Birth, Pregnancy, Prolapse

No, I Don’t Want to Hear Your Birth Horror Story

*Update*
*This post is in no way suggesting that women who suffered from traumatic births have no right to share their story, that is not my intention at all. Telling your story of a birth that didn’t turn out as planned can be incredibly healing. I’m merely suggesting that sharing stories with the motivation of inciting fear is not appropriate, and sharing traumatic birth stories may not be the best way to prepare a pregnant woman for birth*

What is it with women today?

We seem to glory in sharing horror stories about birth. As if you one-up each other in who had the worst experience.

Why do we describe birth as this horrifying experience you just have to ‘get through’ because the baby is ‘worth it’?

What if I told you, you could enjoy birth?

That you could look forward to it, and actually want to do it again?

I know I do! I cannot wait to get the opportunity to do it all again!

I was recently talking to a friend who is very pregnant with her first baby. She told me she is ‘terrified of labour’. It made me so sad. I just wanted to reach through my phone and hug her, and say ‘No, no, noooo! Please don’t be terrified!’.

I think a lot of the root of the fear with labour & birth stems from us being so disconnected from our bodies. Our health system has trained us to fear discomfort. Any time something feels off in pregnancy, we back off. We limit movement, we stop everything. Life comes to a screeching halt as we know it.

I just read an article titled The Scary Truth About Childbirth.  The title alone makes me stabby. To summarize, the article suggests that vaginal (and ‘natural’) birth is over-glorified and it’s injuring women in the form of pelvic floor (PF) injury, prolapse, tears and pelvis fractures. It uses words like ‘horrifying’ and suggests that the natural childbirth movement is to blame. It offers up un-helpful solutions such as get induced early, and have an epidural.

No.

No. No. NO.

NO!

While I believe the intention of the article was to educate women about the risks of vaginal childbirth, which are rarely discussed at length (true). It’s shock & awe, fear-mongering approach is everything that is wrong with medicalized birth today.

Inciting fear into pregnant women is not the way to help the situation. Suggesting MORE interventions is not the way to help the situation. Describing injuries that thousands (millions?) of women suffer from as ‘horrifying;, ‘humiliating’ and ’embarrassing’ is not the way to help the situation.

So what can we do?

Well, first, maybe let’s stop approaching birth as terrifying. Fear increases pelvic floor muscle tension, which in itself is a barrier to vaginal childbirth. The PF muscles have to relax and release, and stretch up to 2.5x their length in order for the baby to pass through. This is not possible if the woman is too scared to let them go. This can result in prolonged labour, prolonged pushing, and ‘failure to progress’. A label as failure to progress usually leads to more intervention, such as instrument assisted birth (forceps or vacuum), which greatly increases a woman’s risk for prolapse and/or tearing (or cutting, depending on the care provider).

Let’s think about this from a different perspective. The hormones needed for childbirth are the same hormones needed to acheive orgasm. Oxytocin is released naturally in the brain when having pleasurable intercourse, and is the same hormone that triggers the uterus to contract. Now, if you were having sex, and you were terrified of an orgasm, do you think you’d ever get there? Uh, nope. Highly unlikely. If you were terrified of having sex, would it feel good? Nope, it might even hurt. Same goes for childbirth.

All this fear mongering, is contributing to traumatic births, which contributes to more fear mongering, which just continues in a cycle.

Just STOP.

There is no benefit to making a pregnant woman fear labour and birth. Yes, there are risks. Yes, she should be aware of them and educated on her options. Yes, she should be made aware of potential outcomes of vaginal childbirth.

But we can do it without scaring the shit out of her! We can do better.

If you tell someone you’re planning on running a marathon, people don’t bombard you with stories of how their sisters mother in laws grandmother ran a marathon once and she had a heart attack in the middle and died. No, they congratulate you, and encourage you, and ask you how you’re training, and get excited! Why can’t we approach birth this way?

