Speaking of Birth, this is the story of what I learned giving birth in a teaching hospital....
Some time before I became a childbirth worker but some time after I witnessed calves being born on a farm, I gave birth to our baby boy. It was a beautiful sunny day in May in New York City.
At the time I did not know about doulas and natural birth alternatives, but I knew I did not want any medications. I didn’t want medications because I’m a bit of a nature girl and I was concerned they would intervene and slow down the natural process. I figured if it was just one day I could bear it.
I did know enough to seek out a midwife at our hospital, however in my last trimester I risked out of using midwifery care due to gestational diabetes
I was using the local, public hospital at the time I became pregnant, I did not have health insurance and when I asked my Obstetrician how much it would be to pay out of pocket for the prenatal care and actual birth, the answer was around $20K. So I visited a public hospital just a few blocks from my apartment to see if they could help. I learned about the cost of medical bills.
Can you guess which New York City hospital it was? It was founded in 1736 and is the oldest public hospital in the US. Its psychiatric wing has a famous history and recently in 2014 it was in the new for successfully taking on ebola patient, and Doctors Without Borders’ MD, Craig Spencer. If you guessed Bellevue Hospital you are correct!
Bellevue took me in and I received medicaid, which I was embarrassed to tell my mother and family because they would not agree with going on medicaid, however I didn’t have a lot of options, so I did what I needed to do for the health of my baby. When my sister asked my mother who was paying for the healthcare, my mother told my sister, “You are, dearie.” (my sister was a New York resident). Thank you New York residents!
So the morning of, I was getting ready for my office temp job when my body produced a giant gush of fluids on the bathroom floor! Was it pee or was it amniotic fluid? I felt pretty sure it was fluids, so called the hospital around 8:00 a.m. and they said to come in, so naturally I postponed going in and opted to clean my apartment instead. This was pre-doula days so I didn’t know much, but I knew NOT to go the hospital right away, especially if your water has broken but you are not contracting.
Around 10:00 a.m., I waddled up and over the 7 blocks and 2 avenues from 20th and 3rd, on Gramercy Park South, to 27th and 1st in Kip’s Bay.
I went to buy some milk from a street cart vendor when I arrived at 27th and 1st, and he wanted to gift it to me. He actually got kind of offended when I paid. I should have let him gift it. I learned a lesson in grace.
In I went to the hospital with my milk, red medical card, and little overnight bag. Bellevue is a teaching hospital, affiliated with NYU and I can safely say the birth of my son provided lots of teaching opportunities for lots of residents.
In triage there was the intern who tried and tried to put the large gauge IV into my RIGHT hand only to find out about 30 mins later that he was supposed to put a smaller gauge IV into my LEFT hand, where he tried and tried again. That day, an intern learned where and how to put in an IV.
Around 11:00 a.m. someone must have checked me because they said I wasn’t contracting and I wasn’t dilated, so they wanted to give me Pitocin.
I called and let my fiancee, and now husband, know that I was at the hospital, but having a very strong work ethic (never misses a day of work type of guy), he thought nothing of saying he’d be there as soon as work was done. For some reason I didn’t really care as I was satisfied to labor without his presence - without a daddy either not knowing what to do (hire a doula if you want your partner to learn how to be more involved!), or seeing me such an intense state.
They admitted me to labor and delivery where I was watched over by nice nurse. I don’t recall her name but she helped me breath. Since I was not contracting, they wanted to give me some artificial oxytocin known as Pitocin or pit. Now as a birth doula, a labor support person, I know many other ways to get nature's oxytocin hormone to release (as well as the negative side effects!), but not having a clue about anything because we only took one parenting class at Bellevue, I agreed.
Next thing I knew, all I can see are my white knuckles gripping the bed rail and my nurse saying, "Ms. Rachel, you need to breath for baby! Breath for your baby!" It was a command and I’m glad she reminded me, because otherwise I definitely would have forgotten to breath for long periods of time. I learned about my own strength that day.
