when they need to be done, delayed cord clamping, whether Mom wants interventions (and which she is most comfortable with, and whether Mom is interested in having student doctors, nurses or midwives attend her birth (ours is a teaching hospital, so that is a very real possibility and something to be aware of). Along with birth wishes, we chatted about what to bring to the hospital (importantly: your own clothes, warm socks, and food and water for yourself and, especially, your partner), and it was advised that all birth partners (fathers in this case) learn how to tie a ponytail.
And then? Cesarean births. I won’t go into all of it, because there was a lot (and it almost deserves its own post – cesarean birth is a huge deal and requires a lot of conversation), but we did discuss the procedure itself and where everyone would be in the room so that Mom and her birth team would be aware of what they could expect, if that was their story, and what they should look out for, in terms of advocating for themselves. A lot is out of your hands in a surgical birth, but there is still room to be in control, or at least helping to drive some decisions and events (that a birth partner is able to have skin-to-skin contact as soon as possible, that a doula or second birth partner is able to stay with Mom after the baby leaves the operating room, and that there are as many or as few attending medical staff as possible (again, this is a question of students in the room. You may be able to control this), for instance).
During the cesarean conversation, we also discussed the language used to describe a surgical birth, and the thoughts and fears that may surround it. There were murmurs of fear, a feeling of failure if labour resulted in surgery, that the baby would be “cut out of [her],” and that Mom would be “sectioned.” It’s all very harsh and cold and uncomfortable. This is where the term “cesarean birth” comes in. A c-section is still very much a birth. I am cognizant of the fears and language surrounding this procedure – I have fears of it, too – and it is important to me that this starts to become less taboo and that Mom feels she still has power and self-advocacy in this situation.
My favourite part of this evening was the very end of class. The coyote circle. In the coyote circle, parents (mothers especially) practice vocalizing (during contractions) as a group. Much of the time, women are concerned about being loud during labour (this may deserve its own post as well, as it really stems from a lot of social upbringing and constraint) and may need some encouragement in order to engage in moaning, chanting, or whatever other kind of vocalization works for them. What better way to do that then to have wolves howling in the background, a doula who isn’t afraid to make noise, and a group of people moaning in unison? You get to lose yourself in the crowd, be one of many making useful sounds, and you start to understand how that will work for your contractions (practicing with tubs of ice water, of course). While I appreciate the wisdom of this concept, that wasn’t why this was my favourite part of the evening. We had a pregnant woman there alone (her partner works evenings, and her mother, who had attended with her before, was busy), so I got to play the role of her doula. I got to be a doula. (For all of ten minutes.) It was awesome! During my part, partners were helping the mothers breathe and vocalize by touching them while they had hands in the ice bath. I rubbed her back, and then took feedback on how that worked for her (turns out, pretty well)! So much wonderful. I was walking on air for a while after that.
The doula role-play was interesting from the partner perspective, too. Mephy has said, time and time again, that watching me in pain and working hard, unable to truly help or take any discomfort away, was the most difficult part of my labour with Bean for him. I have always understood that from other situations where I have watched someone do something that I was unable to help them with, but this coyote circle brought more strength to that understanding. From the perspective of a labouring woman, I understand how important encouragement and support is. From the perspective of a birth partner, I am beginning to understand how to give that encouragement and support (and that it is as personal as it is not. I mean it is not personal when you are barked at and told that what you are doing isn’t working. It’s not you, it’s hard work, hormones, and a mind that is more centred on birthing a baby than coddling you. …and I love that.).
Long story short: great night. Great, great night. Another life affirming event.
*Guys. How brilliant is this? Truly. Your baby is initiating its birth. …with its lungs. I just can’t get over the amazingness of this event. It blows my mind.
Gus Gus – Over (Live)
UNT.
Kim Matheson, Doula 