the power of knowledge in birth
My ultimate role as a doula is to offer non judgmental support to my clients and provide them with as much information as I can. I do this so that they are equipped to make knowledgeable and informed decisions with confidence. We go over a.lot. at prenatal visits, but I know that information requires repeating when the actual birth comes. Sometimes this means simplifying what the Drs and Midwives are saying in the moment. Especially if it is a decision that the Dr has already made and I feel valuable information is being left out.
I have chosen to distance myself from the agency that I received my training from for many reasons. But I do feel like there are a few valuable things I took away from them and for that I am thankful. One of those things is the idea of B.R.A.I.N. Using this acronym to asses each step of your birthing and labor process and to help you make those informed decisions. Essentially the idea is that, with the exception of a true emergency, you have time to think over and talk about everything that's happening in your birth. You have the ability and the right to ask for a few moments alone to think about something before a decision is made. And ultimately, you have the right to refuse any and all medical interventions at your own risk.
Benefits - What are the benefits of what is being suggested? How can this potentially help my labor process or keep me and my child safe?
Risks - Most, if not all, interventions come with risk factors. So what are those? are they minimal enough to outweigh the benefits? And are you ok with the outcome should those risks become a reality?
Alternatives - What else can we try first? What are some other options that might not be as invasive that might result in the same outcome?
Intuition - What is your gut saying? If your only reason for not wanting to try something is simply because you have a bad feeling about it, that is reason enough. Trust your instincts and ask more questions.
Nothing - Continue to do what you have been doing up until this point. Give yourself and your body more time before offering any changes or interventions and come back to it at another time.
Almost always, when I am at a birth, an intervention is suggested with little to no explanation and in a way that seems more like a requirement than an option. It is my job to gently remind my clients of what we talked about during their prenatal and if necessary, further describe the intervention being pushed. It is also my job to work cohesively with the OBs and Midwives and to maintain a good relationship with providers and hospitals. It's a fine line at times.
OK, so here is what brings me to the whole reason for writing this post. This image came across my feed on Instagram today.
This is an internal fetal monitor. It has the ability to give a much more accurate reading on the baby's heart rate than an external one. According to hopkinsmedicine.org "This method uses a thin wire (electrode) put on your babys scalp. The wire runs from the baby through your cervix. It is connected to the monitor."
I was once at a birth where, as a team, we were all working very cohesively. Their baby's heart rate was pretty elevated for a solid chunk of time and my clients OB wanted to use an IFM to capture a more accurate reading. In this situation you have parents who are often scared because they are making decisions based around the fact that their baby's heart rate is not cooperating. Almost always, your first instinct is to agree to what you think will help asses or resolve the situation. Especially when the intervention is being presented to you though a doctor. But the truth is that there are so many options in birth and you almost always have the time, and the right, to think your decisions though. In the very least you deserve to be handed the full extent of the information before committing.
Her OB did not explain what the IFM was or how it worked. She just said she was going to need to use it to get a read on the baby's heart. Again, not so much presented as option and more like a decision that was already in the process of happening. IFM in hand and ready to be inserted.
We had covered internal monitoring at their prenatal, but knowing the chances of them remembering were slim in the moment, I softly reminded them of what was about to happen.
"Remember we talked about this? It is an invasive procedure because it is inserted in your cervix and they have to break your water. But seeing as you sac has already been ruptured it doesn't effect that...." I hadn't gotten to the part about the higher risk of infection, or the fact that for the monitor to work it would need to be attached to the baby's scalp via a small screw *see image below* before her OB SNAPPED at me and in a very violent tone and said
"it is NOT invasive!"
I was literally shocked and taken aback and quickly tried to mend things by explaining that
"I just meant the amniotic sac has to be ruptured in order for it to be inserted..."
When she interrupted me and snapped again saying her water was already ruptured.
This is where that thin lines comes into play and I have to remember that I'm representing my agency and these hospitals and providers are our coworkers. That I need to keep bridges intact. So I step back and let the procedure happen knowing that I tried my best to inform my clients and although the way in which the intervention was handled wasn't ideal, ultimately it was the best one for the situation. I just wish that they had been fully informed beforehand.
But here is the thing. The whole reason I'm sharing this story. Internal fetal monitors ARE invasive. The dictionary definition of invasive is this " involving entry into the living body (as by incision or by insertion of an instrument)" You are literally inserting an instrument into the cervix and then it is attached to the baby's scalp. All prreeetttyyyy invasive if you ask me.