They kept offering pain meds but I was concerned they would slow things down and I didn't want the whole process spiraling downward (I later learned was called the "Cascade of interventions"). As it turns out, I was glad I didn’t have any pain medication because I could feel just how horrible these chemical induced contractions were. Pitocin contractions are much more forceful than a natural contraction, which is more of a wave – Pitocin ones are more of a strong spike.
Being able to feel the contractions made me realize how strong they were – much too strong – how could my baby breath? Now I understand more how it works and how during labor the baby and its cord (supplying oxygen and nutrients) gets kind of squished during contractions and the baby’s oxygen supply gets cut off until the contraction is over when the bay catches its breath again. If I’d had pain medication I would not have felt how strong the contractions were and know how my baby was not getting a break from being squished. I said, ‘turn it down, turn it down” I wasn’t getting a break, they were on top of one another!
After several hours of labor I said I couldn’t take it anymore and I wanted pain medication. A doctor came in – like a real doctor I think (not a student) - and told me I was all the way open and let’s do this. Okay. Let's do this.
It was close to 6:00 p.m. and my fiancee arrived around that time, but all I remember is his washed out red shirt with a constellation of little white bleach stains that he wore. I asked him to stand at my head and shoulders. (I secretly replaced this shirt with new one sans bleach stains after).
The local residents also arrived - in came, what seemed like no less than 15 residents and interns to see this crazy lady on pit with no pain meds deliver her baby (it was probably closer to 8-9 interns). It was a wall of white coats - short and long. They all stood there watching, framing the room. I didn’t really care how many people were present – I don’t know why. My mother, mother to 6 children, always used to say, all modesty goes out the window when you have a baby and I found that to be true - I really didn’t care who or what was in the room. As long as me and my baby could breath and my fiancee was at my head and shoulders, I didn’t care. I know this would not be true for many other women who desire privacy.
The attending was present and she was lovely and very encouraging. I don’t remember much from the pushing phase other than it was really exhausting. I was so tired from laboring all day and the pushing phase was so intense and required so much energy. I felt I could NOT do it! Now when I coach moms, I am glad I know just how exhausted they are when they need to push their baby out, so I can support them the right way. It is hard to imagine the exhaustion. I learned how it feels to have absolutely zero energy left and be told you have to bicycle up a giant hill anyway, on a hot day.
The attending told me I was a good mom and I hadn't even had my baby yet. She made me feel so good with just a few words of encouragement here and there.
Our baby boy was born at 6:30 pm. Our hearts completely exploded with love and joy upon welcoming our son.
Whisked away to nursery because I was “high risk” – I asked my husband to follow them as I didn’t want a switched at birth scenario or anything - haha protective mother I guess! They returned baby soon after and with it my fiancee brought a pint of Vanilla Swiss Almond ice cream, my favorite and something I’d gone without for months due to the gestational diabetes. Thank you Steve!
Baby took right to breastfeeding and soon after, my mom in law arrived and looked with such treasure on her new grandson – it was a site to behold! My parents came the next day and that will always be one of my favorite and most treasured memories is my mother and father coming to meet my new baby – my son and then 3 years later, my daughter. Now that my mother is gone, I treasure those moments even more. In my doula role, whenever a grandparent visits a mom right after the birth, I think how the parents will look back on that as one of their favorite memories and they will miss the grandparents some day. Of course, I cannot say that, but I try to do whatever I can to contribute to them enjoying the moment as much as they can.
So, to me and my Irish sense of humor, the birth was a comedy of errors. I could probably write the same story through a traumatic birth lens and getting poked with IVs, provided not comfort measure, having a classroom full of residents present, but I really don’t feel that way - I feel I had a pretty good birth because it was fast and positive and I could feel what was happening in my body. I learned each birthing woman writes her own story.