How about when you get on the topic of birth with a pregnant mama, you tell her she’s going to do great. You tell her that birth is amazing and it’s going to be one of the biggest accomplishments of her life. You tell her that it’s going to be like climbing a really tall, steep mountain, but the views along the way and at the top are the most breathtaking views you’ve ever seen.

Finally, let’s educate women how how best to prepare their body for birth. Like I mentioned, it’s like climbing a mountain, or running a marathon, except we don’t know how long it will be or how steep the climb, or what barriers we may face along the way. So let’s train for that. Let’s encourage women to move their bodies, nourish themselves (as best the can) and get their mind right for the journey ahead. Let’s teach them activities and movements they can do now that will help them later. Let’s get their bodies strong and capable, so when the time comes they are as well-prepared as they can be. Let’s teach them to have an open mind, and be educated about as many of the potential outcomes as possible so they’re prepared to go with the flow of whatever their body and baby presents. Let’s help them be okay with the unknown, not fear it. Let’s share positive birth stories, and help them trust that their bodies are capable of giving birth, and trust that their care providers will have mom & babies best interests at heart. Let’s encourage them to get in tune with their bodies, so they know how to listen to those primal urges that go along with the process.

Birth is amazing, let’s remember that.

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If you’re pregnant and wondering where to start with getting over your fear of birth, here are a few suggestions, things that helped put me at ease:

Watch Birth Story: Ina May Gaskin & The Farm Midwives

Read Ina May’s Guide To Childbirth

Watch How to Have a Harmonized Childbirth

Read I Came Along, I Wrote A Song For You {The Birth Story Of Sparrow}

Watch Welcoming Theodore

Watch Waterbirth of Scarlett

Watch Birth of Sloane

i-dont-want-to-hear

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Birth, pelvic health, Pregnancy

Hold Your Breath, Count to 10, Push Your Baby out, and Your Uterus too

Have you ever heard the term ‘Purple Pushing’?

I hadn’t either, until after I was diagnosed with a grade 2 cystocele (bladder prolapse) and a grade 1 uterine prolapse.

You read that right ladies, all that preaching I’ve been doing about being safe to prevent prolapse, well it didn’t save me.

And I’m about 99% sure I know exactly why.

Two and a half plus hours of ‘purple pushing’. Now the details of the pushing phase are a little foggy in my memory, probably due to the extreme fatigue I was hitting by that point. But I do remember on more than one occasion, grunting through a push and my midwife telling me to stop ‘pushing into my throat’… READ: shut up and bear down. Well when you bear down like that, you’re not only pushing your baby out, you’re pushing everything out. It’s really a matter of what gives first.

And you’re thinking ‘So what? Isn’t that what we’re supposed to do? That’s how it is in the movies, and on TV and in every birthing video ever

Nope. The research says otherwise. Actually, current UK & Canadian recommendations advise against directed pushing. Directed pushing is when the midwife or OB tells the woman when and how to push, usually at the beginning, middle and end of a contraction (that’s right, 3 full body, everything you’ve got pushes per 1 minute contraction) while they count to ten and you turn purple in the face (hence purple pushing).

I remember my midwife telling me 2 pushes per contraction wasn’t good enough. I remember thinking there was absolutely no way I had it in me to put that much effort in, 3 times, every couple of minutes. No wonder I was passing out between contractions by the time we transferred to the hospital. It just didn’t feel right. It felt forced, and painful, and wrong. Birth shouldn’t feel like you’re working against your body. It should feel like your body is doing this amazing thing and you’re kind of just along for the ride and helping out a little, which is what it had felt like for me up until that point!

The fact is that pushing like this not only is exhausting, it is not effective, it is damaging your body and sometimes can increase the risk for your baby to go into distress before they are out.

Boy can I speak to how exhausting it can be to push like that. It is essentially flexing every muscle in your body, while holding your breath, for 10 or so seconds, 2-3 times in a row, every 2-5 minutes. For those of you who’ve been through it, you feel me. For those of you who haven’t, imagine doing a 1 rep max squat, 3 times in a row. Not fun. This has also been found in the research, the effectiveness of the maternal muscles in contracting effectively to push out the baby is related to how frequently they are asked to contract. So if you contract 3 times per minute, rather than once, the muscle contraction gets progressively less effective, decreasing the efficiency of the push.