So here we are in a situation where I'm doing my job by trying to inform and educate my clients of what is happening to their body and their baby, and their OB is withholding that same information. Because she is what? Worried that if they are equipped with all the information that they may not be comfortable with the intervention? How is that right? Let me tell you. It isn't. Because not only did she withhold information, she straight up lied to my clients. And she scolded me, another professional, in the process.
After it was all said and done and her medical team left the room, my client felt the need to apologize to me for the behavior of her OB. She felt uncomfortable and like I was being attacked. My client, who's sole job is to focus on herself, and her child, and this labor processes, is now worried and apologizing to me for her OB's behavior. Nothing is OK about this.
Alright, so why am I sharing this story? It isn't to attack hospitals, or OB's, or even interventions. All of those things are wonderful. Hospitals, and OBs, and interventions save lives, and I have seen some pretty amazing, and beautiful, and supportive hospital births. I have had those births. But I am telling this story as a cautionary tale. Because not all hospitals and not all providers are the same. That information is invaluable and that you have every right to know, and explore, and voice, your options and opinions. This image sparked a memory in me that I had almost forgotten, but it all came rushing back. I still remember the shock I felt and the tone in her voice. I still remember how confused I was that I was being told IFM was NOT an invasive procedure. I felt violated and it wasn't even my body that was about to be entered into with false premise. This kind of things happens in birth all.the.time. If we don't educate and equip ourselves with the knowledge of what birth is, then we are putting ourselves in a position to be taken advantage of. We are unknowingly victims of unnecessary interventions and, in-turn, we are making ourselves even more susceptible to risks. This is in no way meant to be victim blaming because the only person at fault here was her OB, but I do want you to be able to stand up for yourself and know your rights. It's ok to question the professionals. When in doubt ask for a moment alone and use your B.R.A.I.N. Because, as always, your birth matters.
The internet is a wonderful, scary, huge, small, toxic, beautiful space. It's a space where I have met so many strong supportive women and people. And although I have yet to meet many of them in person, I have made so many true and important friends here. I'm not sure how I came to follow Cynthia on instagram but it was probably through her doula posts. I loved her honesty and imperfect squares. I loved her soul that you could just feel spill through the screen.
Cynthia and her husband, Cassady, had difficulty conceiving and after turning to IVF Cynthia was able to grow and carry her beautiful little girl Penny. She shared her story on her page and with each new piece of herself she shared, I felt a deep investment in her story. When it finally came time for the birth of her lucky Penny I couldn't wait for her to transform into the mother that I had learned to know she so desperately wanted and deserved to be. Right after Penny's birth Cynthia opened up about her home birth turned cesarean. After starting this space I reached out to her to see if she wanted to share any parts of her motherhood journey because I knew it was a story that so many could relate to. It has been two years to the day that Cynthia started her labor and she is just now ready and able to share.
There is a misconception in our society that how a person births is irrelevant if the result is a happy healthy mom and baby. How a person births has a deep and scarring effect. Some scars are physical and some emotional. Some scars tell beautiful and happy stories and some carry pain that never goes away. The fact that it has taken Cynthia two years to open up about her birth story proves just this. There is no timeline on which you have to heal by, when it comes to your birth. There is no right or wrong way to feel.
I want to thank Cynthia for always being so open and raw about her story and I hope that no matter where you are in your healing process, that her story will help you feel the solidarity in motherhood that this site was created for.
6 days is the length of a decent vacation
6 days is longer than the standard work week
6 days is 144 hours
6 days is the amount of time I labored with my heart and soul to get my little girl earth side.
6 days I barely ate.
6 days I barely slept.
When people asked why I went so long the answer is pretty simple. There was never any reason not to other than the fact that it was taking a long time. Every stress test every time they checked her heart rate she never once in 6 days had a dip in her heart rate. I was very closely monitored and my levels and the babies levels all stayed the same and I never spiked a fever.
I dreamt about having a homebirth for as long as I can remember. As a Birth Doula I watched so many woman bring their babies into the world and I couldn’t wait to join this beautiful club.
When we found out that we could not conceive a baby naturally and ivf was our only option I clung to my dreams of getting to bring my baby from their first home (my body) to earthside at home. All the shots, blood test and ultrasounds, along with all the people being involved, carried my heart deeper into the homebirth haven.