I wish I wrote her the day before or the day of, I would have said something like: Hi Ma, It was great to see you at Phoebe’s graduation. We are really looking forward to seeing you this summer in Redding- should we plan a tea party? She probably would have been thinking about the tea party while on the tractor. Oh the burden of unfinished business. I think no matter how long the person is alive, no matter when they leave us or we leave them, it is never enough time. Or as I recently heard Alex Orbison say, in speaking of his late father Roy Orbison on the 25th Anniversary of Mystery Girl, "When someones gone, no matter how much longer they would have been with you, well it wouldn't have been long enough." But I will say, even if you are not getting along with your parent you can still send emails- I did force myself (since I wasn't feeling very loving on account of our relations) to send her a loving note and photos for Mother’s Day. One of my biggest regrets is not sending her email about Stephen Colbert’s video tribute to his mother who had just passed earlier in June. I knew she’d appreciate the video but I wanted to watch it again and send a note about why exactly I was sending it, to mask the elephant in the room of her impending death (atleast in my mind I feared she wouldn't be with us much longer). So I waited and wouldn't send it until I had time to watch it again and find the right wording. If I had sent it, I might have written something like, "Sending you Stephen Colbert's tribute to his mother since we both like him and since it is such a nice tribute to an amazing woman and a mother so dedicated to her children. Thought you could relate.," effectively blending my need to send her love and gratitude while feeling some resentment and a distance. Read more....
Happy Birthday to my mother, who would have turned 80 today. She loved animals and kept one of each like a little petting zoo at our "farm" in rural Connecticut. We kids learned many life lessons from the resident animals- if you are a cute, little chicken, do not stand under the garage door or you will get squished; if you are a cute little duck, a mother hen may take you under her wing and you will grow up wondering why you waddle and do not strut; if you are a blind, old gander still running into things at full force with your beak and biting them, you can regain consciousness by vigorously shaking your head; a way to see if an animal is dead is to poke them really hard and see if they respond; if a 14.2 hand Quarter Horse wants to visit her boyfriend across the street, she is more powerful than a GMC van driving 35 MPH; if a 40 pound Springer Spaniel wants to visit his girlfriend across the street, he is not more powerful than a sedan; ducks can pair off male/female or male/male, female/female; and of course, there is not room enough for 2 males among the females... so off to the you-know-where with the ill-fates rams, bulls, cocks and ganders.
My first exposure to birth was (I believe) around the time this photo was taken and I was about 7 or so. Mother Heifer was pregnant and was going to give birth to her baby in the stall- i.e. in the garage turned "barn" housing two stalls padded with straw. I must have seen the scene a few times because I remember quite distinctly that when the cows were in labor they were so active. Normally the cows were very calm and moved very slowly but when in labor would pace and make sudden movements that they never made otherwise. After some time, calf's front hoofs would emerge and she Heifer would bellow - probably wondering what the heck is happening to her privates. You wish there was a Doula-Cow to reassure her, but no such luck! Slowly, very slowly the hoofs would emerge and mother cow would either be laying down on the ground or try to rise suddenly in the middle of the calf emerging, which didn't seem like a great idea, because I remember the calf emerging in one the sudden movements and squishing to the ground in a gelatinous, bloody sac - eek. Calf would start moving quite quickly making its way out the sac, mom would lick sac off baby, and then within no time at all, calf would attempt to stand on those little matchstick legs, wobbly, resisting gravity only by its attachment to its mother's teat. That is how I remember it - quite a site for a 7 year old but I wonder if that is played a part in being a birthworker in my adult life.
So Happy Birthday Granny Bunny- we think of you all the time and remember all the animal husbandry adventures you took us on while at Meeker Hill. Much love to you in heaven where surely you are seeing many baby animals be born since you forever possess a childlike curiosity and love for animals.
This video shows it pretty much exactly as I remember - adding one detail I must not have noticed, which was the Heifer virtually leaps up (or whips around) immediately after giving birth because she wants to check on the calf and start licking the sac off. So much for not tugging at the placenta! It just comes flying right out- not sure if this always works out for the heifer but I realized watching this that... they don't wait for it to expel. Their movements just remove it quickly. Watch only if you are Not squeamish!
The day is my choice, I have the right to change my mind at any time, it is my right." - Brittany Maynard
Does that statement sound familiar to you birth workers out there?
More than anything, of course, I wish Brittany Maynard a miraculous reversal of her brain cancer within the next 48 hours, so that this blog is no longer relevant. If that becomes a reality, what will be remain relevant for years to come, is the work Brittany is doing for the Compassion and Care movement. For those not familiar, "This spring, 29-year-old newlywed Brittany Maynard learned that she had terminal brain cancer. After careful assessment of her prognosis and end-of-life choices, she and her family reluctantly decided to move from their San Francisco Bay Area home to Oregon, one of five states (including Washington, Montana, Vermont and New Mexico) that authorize death with dignity."