If a woman is allowed to push spontaneously when birthing (i.e. when she feels she needs to), it has been found that she instinctively pushes with the peak of the contract, once per contraction, thereby maximizing the efficiency of the push and making the most of the effort she is putting in voluntarily (if you can call it that). If you triple that effort, without any marked increase in effectiveness, it is possible the woman may become physically exhausted, before the baby is born, increasing the likelihood of an instrumental delivery.

This is exactly what happened to me. I was SO tired, and we intended on going to the hospital to use a vacuum to assist. So we took a break from ‘coached’ pushing, I was basically left to push voluntarily for about 10-15 minutes during the transfer, and I believe that, coupled with the moving around required to get to the hospital, helped Nugget get to the point where we didn’t need a vacuum after all.

I also believe that pushing like this is what has caused my prolapse. You see any time you bear down (think actively pushing out a poop, sorry if that’s too vivid for some, but I think we’re way past that if you’ve read this far!) you are putting pressure on your pelvic floor. The act of bearing down creates tension in the diaphragm, core muscles and directs all of the pressure created in your abdomen downwards, onto, you guessed it, your pelvic floor and all of those lovely organs sitting on top of it. So if you think, 3 pushes per contraction instead of one, thats 3x the amount of pressure placed on all of those muscles and organs. No wonder 50% of women who have given birth vaginally are estimated to have some degree of prolapse!

This act of holding your breath and pushing also increases the risk of harm to the baby. Let’s think about this logically: when you hold your breath, you are not taking in oxygen. Now, sitting on the couch doing nothing and holding your breath for 10 seconds probably isn’t a big deal. But when you’re literally flexing every muscle in your body and also you are the only source of oxygen for another human currently contained within your body, you are consuming oxygen at a much higher rate. And if there is less oxygen circulating in the mother, there is less oxygen getting delivered to the baby. There is even evidence that bearing down for more than 5 seconds can cause late-decelerations in the baby’s heart beat, often a precursor to an emergency c-section.

So why are we still holding on to the era of ‘we must actively push the baby out’? There are a lot of reasons. The medicalization of childbirth, where it is made to be the most convenient for the doctor, woman on her back, with an epidural working against gravity. Another is our bodies are no longer the bodies of ‘natural’ humans. We no longer hunt & gather, walk miles and miles each day, squat to forage and toilet. Our musculature is different than that of our ancestors due to the vastly different environment we live in. More often than not, we hold a lot of tension in our pelvic floor muscles, and those interfere with childbirth, especially when we are tense and scared of the event at hand. But if we were to take care of all of those variables, the fact is we wouldn’t have to actively push at all to give birth. Do you see elephants and lions and any other mammal that has a uterus holding their breath and grunting on those nature shows? No. 99% of the time the baby animals literally just fall out of the mother, after the uterus does all the work!

This is why we have to take care of ourselves in pregnancy, be educated about our rights and options, and choose healthcare providers that align with our goals and intentions. We have to be our own advocates and stand up (both literally and figuratively in this case) for what we know is right! We have to listen to our bodies, and I mean really listen. We have to get to know them in great detail, know every sensation, what is normal and what isn’t. That way when big events like this come along, we are prepared to work with our bodies instead of against them.

And above all, Squat!

Just keep squatting everyone.

makes-1

Birth, motherhood

What do you mean you didn’t get an epidural?

 

I am at that age, 29 years old. The majority of my friends are trying to get pregnant, pregnant or just recently had a baby or two. So, as women do, we talk. A lot of the currently pregnant or recently pregnant women have asked me about my labour and delivery. I shared my story, as I did here, but they wanted to know how. So here are the ins and outs of how I managed an unmedicated birth.