When I went into labor I was excited. I wasn’t afraid. I sat on my birthing ball and listened to my hypno birthing and let my husband sleep. With my birth training knowledge I knew even though the contractions were coming consistently it was still too early to alert anyone. For a few hours I paced in the apartment contracting by the light of the Christmas tree. I felt my baby dancing around in my belly. Around 4am we contacted our Doula. I got into the shower to see if my contractions would slow down any but they stayed steady at 3/4 minutes apart. Our Doula came and contractions kept building. Around 9:30am our Doula alerted our midwife that it was looking like she needed to come. She looked me in the eyes and said your going to have a baby today. Contractions were staked ontop of one another and our midwife suggested doing a vaginal exam. So I laid on my sofa and took a deep breath. It felt like she was ripping my body in two. She seemed confused. I had already been laboring for 12 hours and I wasn’t dilated. She seemed dumbfounded. She asked if she could invite another midwife to come check. I said okay and after a few more hours of laboring the second Midwife came. She came and confirmed I had yet to start dilating. I felt defeat but I was like this is my first baby and me and my body have this. So everyone left and I was alone with my husband and mother. The contractions didn’t stop. Around 9pm the next night I was laboring on my bed and with a giant contraction my water broke while I was in the arms of my husband and mother. My mom said “this was good this is what we were waiting for.” So we rang the Doula and the midwife and everyone came back over. Even though I was ruptured our midwife said she wanted to do another check. I was dilated 4cm and fully effaced. This felt like a huge victory after 2 days of labor. I was like okay I got this. My midwife had another mama in labor so said she was leaving but that she would return soon. I felt good and got into the tub and just kept trucking along.
After she returned from her birth it was the first time I saw a side of her I didn’t really love. She said “sorry but it was her (3rd or so baby foggy on that detail) but continued to say that that mama deserved it.” I wasn’t upset or put off in the slightest that another baby was born before mine. But for some reason she wanted me to be.
Everyone ordered pizza and gathered in the kitchen. I labored in my bathtub determined to get this baby out. Later my midwife and Doula took me outside to walk and lunge and get the baby moving.
We paced up and down the blocks and with every contraction we used the stoops to help open me up. I lunged and leaned into each wave and begged that baby to get moving, people on the street yelled that someone needed to get me to the hospital but we kept moving. I started feeling weak and tired. It had been 3 days and I was beginning to think that there was never going to be a baby.
We got back to the apartment and they suggested I try and get a little rest. So they made me a little cocoon that I could rest on. They got me benodryl in hopes that it would make me drowsy enough to sleep. Cassady laid down and I watch him snooze a little relived he was getting some rest. My Doula slept on the floor. I laid down but was awaken with a contraction every 3 minutes. I couldn’t stay laying down because it hurt too much. So I would jump up in pain and my midwife would push against my back and I would breathe and push through as best I could. Reminding myself of every mantra I had told the laboring mamas before me.
The morning came again and our midwife and Doula left. My Doula friend came over and walked around with me to get me out. Contractions slowed a little at this point so that evening my midwife suggested I take caster oil and see if that just took everything up a notch.
We walked to the ice cream shop (contracting all the way) and got my favorite flavor and made a little milkshake to drink. Within the hour the contractions had gone from intense to barely tolerable. I was paralyzed on the floor. Everything but the baby was pouring out of my body. Finally there was some blood! I was so relived. Things were happening. So slowly but they were indeed happening. For hours I was on all fours in the light of the night with my body getting rid of everything. My husband attending to both ends of my body. Cleaning vomit and comforting me as best he could.
I don’t remember at what point or what day it was by this point but our midwife suggested we do another exam. 7cm this was huge. 5 days and 7cm I was so close. Our acupuncturist came and I sobbed as she put tiny needles into me. I tried to mediate and let me body relax. I contracted. My friend came to deliver food. And another friend came and did reiki she said that it wasn’t my body and that the baby was trying but couldn’t.
My midwife had me get on all four and try pushing to see if I’d open up more with a contraction. So she put her arm inside me with a contraction held me open. When I first met my midwife she said that she felt like I was just going to plop the baby out on the kitchen floor. She said we didn’t even need to discuss an alternate plan because she said she knew I was a rockstar.
The sun came up again and everyone’s energy had shifted. Our midwife suggested me might need to think about transferring. I was so sad. We went for a walk and I sobbed in my husbands arms. I didn’t understand. My body was made for this. Was it because there was no baby? Was I going to end up on the news as the lady who thought she was pregnant but had made it all up?? Slowly I was unraveling and fatigue was setting in.
We got back to the apartment and agreed to go to the hospital. There was still hope that this baby was going to come out vaginally but it wasn’t going to be here. My Doula and midwife said that maybe I just needed a little help.
The hour drive to New Jersey was awful. I couldn’t sit in my seat so I sat backward clinging to the headrest wildly contracting. Things were picking up. Maybe the fear made my body go into over drive.
Arriving at the hospital it was cold outside I realized the next time I would be outside I would no longer have a baby in my belly. However I wasn’t convinced there would be one in my arms. I remember my husband asking questions about insurance. I felt numb and disassociated from what was happening. They lead me to the room and hooked me up to iv fluids and we met with the new midwife. She said she thought I needed just a little help and this babe would be out. My husband snuck me in a grilled cheese.
Next came the pitocin the dreaded drug that is being sold to me as the ticket to holding my baby. So I agree to the pitocin as long as I don’t have to stay in the bed. So the needle goes in and I say a prayer. All of my hopes and dreams of how I envisioned bringing my baby into this world are shattered with that first drip. I believed in my body. Why wasn’t it working.
Around midnight they suggested giving me a sleeping aid. I agreed but that ended up being insane. It was a drug that made me hallucinate. I got in the bed and fell out of consciousness until the next contraction where I would be awoken without any recollection as to where I was. This happened every four minutes for hours. I was scared. I hated it. I wanted to escape my own body. I felt powerless and terrified every minute of this. I asked to be unhooked for just a little bit. They reluctantly agreed and I got to get in the shower. Tears and water streamed down my body. After 30 minutes they made me get hooked back up again.
The sun came up again. And the midwife came back and was shocked that I hadn’t yet gotten an epidural. 18 hours on pitocin at its highest volume
18 hours on pitocin and no change. . . I remember standing and trying to shake the baby out I screamed please please get out. But nothing.
The new game plan was that I needed to have an epidural to rest. They said my body was tired and I was going to need to get more strength to push. I reluctantly said okay. So they tied me up to the bed with cords and more cords
They inserted the epidural and my heart collapsed. I was like how am I going to have to say I had an epidural. I failed. I was so depleted that I couldn’t birth my baby. I laid down hoping that I would finally get some relief and wake up with the urge to push and my baby would be in my arms.
But the pain didn’t go away. The catheter hurt. I had been in labor for 6 days and this was the first time I had complained. I felt like a dog strapped down. The contractions became unbearable because I couldn’t move my body into a position to get some comfort. I couldn’t believe I was trapped in my worst fear.
I asked the nurse to please remove the catheter because it was hurting so badly. And she said that I couldn’t possibly feel it because I had had an epidural. But I begged and finally she did. It was such a relief. She told me I’d have to have it put back in eventually. So I said that I wanted someone else to do since it felt like she scrapped out my insides when she had inserted it.
3 hours I was strapped to the bed sobbing in pain. The midwife came in and said they had exhausted all the options and that I was going to have to have the baby surgically removed. I felt my body disappear like sand through your fingers. The sounds got quieter and I had no fight left.
They rolled me into the operating room and I asked that I be nude. I didn’t want anything in the way of touching my baby. Everyone kept saying how cold I would be but I didn’t care. I wanted my skin available for the baby. They started playing music and assembling the room like clockwork and I wish that I could remember what music it was. Something familiar but not comforting. As they prepped me I was very concerned that I could still feel my legs but no one seemed to care or believe me. I told the dr and he said he was going to do a test. He ran a wet cloth up my shin and asked if I could feel anything. I said yes it feels like you ran a wet cloth up my leg. Then he screamed “get her up get her up.” And then they said I had to have a spinal. They laid me back down. The surgeon laid his head down next to mine and said he knew this is not what I wanted but I was about to become a mother. They brought in my husband, my Doula and both midwives. Minutes later they cut our little girl out of my belly. We had asked for delayed cord cutting but once they opened me up they said that her cord was too short that they had to cut it to remove the baby from my belly. They asked Cassady if he wanted cut the cord. It was so thick he said it felt like cutting through a garden hose. Once he did they held up the baby and told Cas to say the sex. It’s a girl. I said that’s our Penny girl as I fell in and out of consciousness. I struggled to keep my eyes open. She was here and I was slipping away. I don’t remember hearing her cry.
I don’t remember getting brought back to the room but I do remember that they didn’t take me to recovery. They brought me back to the same room I had been in. They asked if I wanted anything and I said yes food. That’s when the nurse told me that I couldn’t eat for 24 hours. I couldn’t believe it. It had been nearly a week since I had had a proper meal and now they were denying me something to eat. I literally felt like things couldn’t be worse. Every dream I had had was the complete opposite.