Brittany's experience, and the language she is using around it, runs parallel with many of the choices women make in childbirth. Doulas work to support these choices. A birth doula is a person, usually a woman, who supports a laboring women thru birth physically, emotionally, and by providing information to aid informed decision making. Occasionally, the birth doula acts as an advocate for the laboring mom (when called for). As birth doulas we support all the same choices for laboring women who are ushering in birth, as Brittany is exercising in preparing for death.
Saturday November 1st West Coast in her bedroom surrounded by those she loves — in her bed, on an upper floor of her Portland, Oregon home, with cherished music filling the room. We are all familiar with Brittany's Preferences for her gateway into death. She has gone to great lengths (moving to a different state for one) to be able to choose when, where, how, and with whom she will be born into death. She is doing this the same way we doulas support women to be able to choose when, where, how, and with whom they will birth.
When creating birth preferences, a doula encourages women to think about when, where, how and with whom they will birth and about the birth setting. What music will be playing, how the light will be set, what kind of medications they are willing to expose their bodies and babies to? Where will they be- at home, birth center, hospital and if in a hospital will they be in a bed or in a bath or holding onto a bar? Who will be at the birth- MD, Midwife, provider of your choice.
Unfortunately many laboring women do not have control over which hospital staff, and sometimes which Obstetrician in a revolving practice of MDs, will attend their birth. The laboring woman is expected to adjust and collaborate with this stranger (or someone they've met one time) at one of the most important events in her life. This can be very dangerous because if you don't know a person, you also don't know what will come out of their mouth, and the words and things people say to a laboring women will stay with her her entire lifetime. A doula can encourage supportive language at a birth by injecting positive words and phrases into the atmosphere. These are two of the most important aspects a doula provides- holding the space and providing continuity of care. At birth, if a woman is juggled by different nurses and even different doctors, they atleast have the continuity of care of their doula and a partner, when applicable. For Brittany to be able to choose her support team, her death doulas, is critical. Brittany understands this well and has chosen to be with her closest loved ones – her husband and her mother.
Brittany has my support in all her choices- and if she changes her mind, that is her choice too! Brittany can choose to continue staying alive past Saturday or she can choose to die as prepared for on November 1st or on another date of her choice. “The day is my choice, I have the right to change my mind at any time, it is my right." - Brittany Maynard
A laboring woman has the right to change her mind, too. I support Brittany the same way I support a laboring woman and if the woman changes her mind from 100% natural birth with no medications to wanting a epidural- okay! If she wants pain medication and then decides to go natural- okay! If she wants to question her provider's every step and then decides to just do what they say- okay! It's the woman's choice. If you change your mind from when, where, how, or with whom you want to give birth or cross over into death, you have my support! It seems silly to me to state such a basic human right but as we've seen, Brittany had to relocate states to make this choice a reality so evidently it is not obvious to all. Women preparing for a gentle birth also go to great lengths just to be able to have the freedom of choices. Brittany is a beacon for how to illustrate, outline, and expressing preferences in advance of death, while being fluid to the changes possible. Brittany is preparing herself for her best death, for a positive death experience, and open to change.
Doulas also support a positive birth experience and understand births can look very different from one another- medicalized, natural, home, hospital, surgical etc.. but as doulas we support the woman to have her best birth possible, whatever manifestation that may take.
Brittany.... I am wishing you the most amazing last few days with your loved ones, who are so lucky to have known you in your short life, and you them. On November 1st, may you feel all the love and light and support in the world as your husband and mother (your end of life doulas) and the universe hold your hand across the gateway of death. If you’ll let me I will hold your hand from afar too and will light a candle with my loved ones in your honor. You have support of so many across the globe, and I imagine we will all be holding your hand from afar on Nov 1st. Thank you for sharing your love and compassion with us. Wishing you love and light in life and death. We will forever feel the glow of your person as well as the light you have created around the issue of gentle death.
"And in the end, it is not the years in your life that count, it is the life in your years."
- Abraham Lincoln
Visit the Compassion & Choices site and sign the card and let Brittany know you support her bravery in this very tough time.
April 4th, 2014 marks one year since Caroline Anna Jones traveled from a world where her loved ones can call her to say hello and how are you, to a world where her loved ones cannot. I think of Caroline and her girls every day and father Devon too. Below is what I read at her New York celebration of life. Please share your thoughts and recollections in the comments if you wish. Also Caroline's brother, Adrian, started a blog to celebrate Caroline and all the many small details of life that she loved and shared, visit sometime Sit Wherever You Damn Please.
Below are couple pictures from one of Caroline's NY visits from San Francisco. On the left, my Sarah & Caroline's Eloise looking down 5th Avenue in NYC- they were about the same age in the picture as Caroline & I were when we first met.
April 13, 2013
If you feel like you should go visit someone... GO. Last Thursday after 6p I collapsed in bed unable to move, not knowing what was wrong, only to find out that dear Caroline, lost her battle to brain cancer at that same time on the west coast. I am now so grateful I flew to San Francisco in November to attend her 40th. It was tough decision to go, leaving the kids and the expense, but my husband and I felt it was important. At the time I didn't believe we'd be here in this place. And at the time we all enjoyed a good party, which is how it should be.
Our relationship was bookended by childhood- first when we were children and then when we got married and had children of our own. We pretty much by- passed the high school and college years so I was pleasantly surprised when we reconnected over weddings, then sippy cups, mini-mops, breastmilk, and the avocado and mango puree tips of early parenting.
Caroline and I met when we were toddlers. Her family would come out to Redding, Connecticut to spend time in the country, where my family lived. She was city mouse and I was country mouse. It was the 70s. Tony (Caroline's father) and Caroline would go on trips to Caldors. This was the time. We spent the better part of many summer weekends for much of our childhood simply playing and spending days with one another. We played and played and played and played: on the zipline, trampoline, swimming, endless loops around the circular paved driveway- a young bicyclist paradise. Rainy days brought license to bicycle up and down the interior corridor that led from the Tukul / the octagonal shaped, lofty, inspirational building to the the sleeping quarters on the other end. We also received the occasional HagaanDaaz ice cream treat.
It felt like we were sisters and when we were a little older, maybe age 6 or 7, I started sleeping over. Caroline’s bedroom had a bunk bed. I remember one of our conversations she said, “I’d never want to be a model because then I could never eat pizza again.” Then she probably said “I luuuv pizza!” She loved the little things in life- always appreciated the little things in life no matter how grand her life. She lived in fancy houses and came from a fancy family, but she was always so down- to-earth– so real.
Sunny days invited walks down the hill to Caroline’s grandparents to play openly there as well- furiously peddling the paddle boat to get it to the mysterious island in the middle of the pond where Adrian and a friend played Pirates, plus stick races under the bridge, walking on the boardwalk, and many other adventures. I remember only playing- only remember the freedom to be a child and play in this inspirational world. Magda (Caroline's mother), and I believe the Tukul itself, provided this gift of inspiration and the freedom and safety to be a child.
Caroline mirrored this in her parenting- creating an inspiring, free and safe place for her children. Caroline was a magnificent mother and had a special gift for parenting with Charlotte and Eloise. And I believe she absolutely adored the early-parenting years. Dear Caroline lived the beautiful life of Caroline Anna Jones 40 years longer than anyone who was not Caroline Anna Jones. Thank you Caroline for being here with us for those years and thank you and Devon for bringing your beautiful daughters Charlotte and Eloise into this world. My dear friend Caroline, I love you, and will now think of you every night giving protective hugs and kisses to Eloise and Charlotte every night, and Devon too.
When I was going to school in the 90s at Evergreen, Nirvana would literally be playing in the mods (Evergreen's form of a modular house for hippy families), and we would listen to them from the parking lot because there was a crowd surrounding the mod. This video is from the studios at Evergreen in 1990- looks so 80s! Ok, these blogs are starting to feel like obits. I need to stop going down memory lane soon!