In this issue:
- Preventing breastfeeding problems by preparing prenatally
- Tips from a midwife: natural induction methods
- Working with disappointment
- An almost birth story
BirthWays Newsletter
The Unexpected
July 1, 2010
Preventing Breastfeeding Problems
by Preparing Prenatally
By Sabrina Easterling, MPH, IBCLC, ICCE
When it comes to feeding your baby, many expectant and new parents have heard about the importance of breastfeeding and breast milk. For instance, you may have heard that breast milk is the perfect food to support a baby’s developing brain, that it completes the development of baby’s immature immune and digestive systems, decreases the risk of reproductive cancers for moms, and provides cost savings for parents and the health care system. Studies even indicate that parents of breastfed babies get more sleep, on average, than their formula–fed counterparts. This may explain a bit about why the percentage of U.S. moms who initiate breastfeeding – approximately 77% – is the highest it has been in the past several generations.
Similar to other vitally important health activities, like exercising regularly or consistently eating a balanced diet, knowing that something is good for us is only one small part of the picture. It may provide the rationale – the “reason why to do this” – but it doesn’t always provide the motivation and support to make it feasible for the long haul. This may be some of the reason why less than 15% of babies are exclusively breastfed for the first six months of life – the length of time that the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) strongly recommend.
For expectant and new parents who are hoping to start the breastfeeding relationship off on the right foot, the great news is that each year there is more research that can serve as a guiding light. After your baby is born, a combination of education, counseling, and hands-on assistance with breastfeeding techniques and problem-solving provides essential support. However, studies consistently show that prenatal preparation is a critical, if not crucial, component of breastfeeding promotion, and mothers who are prepared prenatally are likely to nurse their children longer than women who are not.
Here are some key considerations of what to consider or do before you have a baby in your arms:
Take a great breastfeeding class and do some reading on your own time
Studies indicate that breastfeeding knowledge is strongly correlated with breastfeeding confidence, and that learning prenatally about various breastfeeding issues increases the length of both exclusive and total breastfeeding.
Strike the right balance between empowering yourself with information and hitting info overload. It’s a good idea to bring your partner and/or a close family member along with you to a class, since two brains are better than one when it comes time to remember some of the things that you learned.
Get your obstetrician or midwife in on the action
While it is natural during pregnancy to put a lot of focus on preparing for the big birth day, a common sentiment heard from moms postpartum is that they wish they had spent more time learning about the thing they would have to do every day with their baby – feeding it!
Your health care provider is likely focused on pregnancy and birth-related issues, too, and you may need to be proactive and ask for breastfeeding-related care. Ask your health care provider to do a breast and nipple exam. It takes just a few moments, but can provide really helpful information. For instance, if you have flat or inverted nipples it is helpful to learn a bit more about their potential impact on breastfeeding (and strategies that can help) before your baby’s birth day.
Another thing to discuss with your health care provider before birth is whether there is anything in your health history that may impact initial or long-term milk supply. While more than 95% of women can produce the milk their baby needs, women with a history of diabetes, anemia, hormone-related difficulties getting pregnant, thyroid issues, or breast surgery sometimes need professional lactation support to help stimulate and maintain milk supply.
Finally, you may want to learn a bit more about the potential effect of birth practices on the early breastfeeding days. While it may be true that a suggested birth intervention is the most appropriate thing in the moment, making informed decisions also includes considering their potential impact of birth practices on the initiation of breastfeeding (this way you can ask for the breastfeeding support you need immediately). For instance, some birth practices may have an impact on a baby’s ability to latch and feed effectively. These include epidural anesthesia or analgesia, assisted delivery, and Cesarean birth.
Know that until recently medical schools and residencies did not provide instruction on breastfeeding-related issues – even for obstetric and pediatric specialties – and many health care providers are still unconvinced or unaware of the research. You can talk to a breastfeeding educator or lactation consultant about the impact of potential birth interventions on breastfeeding if you prefer.
Choose your pediatrician wisely
While there are likely several important factors at play when you choose your pediatrician, be sure to keep breastfeeding issues in mind. In the first year of life, some of the top reasons why babies need to be seen by their pediatrician or other care provider – diarrhea, ear aches, and colds – are significantly less common among breastfed babies than among formula-fed babies. Some new mothers who want to breastfeed encounter challenges along the way. Since many parents rely on their pediatrician to offer guidance, studies show that the information and recommendations parents receive from their pediatrician strongly influence their feeding choices. It would serve you well to ask potential pediatricians what kind of training they have regarding breastfeeding issues and how they stay up to date on them.
Learn more about pediatric support for breastfeeding. Beyond words, what do they do to support breastfeeding? Things to consider are:
- Do they work in collaboration with an IBCLC (Internationally Board Certified Lactation Consultant)?
- For which medical indications do they recommend the use of formula?
- Do they routinely assess the lingual frenulum of a newborn? (This is the connective tissue under the tongue that, when short, can affect the mobility of the tongue and a baby’s ability to latch on well to the breast).
- If your baby has jaundice or is born late pre-term or pre-term, what are the things that they do to help you learn more and get the professional lactation support you may need?
Plan for getting support while you are learning the ropes
After the baby is born, most hospitals offer professional breastfeeding support from a Lactation Consultant (IBCLC) during your hospital stay. Before birth, ask your health care team – or directly contact the hospital if need be – to find out how early and often you can anticipate breastfeeding support. Helpful questions to ask are:
- Will someone be available to help my baby to nurse in the first hour or two after birth?
- Will I be able to see a Lactation Consultant before the day I am discharged?
- Will I be able to see a Lactation Consultant more than once if I need the help?
- What level of breastfeeding support can I expect from my postpartum nurses and what kind of training do they have in providing support?
Similar to many medical schools, until recently most nursing schools did not provide lactation-specific training to students and many nurses have not received recent training on the topic. Therefore, misinformation abounds. For this reason, many people plan ahead to have a lactation consultant visit them either in the hospital or soon after.
Don’t go it alone: plan to get support when you need it
Though it is natural, breastfeeding isn’t always as simple as it seems. If things feel a bit wobbly once the training wheels are off and you are home without a lactation consultant or nurse a call button away, getting help early and often can help you get to the root of what is causing the challenge and get you on your way to resolving it. As the old adage goes, “An ounce of prevention is worth a pound of cure.” It’s nice to have a lactation consultant in your back pocket in case you need to tap into her knowledge base, and support may also provide important comfort.
A lactation consultant can guide you and your family on what to expect, assist with trouble-shooting and problem solving, and provide practical advice and solutions. (Local breastfeeding resources are listed at the bottom of this article.)
Build confidence
Learning about breastfeeding prenatally has been associated with increased confidence about breastfeeding – a valuable ingredient for reaching breastfeeding goals. Believing you can make it through the early weeks while keeping your breastfeeding relationship intact may help you on the days that you are feeling just darn tired, irritable, and as though you are running on fumes. Each person has a different tolerance level and capacity for exhaustion and coping when it’s just not smooth sailing. Having that seed of confidence deep down can be your guiding light when you need it.
Leave pressure and judgment at the door
For those who have breastfeeding challenges, the combination of postpartum exhaustion, significant hormonal shifts, and uncertainty is a recipe for self-doubt. Many moms start to reconsider whether breastfeeding is really possible for them. Be kind yourself. Allowing yourself some emotional flexibility can take some of the pressure off.
Surround yourself with supportive people who do not have any “agenda” other than helping you and supporting the decisions you are making.
If you find yourself wondering if you can “make” it, try not to think of the long haul. Studies show that women who are nursing at six weeks have a strong likelihood of nursing at six months. Many women make a commitment to get to six weeks – day-by-day, week-by-week – and take it as it goes from there. Often by that point breastfeeding takes less time and energy than in the first six weeks and is a pleasurable experience for both mom and baby.
Recognize that breastfeeding has a learning continuum
While you will learn to breastfeed “on the job,” learning about breastfeeding before the baby comes can help expectant parents have realistic expectations, gain some perspective, and anticipate some of the ups and downs of the early breastfeeding relationship. Learning to breastfeed is like learning to ride a bike: it takes patience, practice, and for some a bit of perseverance, but once you have it down you don’t have to think much about it – you just do it.
Your Local Resources
- For an abundance of great, researched-based info: BabyCenter.com or Kellymom.com
- Low-cost breastfeeding clinic (Tuesdays): BirthWays.org
- Referrals to local lactation consultants (in-office or in-home): BirthWays.org
- Local Breastfeeding Support Groups:
• TheNurtureCenter.com
• AltaBates.org
• DayOneCenter.com
Sabrina Easterling is a Lactation Consultant for Contra Costa Regional Medical Center and Then Comes Baby, and a Perinatal Educator with UCSF and BabyCenter.com. You can contact her by email.
Tips from a Midwife:
Are there natural ways to induce labor?
By East Bay Homebirth Midwifery
There are many things that influence when labor begins. Hormonal changes, fetal development, stress, lifestyle, and even your own sense of readiness all contribute to determining when your baby will make its way into the world.
To improve your likelihood of going into labor “on time,” is important that you begin with the right due date. This is something you want to establish with the help of your provider during your first prenatal visit. Familiarize yourself with how your due date can be affected by both the date of the first day of your last period and the length of your menstrual cycle, and be aware that your provider may be using a calculation method that does not take these factors into account. You may find it useful to do your own calculation in advance, and to bring your calculation to your first visit.
Ultrasounds can never date a pregnancy exactly, and depending on when they are done, have a greater or lesser margin of error. Therefore, an estimated due date based on your last menstruation could be much more accurate than an ultrasound estimate. Avoid agreeing to a due date that seems wrong to you with the idea of clarifying it later on, as providers may base their recommendation to induce labor on the due date that was assigned at the beginning of your care.
Whether your body will respond to nudges towards labor and birth will depend primarily on the readiness of your cervix. Before labor begins, the cervix goes through a process of “ripening” or softening. A soft, buttery cervix can open more easily than a relatively firm cervix that has yet to ripen. This ripening process is influenced by prostaglandins, a hormone naturally produced by women’s bodies in late pregnancy. Exposing your cervix to semen, which is prostaglandin-laden, as often as possible during the last four weeks before your due date can make a big difference in readiness for labor.[i] Make sure that you remain in a supine position (lying on your back) to allow the semen to stay in contact with your cervix. (Please note that any kind of penetration should be avoided after your bag of water breaks to avoid increasing risk of infection.)
Your provider can get a sense of where your body is in the process of getting ready for labor by judging cervical effacement, dilation, and softening, as well as the location of your baby’s head. If, at 36 weeks of pregnancy, your provider finds that your cervix has not started to get ready yet you may want to use evening primrose oil, another rich source of prostaglandins, to help ripen it. Take two capsules daily by mouth, and at bedtime insert two capsules vaginally after first piercing them with a pin. You can also begin to take one of the late pregnancy (pre-labor) herbal tinctures that are available online, following the instructions on the bottle.
The use of acupuncture in late pregnancy is very valuable in preparing the body for labor. Find a practitioner who has experience with induction points, and expect that it will take about three treatments around your estimated due date to have an effect.
Sweeping or stripping of the membranes can be used to encourage labor. One of the risks of this procedure is spontaneous rupture of the membranes (breaking the bag of water, thereby creating a pathway for infection).[ii] This procedure must be done by your provider and it is important that it’s only done after careful evaluation of its benefits versus risks.
There is controversy about the use of castor oil to induce labor. In our practice we have used castor oil for over 20 years with great results if the cervix is ripe. Some practitioners claim that they have seen an increase in meconium (baby’s first stool) in the amniotic fluid when using castor oil, but that has not been our experience.
We have also had great outcomes with the use of a homeopathic spray solution called Birth Ease available in some herbal stores.
These are tools in our baskets. We often use a combination of several of them to induce a labor successfully. Make sure that you consult with your provider before deciding on your plan of action.
–Blessings from the midwives of East Bay Homebirth Midwifery
The information in this column is not intended to be used for medical diagnosis or treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.
[i] A study found that 6% of women who had sex an average of four times after 36 weeks were still pregnant beyond 41 weeks as compared to 29% of women who did not have sex during this time. See “Effect of Coitus at Term on Length of Gestation, Induction of Labor, and Mode of Delivery,” Obstetrics & Gynecology, July 2006.
[ii] According to one study, membrane sweeping increased the likelihood of prelabor rupture of membranes (breaking water) for women who were dilated 1cm or more at the time of the membrane sweep, but did not decrease the likelihood of induction or the average age of babies at birth. See “The Effect of Membrane Sweeping on Prelabor Rupture of Membranes: A Randomized Controlled Trial,” Obstetrics & Gynecology, June 2008.
Working with Disappointment:
When Things Don’t Go As Planned
By Gina Hassan, Ph.D.
Unlike other creatures, human beings are prone to a particular “habit of mind.” We expect! We look forward to, we consider, we think. We have ideas of how things are supposed to be, and, therefore, how we want them to be. But life does not always unfold as planned and disappointments can be hard to weather, particularly in a culture that teaches us that if we work hard we can make things happen according to our wishes. While practice, discipline, and intention certainly influence what happens, the idea that we should be able to control how things unfold is a mistaken belief that can lead to great suffering.
Pregnancy, childbirth, and parenting are not subject to our control. When we get pregnant, how our baby arrives in the world, whether breastfeeding goes smoothly or not, and exactly who our child is – these are things that we can influence, but not dictate. Yet we often come to these experiences with elaborate fantasies about how things are supposed to be – and, when our expectations diverge from our lived experience pain, suffering, and, in particular, disappointment can result.
So how can we work with the emotion of disappointment? How can we make room for the experience we are having rather than cling tightly to the experience we hoped for? Whether this means letting go of our fantasy of natural childbirth, or of an easy entry into breastfeeding, or of being able to breastfeed at all, acceptance can be hard to come by. For some, acceptance is equated with a kind of helplessness, passivity, or even depression.
There is, however, a way for us to honor our disappointment without being caught in its grip. After all, when we try to pretend that something isn’t so, or try to force ourselves to “think positively” in the face of disappointment, the emotion doesn’t usually diminish. We may be able to hide from it briefly, but the power of the emotion will persist and will ultimately take up more room than if we grant it the space it needs. In fact, the harder we try and push something away, the more persistent it becomes.
To clarify, acknowledging disappointment is not the same as wallowing in it. In fact, we can notice the contour of the feeling without getting caught up in the content or the story. We can observe our disappointment, for example, as it arises and as it passes. We can also notice when there is a story attached to the emotion. The story usually has something to do with culpability: It is my fault that I can’t feed my baby as nature intended, or it is my OB’s fault that I ended up with a C-section. We can get caught up in the “if only she had …,” or “if only I had…” Getting caught up in the story in this way usually intensifies emotion, trapping us in its grip. Accepting that things are not always in our control and that things happen for unknown reasons, that they are simply part of life’s journey, is a stance that can ultimately help us to move through difficult emotions.
As parents, we frequently find ourselves in the position of having to make difficult decisions. Since we cannot see or control the future, we make the best decisions we can, given the support, resources, and information we have at the time we are making them. The reality is that no matter how much we have prepared, how many books we have read, how many prenatal yoga classes we have taken (or skipped), or how well we have eaten, things don’t necessarily turn out as planned. When we have worked hard to have a natural childbirth, for example, and end up with medical intervention we may feel that we are at fault, we could have done something differently, should have known better, should have prepared more, etc. The truth is that we are not in control of the outcome and we are not at fault.
To sum up: If you find yourself caught in the grip of a difficult emotion try observing it through the lens of the following paradigm. An easy mnemonic for remembering this paradigm is – R.A.I.N.
Recognize: I am feeling disappointed.
Acknowledge or Accept: I am aware that I am having this feeling and will try as best I can to accept it without judgment.
Inquire or Investigate: I will notice what this feeling of disappointment looks like, feels like, sound like, etc.
Non-clinging: I will make space for this feeling to arise and to pass, I will neither cling to it nor push it away.
Gina Hassan, Ph.D. is a perinatal psychologist who offers individual and couples therapy, as well as Mindful Mothering Groups. She has been on the Birthways board for 3+ years. For more information visit www.ginahassan.com.
An Almost Birth Story
by Mosa Maxwell-Smith
Monday
On Monday I became a patient. As my husband and I walked through the automatic doors into UCSF, I realized that something had shifted. I wasn’t visiting the hospital; for the first time in my life, I was a patient at the hospital.
We were in pretty good spirits. I was there for a simple procedure: external cephalic version. After weeks of swimming and moxibustion and acupuncture and chiropractic treatments and sadistic yoga classes, the little girl growing in my belly was still head-up. This procedure, we were told, had about a 50% chance of turning her. We were optimistic.
Our midwife, with whom we’d been planning a home birth, showed up after a while, and the three of us laughed and joked as we watched my baby’s heart rate tick away steady and strong on the fetal monitor. Doctors and nurses assembled to give me a mild muscle relaxant and attempt to flip my breech baby.
Another mother had told me the drug would make me feel jittery – it didn’t. I practiced my deep relaxation breathing as three doctors worked together pushing and shoving my belly and my baby inside of it. It was not comfortable, and a couple of times I thought I might throw up.
Despite their efforts, the doctors could not get a grip on my little girl’s head. Based on the ultrasounds I’d seen, she seemed to be wearing a placenta beret. I could just imagine it drooping down seductively over one eye. Oooo la la! Nonetheless, her nascent sense of style prevented the doctors from getting a good grip on her head to flip her around.
We were disappointed, but knew that it was not uncommon to schedule a second attempt at external version. We were offered a second try, this time with spinal anesthesia, and I gladly accepted.
I spent the next few days trying everything under the sun to help my baby turn. I even spent two restless nights tossing and turning with headphones blaring a heartbeat strapped to my upper thigh – the thought being that my little one might poke her head down to investigate.
I also put some effort into coming to acceptance. I was basking in sunshine again, content that no matter how my daughter chose to enter the world, I was going to get to meet her soon. I was feeling happy, safe, and ready to enjoy the last few weeks ever of having this particular being in my body. What a joy! How lucky I am!
Friday
Despite my fear of needles, we drove to the hospital again on Friday for our version with spinal anesthesia. My stomach rumbling with anxiety and lack of food (I’d been told not to eat before the procedure), we made camp in the busting waiting room for several hours. After choppy discussions with numerous nurses and a doctor or two, we were told the staff was too busy to perform the procedure that day after all.
It was strange to leave the hospital this time. Both my husband and I had felt like something was going to happen – something was going to be decided. We left with our infant car seat and overnight bags untouched and neatly tucked away in the trunk of our car and a promise that someone from the hospital would give us a call on Saturday morning to reschedule.
Saturday
I didn’t eat at all on Saturday morning, imagining (hoping) that we might get a call on the early side. After several calls back and forth, we arrived at the hospital right around noon. We bypassed the now quiet waiting room and were led straight to a private room – already a good sign that things might actually happen this time.
I changed into the gown of immodesty and was quickly hooked up to the fetal heart rate monitor. I laughed and joked with the nurses and even did a pretty good job coming to terms with the IV they stuck in my right hand – I hadn’t been expecting that. Despite not being so into the IV, I was soon glad for the intravenous fluids that began to drip, refreshingly into my arm. I was thirsty, and I got a kick out of the cool sensation that cascaded into my veins though the needle in my hand.
Everyone that came into our room commented on how strong and steady our little girl’s heart was. I was feeling good and ready. I had renewed hope that I might actually get to precede with the homebirth my husband and I had so consciously planned. We talked to my belly girl and told her again what the plan was for the day, explaining that the doctors were going to try and help her turn.
After introducing themselves to me separately over the course of a few hours, the hospital staff managed to assemble, and I walked, wrapped in the ill-fitting hospital gown and the blanket from my hospital bed, to the operating room. One of the anesthesiologists told me that nobody around there had any modesty, and that I didn’t need the blanket. “Really, no modesty? Then why don’t they make your scrubs with a gapping hole down the back?” He had to admit I had a point.
I was still feeling confident and full of smiles when I entered the OR. I calmly held on to my husband’s shoulders as they prepped my back and gave me spinal anesthesia. The anesthesiologist was adept at explaining to me precisely what sensations I would feel next – first stinging with the shot, then pressure as he pressed the needle between my vertebrae, then warmth, then the inability to move my legs. As they lay me back on the skinny operating table, I marveled at the new feelings (or lack thereof) in my body and how quickly they had taken effect.
I was given the muscle relaxant again, and I remember laughing at how funny it felt to not really have any feeling in my belly but to feel it jiggling with laughter just the same. This only made me laugh harder which made the fetal heart rate monitor bounce and jiggle, too. Everyone was laughing. I was feeling ready and optimistic. I was glad to have my husband – my partner – smiling down on me and holding my hand.
I closed my eyes as the doctors began to manipulate my belly. Despite the lack of pain, I could feel my baby moving inside of me. I felt my uterus stretch as her head moved from the apex of my ribs down, to the right – almost horizontal! I kept urging her on, “Come on, you can do it, good girl, good girl, good girl! So close!” Suddenly, there was what seemed almost like the snapping of a rubber band, and I felt her head bounce back into its usual spot. They tried again. Same result.
Since they had tried turning my little one to the right on Monday without success, and they had just tried it again twice, we asked that they try to turn her to the left. As they began to do this, I started to feel light-headed and woozy. I thought it would pass, but when I was unable to open my eyes, I said something. “I think I might pass out.”
“No you won’t. You’re fine. Totally normal,” from the senior anesthesiologist.
“Her blood pressure is low,” from a doctor.
“I just gave her something,” from the senior anesthesiologist.
“To raise her blood pressure?” from my husband.
“No, to help relax her uterus,” from the senior anesthesiologist.
“Something is wrong,” from me.
Usually before I throw-up, I feel like I have a choice. I have time to make it to the bathroom or at least a sink. Before I knew it, and before I had a choice, I was throwing up. In one of his more endearing gestures, my husband held out his cupped hands to catch my puke. I tried really hard to stop vomiting because I remember thinking it would be hard for the doctors to manipulate the baby and help her turn if I was contracting my stomach muscles. Everything was blurry. I remember feeling very thankful for the pulsing and squeezing of the blood pressure band on my arm. It was something familiar that I could count on, and the steady pressure at regular intervals felt good amidst the chaos that was fast enveloping me.
Just as quickly as I had started to feel like I was losing consciousness, I started to feel better because something else was injected into my IV that stabilized my blood pressure. The vomiting stopped, and I was able to open my eyes. What I saw did not reassure me. The bright operating lights had been turned on. Suddenly, the room was full of people. I was confused because as I was starting to feel better, everything around me was getting more intense – something was clearly wrong. My baby’s father kept stroking my hand and saying, “It’s alright. She’s gonna be fine.” Of course, she’s gonna be fine, I thought. I mean, I’m feeling better, so she’s got to be feeling better. I only learned later that my baby’s heart rate had dropped from a healthy 140 or so to somewhere around 70 beats per minute. It was hanging out there.
There was lots of movement all over the room. Then it hit me. Oh, no! They are getting ready to do a C-section. A woman with smiling eyes looked down at me and introduced herself as the pediatrician who would be taking care of my baby. “Not today!” I said. “Not today!” I thought for sure I was doomed to the hospital birth I had worked so hard to avoid. My first glimmer of hope came when the head doctor had them hold off on painting my belly with antiseptic. “Give it one more minute,” she said.
Despite the hustle-bustle everywhere, all I could focus on was my husband – the father of my child. He looked so worried, so pained. I felt sad for him that I had caused him so much worry. I felt bad that for the first time in our eight-year relationship, I had puked not only in front of him but on him. I didn’t know he was still transfixed by our daughter’s sluggish heart rate pumping away on the monitor. Tension permeated the room. Everyone stood poised and at the ready. Seconds seemed like hours. The head doctor said something like, “It’s my call, and I am not going to call it yet.” It was reminiscent of a doctor on one of those medical dramas calling time of death – the death of my birth plan.
Eventually the tension began to ease. The doctors sheepishly apologized and left the room. Before the head anesthesiologist left, I managed to ask him what he had given me that made my blood pressure drop. “Nitroglycerine,” he said, “It was to help relax your uterus, but it lowered your blood pressure. We knew that might happen. You showed classic symptoms of a pregnant woman with low blood pressure; you threw up.”
After hoisting me onto a gurney with the help of my husband, the nurse wheeled me back to our room. She monitored us as my legs came back to life and my appetite began to stir – it was after 4pm now. I ate popsicles and crackers and enjoyed increased sensation as my husband squeezed my toes. Before the drugs wore off completely, we convinced the nurse to remove the catheter they had inserted in preparation for my almost surgery. After I got up and peed on my own, she agreed to remove my IV. As pieces of medical technology were removed from my body, I began to regain pieces of myself.
One of the doctors gave us the “OK” to leave, and told me about the doctor at UCSF who decides whether or not women are candidates for vaginal breech delivery. I said I would talk to him, but I was tired. I was done with hospitals, yet I knew I couldn’t be. At this point it seemed like a hospital would be part of my birth plan no matter how I looked at it. I still planned on playing in the pool and doing moxibustion, and trying to reason with my heads-up daughter, but I was also trying to come to terms with my options.
My husband and I left the hospital to celebrate our daughter’s “very merry unbirthday.” We reminded ourselves that we were going out to dinner as a twosome without having to pay a babysitter. We drank a toast to that and to our daughter’s healthy heart.
Sunday
Today we are celebrating Heads Up Day. We are not urging movement. We are not doing moxibustion. I will not strap the headphones to my inner thigh and blare a foreign pulse. Today is the day to just be with what is. We are taking a break from forcing and changing and manipulating. My daughter’s kicks to my ribs tell me she’s glad.
~~~
My beautiful baby girl entered the world via planned Cesarean at Saint Luke’s Hospital on June 3, 2009.
