birth

The Best Outcome Possible: How I Learned To Love My Cesarean Birth

Just moments after meeting our baby girl, via c-section 

Just moments after meeting our baby girl, via c-section 

When I gave birth, to my now 6 year old daughter, I had already been a doula for over 10 years and I was truly excited to finally have this powerful experience for myself.  In my prenatal planning I had decided to not have a birth plan at all. After all the births I had been to, I knew that I would rather roll with the punches and gracefully accept the events as they would unfold in front of me; with one caveat: I did not want a c-section.  I told my midwife that as long as I don’t end up with a c-section I would be happy.  I wanted to experience the full gamut of birthing, every contraction, every emotion, every high, and every low and then to have it end with me pushing my child into the world and into my awaiting arms. I wanted to feel all the power of the many women that I had supported in birth.  Almost 2 weeks after my estimated due date, I began having contractions, but they would suddenly stop and then start up again. This cycle, also known as prodromal labour, went on for days.  I won’t go into all the nitty gritty of the details, but I will say I certainly did have the full experience of birthing, just not in the way I had envisioned.  It was decided after a very long time of being in labour, I would need a cesarean.

It took me quite a while and a lot of reflecting to really realize the true value in my experience with the way my daughter was born.  The impact that the birth of our daughter had on her father was actually quite beautiful, and in many ways this was because she was born by cesarean.  Throughout my pregnancy, I had the experience of this life growing within me, while my partner was somewhat detached from it all. He went to the ultrasound appointments, felt the baby kicking and even talked to my belly, but he admits that he didn’t really grasp how his life would change once he became a father.  In the OR , my viewpoint was basically limited to what I could see within a few feet in front of me, with a curtain wall hiding anything from the chest down from my sight; I was relying on my partner to be my eyes. He watched as our daughter was brought into the world by a scalpel and firm, yet careful, hands. He got the experience of being the first to see her; something that he felt was just for him. He later explained to me that all of the stuff I got to experience during my pregnancy was not anything he could ever have, so this was his moment for him to cherish. I never expected to look up at him and see tears in his eyes, but sure enough they were there, and even though the surgical hat and mask hid most of his expression, his eyes said it all, he was beaming with pride. My daughter was placed beside my face so we could meet and she briefly sucked on my nose, but then daddy got his turn with his new little girl and was proud to show her off to awaiting family.

 

I will never know if he would have had the same experience had I had a vaginal delivery, with my mom and best friend also there, but to speculate does not matter, because how it turned out was beautiful and the bond between a girl and her daddy is stronger than ever.

 

When we as doulas talk about our many benefits, we sometimes speak to the studies which show how doulas assist in lowering cesarean rates.  We often pride ourselves in how our support contributes to ‘better’ birth outcomes.  While this is true and studies do back this, it leaves me wondering what message this portrays to our clients that give birth the cesarean way, whether by choice, planned or unplanned. Does it mean they did not successfully birth their babies?  Why did I feel that this would be the worst case scenario for myself?   I spent a lot of time pondering and wondering what I could have done differently to have prevented the cesarean, I was a doula afterall.  I am now at peace with my birth story and I feel like it has brought me to a new place as a doula.  In recent years I have had the opportunity to support clients in their own cesarean births and I feel so much better equipped to know how I can best support them in feeling that their birth is just as it should be.  Cesarean brings about different elements to birth, but really and truly every birth I have ever been witness to has been different, no vaginal birth is the same as another and does not come without its own challenges to overcome.  

 

My wish going forward as a doula is for all of my clients to feel supported and empowered in the choices they make and how the events of their experience unfolds , no matter how they birth their babies.

 

Having to accept that I had a cesarean and even learning to appreciate that this was my birth story, is an invaluable lesson as a mother.  As parents we set a lot of expectations of how we want to raise our kids, how we think they ought to be and become.  Just as quick as we set those expectations they are just as quick to knock them down.  We can have wishes and desires for how we want things to be, but we don’t get to control them. We can take a deep breath and accept the challenges that we are thrown at us in birth, parenting and in life, and it will all become the story of us.

Talk to any woman about their birth story and you will see how impactful it is on her life; the birth of my own daughter is now at the core of my being.  As a doula I look forward to supporting many of you through your story. It is my hope that the story you will tell is not  defined by vaginal vs. cesarean, medicated vs. unmedicated, but rather one of being supported, empowered and just the way it should have been.

 

-Jody 

Baby Brain - Myth or Fact?