When they finally transferred us to the new room it was freezing. I held Penny in my arms and just cried. Cried from exhaustion. Cried from pain, cried from hunger, cried for the things I didn’t get and for the things I had dreamed.
My heart was expecting to explode with love but instead broke. What I thought was going to be the happiest day of my life felt like the saddest. Raw. Hopeless instead of hopeful. My daughter was here and I just wanted to take it all back. It felt like a punishment for messing with nature.
Alone in the room with the catheter still in and my legs bound by some weird machine that was supposed to help with the swelling from the loads of drugs they gave me. I looked down at my feet in complete disgust. I didn’t even recognize my toes. They were so swollen it looked like you could squish them open like grapes.
My body hurt. I had this little person but I could barely move. I felt like I was hit by a train. Every inch of me hurt. But I held her and she nursed every hour. The nurses told me that I had to buzz them whenever she wanted to nurse. This felt strange but I was so tired and barely had enough strength to breath that I just did as I was told. She nursed. I buzzed. The nurse came in and pricked her little foot. She cried. The first time I heard her cry was on my breast because someone was hurting her. They did this every hour for the first 5 hours of her life.
Finally I said why?? Why are you doing this. I couldn’t take it and they said because of her birth weight. Blah blah blah. I said I can I say no?? And they said yes. So we declined any more pricks. Being an ivf mama I knew all too well how much those needles hurt.
Why were they doing this to her? We were supposed to be home in our cozy bed eating spaghetti. Not here.
Morning came and the Lactation consultant came in. I said I didn’t want any help. She left and then quickly came back. She said she heard our story and just wanted to say how sorry she was. Tears came. More tears. I couldn’t believe this was my reality.
The catheter finally came out. I wanted to shower. Dreaded taking a shower. I was afraid of standing. Who’s body was this. My feet hit the ground. Felt like ice. Why was it so cold. We all went to the bathroom together. I looked in the mirror and luckily my belly was still too big to see the stitches. But the iodine stained stomach wouldn’t stop glaring at me.
I turned on the water and stepped in. I don’t remember where the baby was. Was she sleeping?? In cassady’s arms? I don’t remember. Water hit my back but felt like needles. Hard not soft or comforting. I was too afraid to get my stomach wet. I got out as quickly as I had gotten in. I cried. More than anything else I remember crying.
We shivered through another night. Penny slept on my chest and the nurse came in and yelled at me. Said the baby had to be in the bassinet if I was sleeping. I said okay then I won’t sleep. I just laid there. Who was she to tell me what I could and couldn’t do with my baby. I said we need to leave we have to leave we have to get out of here.
The sun came up again and I was determined to go home. I said I was leaving weather they said I could or not.
The Lactation consultant came back again. She couldn’t believe how cold the room was. She asked us why we didn’t ask to move rooms. We were in such a fog it hadn’t even occurred to us that we could. Or that we should.
So we packed up and moved rooms. It was warm. We waited for the pediatrician to come so we could be discharged. I was determined to get out of this place.
We cut her tags off and signed a paper saying we were choosing to leave against medical recommendation. There was no reason to stay other than the fact that they had just cut me open. But my heart needed to go home. So we did.
She was 5 days old. 5 days. Almost the length that it took for her to get out of my body for me to realize I hadn’t even really looked at her. I hadn’t counted to see if she had all her toes. I hadn’t looked at her little fingers. I hadn’t look at her body. It took 5 days before I realized I should.
Cynthia is a mom, hairstylist, and wife among so many other things. You can find her instagramming @cynthiavanis
Over the past week Jessica Bates, author of Birth & What Came After: poems on motherhood, has shared her miscarriage story and some of the poems from her upcoming book based on her loss. Today is the last day of pregnancy and infant loss awareness month and Jessica has graciously offered to host a giveaway of her book
Via the book listing on Amazon
"The body forgets pain, she said. Otherwise women would only have one child. Is it true? Has my body forgotten?"
Birth & motherhood transform us. They shake our foundation with sacred, unconditional love. These 56 poems reflect on birth, motherhood, breastfeeding, raising children, confronting fears, and feeling joy in a fleeting moment. A perfect gift for a new or seasoned mother, and also a great read for those of us who aren't mothers. Birth is universal; we all came from woman. Let's celebrate the power to give life.
To enter the giveaway visit the my instagram account and like the image. Make sure that your following both @motherhoodtabutiful and @_jessicabates comment "done" and you will be entered. For extra entires tag a friend. Each tag is an individual post and entry. Good luck!
A collection of posts from different humans all over the world, sharing their stories about the struggles they have faced in their individual journeys to motherhood.