Now I am not by any means suggesting I did it the ‘right’ way. Or that these strategies will work for you. It was just really important for ME to try my best to have an unmedicated birth, ideally at home. If you chose to schedule a c-section, or get an epidural the second the first contraction hits, or give birth in the forest with deer and bunnies, the more power to you! As long as it is what is right for you and your baby.

I remember my close friend getting pregnant a few years ago. Well before I had even considered the idea of having a baby. She was telling me all about how she was planning to have an unmedicated birth and all the preparation she was doing.

I thought she was absolutely insane.

I was fresh off a labour and delivery placement in nursing school and seeing what those women went through made me cringe at the thought of feeling aaaallllll of that.

Then I got pregnant and my perspective completely changed. All of a sudden it wasn’t about me, it was about this child, and what I felt would be best to bring him into this world. I did research, watched documentaries, found a midwife, fell in LOVE with Ina May Gaskin and watched Birth Story: Ina May Gaskin & The Farm Midwives over and over and even made my husband watch it too.

I think having the right mindset was key. You have to believe you can do it in order to be able to. I’ve been an athlete in one form or another my whole life so that was something I could relate to. I decided to approach labour like an athletic event, like a marathon or climbing a mountain. I tailored my workouts at the end to be like labour training. I’d do one minute on, one minute off of different exercises to prepare myself mentally for the work of continuous contractions every two minutes. I used positive self-talk and told myself over and over again that I can do this. One of the biggest things that I found helped me was doing some research on Hypnobirthing and watching relaxation videos.

When the time came for me to actually be in labour I was excited! I was not scared at all, I saw it as a goal for me to challenge, not as something I needed to survive. I felt every contraction as work towards my baby coming earthside. I knew the stronger the contractions the sooner I’d get to meet my baby, so as they got stronger and closer together, I got more energized and excited. I felt like I was working with my body, not against it. Allowing it to do the work it needed to do.

When my midwife arrived in the middle of the night and checked me, she was so surprised to find I was already 7cm dilated, as I was still smiling and chatting in between contractions. I watched an entire season of friends and laughed and joked.

Now, don’t get me wrong, it wasn’t all sunshine and lollipops and rainbows. Pushing was, let’s just say, not the funnest thing I’ve ever done. At first it was great, it felt like a relief to finally be able to push with the contractions. I felt like I was actively doing something to help my baby arrive.

That was until my pubic bone began to separate.

That’s where the real work, the mental grit, came into play. It was hard. It was the hardest thing I’ve ever done. This part of my labour was all a bit of a blur, but my husband tells me there was a lot of screaming and swearing and definitely a few F-bombs were dropped. This is where I think being a homebirth made the difference between me staying with my unmedicated plan, versus taking something for the pain. It simply wasn’t an option. I didn’t think about it, it wasn’t offered, it wasn’t an issue. It wasn’t until I was 2 1/2 hours into pushing and just physically and mentally exhausted that the idea of maybe trying to go to the hospital for some help was even brought up.

Once we got to the hospital, we tried to use the gas, but for whatever reason we couldn’t get it to work. And at that point, I wasn’t even having the same pain that I was having at home. Baby’s head had slipped past my pubic bone and we were in the home stretch, so we didn’t even worry about it.

I truly believe that the key’s to making it through were having a midwife and attempting a homebirth. I was so much more relaxed, I knew my midwife very well by the time it came to deliver so I was very comfortable around her. I went into it with the right mindset and a positive attitude. Even though women tried to discourage me with comments like ‘oh just you wait’ and ‘the pain is real’ I wasn’t phased. I knew I could do it, and I did.

motherhood, postpartum, Self Care

Pain, Weakness, Defeat – How I felt Postpartum

As mentioned in my Birth Story, I had what they call a ‘prolonged second stage’ which means I actively pushed my baby out for over 2 hours, just over 3 hours to be exact.

It was the most excruciating, difficult, empowering thing I have ever done in my life.

It was worth it.

Would I do it again?

Absolutely.

Would I try and do everything possible to avoid doing it again if I knew it was an option?

Definitely.

Would I have chosen a C-section over what I went through?

Unquestionably, NO.

I believe everyone gets the birth they need. I will admit I went into labour cocky. After all my baby was so far engaged my midwife had never seen a baby that low before. When she checked me in early labour, she said he was ‘right there’. I thought when it would come time to push it would be, 1, 2, 3 he’s out, break out the champagne.

Nope.

And what do you think all of that pushing did to my pelvic floor?

Well… It wreaked a little bit of havoc.

No one tells you what it feels like AFTER you give birth. Sure they say it’s like a period, they talk about the cramping, and the breastfeeding difficulties, and the sleeplessness. No one talks about the fact that you might feel like you’re sitting on a swollen baseball or like your organs are going to fall out or you can’t hold a full bladder anymore. Or that doing something simple like walking around the grocery store might cause you pain in a way you hadn’t even considered.

No one talks about that.

Because you have a baby! And he’s amazing, and adorable and the greatest thing that has ever happened to you! (truth) But the fact that you have a perfect, healthy baby doesn’t negate how you are feeling. I was so caught off guard by the pelvic pain and weakness. After all, I had worked really hard when I was pregnant (I thought) to ensure my pelvic floor was in tip-top shape! I thought I’d be a rockstar, pop this Nugget out, and be back to normal in a jiff.

Not the case.

By my 6 week check up with my midwife, I was still having pain, and feeling weak and while I was lucky enough to not have incontinence, I still didn’t have the same control I once did. Luckily, my midwife had a contact for a Pelvic Health Physiotherapist (PHP) in my city and I booked an appointment.

6 weeks later I finally got in to see Michelle. (She’s that busy)

I recently was telling my friends about my experience with Michelle. I used words like ‘magical’ and ‘tender’ and ‘professional’.

You have a really intimate relationship with your PHP when you’re done. She helps you with things you may not even discuss with your mother.

She gave me confidence to know what is and isn’t normal within the context of my own body. She helped me realize my version of a Kegel was not very effective and helped me perfect it. She also made me realize I hold a lot of my stress and tension in my core by bracing it way more often than is necessary, which was resulting in a lot of tightness in my PF. She helped me learn how to relax and release that tension so I could enjoy things I hadn’t been enjoying before. She even helped me work through the grief I was feeling over the fact that I had worked so hard to keep my core strong, and here I was, so weak that wearing my baby for a trip to the grocery store was causing me pain.

Let’s just say, after I finished my last session, the first thing I did the next day was send her flowers and a Thank You note.

I truly believe every single woman should see a PHP after she gives birth. Regardless if it is vaginal or C-section, uncomplicated or complex, easy or traumatic. See a PHP!

What most women don’t realize is that during pregnancy your core all but shuts down. It get stretched so much that it is really difficult to connect with those muscles and keep them toned. A PHP will help you reconnect, and become more functional and I promise you, it will help you in every movement you make.

Birth, fitness, pelvic health, Pregnancy, Self Care

Pregnancy Fitness – How I did it

In previous posts I mentioned that I maintained working out throughout my pregnancy. Now let me preface this by saying I am not a doctor, midwife, physiotherapist or personal trainer (working on this one!) and I am simply explaining what I did, what worked for me and how I felt doing it. Before I got pregnancy  I was working out regularly, lifting (relatively) heavy weights and doing some high intensity workouts.

Most women experience a dip in stamina in the first trimester, and I was no exception. Even though I only had minor morning sickness I definitely had the fatigue, all I wanted to do was sleep. And I did. Because why not? I was smart enough to realize that come 8 or so months from then I wouldn’t be able to sleep all day, so I did! In addition to magnificent, glorious, magical sleep (can you tell I am writing this post-baby, with a 2 month old who still enjoys multiple night wakings?) I continued on my merry way working out the way I normally do. I lifted weights 1-3x per week, depending on my work schedule, and walked 25-60 minutes with the Big Brown Dog 4-6 days a week. I did not do traditional “cardio”, mostly because I fucking hate running. Hate. Despise. Loathe. I tried it once last year in preparation for the Tough Mudder. I managed to scrounge out a few 8km runs and deluded myself into believing I found the ‘runners high’ but nothing stuck.

I digress.

The moral of the story is until about 14 weeks, nothing changed. I worked out normally, lifting ‘heavy’, walking. Living life. Somewhere around the beginning of the 2nd trimester I decided to purchase the Fit2Birth Mum program from pregnancyexcercise.co.nz. I cannot say enough good things about this program. It felt exactly as hard as it should, I ended my work outs sweaty, but I never felt overworked or out of breath. The best part of her program is the owner, Lorraine Scapens, also hosts a Facebook group for each program and answers questions from users about their specific needs in a timely and friendly fashion.

In addition to the Fit2Birth program I continued my weight lifting, progressively lowering my weights as the weeks went by. For some perspective I started deadlifting and squatting approximately 150lbs, and my final weight lifting session was somewhere around 34 weeks and I was lifting about 65lbs, read: less than half my normal, but probably way too heavy for some other women. I also focussed on maximizing the strength and flexibility of my pelvic floor. I did many stationary squats (think peeing in the forest) as this has many benefits for pregnant ladies, which I will get into in it’s very own post later on down the road.

Now for the benefits, at least from my perspective.

As mentioned previously, around 9 weeks or so, I made a lengthy journey across the country to share the good news with my family in person. This included many hours sitting awkwardly in an airplane. I think it’s no coincidence that this is also when I started experiencing sacral-iliac joint pain. I thought this was the end of the world as I knew it. Working out keeps me sane. I knew a lot of women start having SI joint pain, and they are hooped. No more workout. No more walking. No more functioning. Done. So I snuck down to my nice little basement gym and did the easiest workout I could muster, and prayed and went to bed. The next morning before I got up, I was so paranoid that the soreness from my workout would be the death of my in addition to my newfound SI pain. I got up. I was sore. But no SI pain? Magic!

Well if you think about it, SI joint pain is usually born from a poor interaction of the sacrum and the ilium, two bones on the back half of your pelvis. Relaxin allows the ligaments holding the two bones together to loosen, allowing the bones rub painfully. One would think, strengthening the muscles around these bones would help hold them in place properly, decreasing the amount of pain. This was certainly true for me. This carried on throughout my pregnancy, every time I got lazy and didn’t work out for a while, my hips would get sore, I would work out, the pain would go away.

I also believe working out helped Nugget be in the perfect position for birth from early on. At my 20 week ultrasound his head was so low in my pelvis the tech had to all by smash my bladder in order to see it well enough to take measurements. This was true again for my follow up ultrasounds at 24 and 34 weeks. As soon as I knew that he was head down, I squatted until I could squat no more! Squatting is a functional movement. Back in the day (re:100+ years ago) humans used to squat regularly. Think hunting/gathering/child rearing/harvesting fields etc. Our bodies were designed to squat! It makes so much more sense physiologically than bending at the hips. We are so much stronger in a squat! Also, squatting helps open up the pelvic bones and lengthen the pelvic floor to allow the baby’s head to descent into the pelvis and make it less likely to flip. I’ll explore and share my love for the squat in it own post later on, as I could go on forever!

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While I am in the process of obtaining my PT certification with prenatal/postpartum specialization, I’m not quite there yet. Even then, I won’t be able to help everyone, but I don’t want that to hold you back from reaching your goals. My lovely friend Lorraine Scapens over at Pregnancy Exercise has most generously offered to give my readers a 10% discount on her programs that I used when pregnant and still use postpartum; Fit2BirthMum & Birth2FitMum as well as her other programs Super Fit Mum & No More Mummy Tummy Challenge. Simply enter the discount code ‘HMHB‘ at checkout to get your 10% off!