Pregnancy brain, mommy brain, baby brain, all of these are names you may have heard to describe the symptoms that seem to produce a sort of Momnesia in pregnancy and afterward. If you’re experiencing increased forgetfulness or a general lag in your mental sharpness, it’s not likely you’re not losing your mind; both literally and figuratively.

The research on the subject isn’t extensive, but the research seems to show that while mental sharpness definitely takes a hit, it’s likely due to a major increase in estrogen and progesterone, clouding memory and inhibiting optimal mental function. These studies are reassuring though, suggesting that this is a temporary issue; there does not seem to be any actual lasting affect on the functioning of your brain due to these hormones, just a temporary annoyance (that occasionally comes in handy as a great alibi for forgetfulness!)

As inconvenient and frustrating as this common pregnancy and postpartum issue can be (because it certainly doesn’t seem to let up in those early weeks and months after birth), there could be an evolutionary explanation for baby brain. While you may be missing appointments and forgetting what you walked into the kitchen for, your brain seems to focus your attention on what’s most important during this time; caring for yourself and your offspring is at the forefront of your mind and seems to take the number one priority, putting the less-important things on the back-burner.

So what can you do to help yourself out and lessen the impact of this annoying symptom? Don’t rely on your memory to try to keep appointments, complete deadlines, and finish errands; your brain could use a break from the extra space those things take up, and there are simple ways to do this!  Make lists (and try to keep them in one place!) and utilize your cell phone calendar or set alarmed reminders for yourself.

Getting extra sleep will go a long way, too. There’s a good chance you feel like you are needing more sleep than ever in pregnancy, and after baby is born you may experience a lack of sleep like you’ve never known before! Don’t hesitate to take a mid-day nap, and ask for an extra pair of hands to hold the baby or watch your toddler so you can catch up on sleep. Your baby brain will thank you! 

Rest assured that this unsettling feeling that someone has loosened a few lightbulbs in your brain, is only temporary one. Be gentle on yourself during this time when your body is undergoing an extreme takeover. This too shall pass! 

The Only Guarantee Your Doula Can Offer...(hint: it's what really matters!)

DoulaStats.jpg

There’s hardly a doula fresh out of training that hasn’t shared some variation of these statistics that you see above, myself included. Shorter labor, reduction in caesarean birth, oxytocin, analgesia, and epidurals; all of these things are meant to illuminate the value of doulas. These numbers are meant to wow the masses of what it is we can offer to ‘improve’ birth out comes for our clients. It’s well meaning, but it’s time for a healthy dose of perspective.  

The Cocherane Review has one of the most recognized studies that speaks to the benefits of doula attended births and provides evidence for these claims (You can see the actual study with accurate facts and figures, here.) This study is an excellent compilation of research that does in fact illuminate the difference a doula can make for a birth, but the way these statistics are being shared in the birth world may be doing more harm than good. 

When I share with you the ways in which I may be able to ‘enhance’ your birth by preventing analgesia or epidurals, I’m assuming you want to give birth without medication.

When I tell you that studies show my presence may reduce the length of your labor, I may be setting you up to feel as though your long labor was the result of a broken body or some bad luck.

When I suggest that, with my help, you may be able to avoid a cesarean birth, I’m assuming that this isn’t an ideal option for you, whether by necessity or by choice.

Here’s the thing: there is no golden standard for an ideal birth.These statistics suggest differently. Each of these numbers represents a preference, a personal ideal. Too often there ends up being an unnecessary weight of guilt and disappointment that mothers carry when their birth doesn’t meet expectations either set by someone else’s standard or their own. 

Nobody should expect or hope that any of the issues on these lists are important to you– maybe they are, maybe they’re not. Your doulas job isn’t to try to provide you with some statistically ideal birth plan, our job is to offer unconditional support to you through the birth you end up having; through the choices you make and the outcomes beyond your control.

Neither you or I can determine the outcome of your birth. If I take on the burden of trying to measure up to a statistic, I may not only be setting myself up for failure, but I may actually prevent you from birthing the way you want to. Birth doesn’t always stick to the plan; the unpredictability of labor means that you need to be ready to be flexible, to change your mind without apology, to grieve the things you’d hoped for and lost, and then celebrate how incredible you are for bringing life into this world.

So what is relevant here? What’s the point doula support if it comes without the guarantee of the birth you’ve planned for? Studies have shown that a woman’s satisfaction with her birth isn’t a result of interventions, outcomes, or having things go as planned; it largely relies on how she was cared for, heard, and supported, and that is an outcome I can promise to deliver. So here’s a statistic I think is worth sharing: