Birthing Henry

We're so excited to begin sharing some of the birth stories of our followers.  This first story is one of two from a fierce mama!  Thank you, Rachel, for sharing your precious memories with us!


Wednesday April 27th, 2011

Expecting Henry

I had my cervix rimmed this morning. I spend the day running errands and every time I was sitting in the car I would have some contractions, but when I got home they stopped. I wanted to clean the house, but I wanted to wait until John was home in case it sped things up in the labour department. It did. And I didn't get very much cleaning done at all.

8:00 pm: I started to have contractions again, but more consistently.

10:00 pm: We decided to go to bed, in case this was the real deal.

10:45 pm: It was pretty obvious that I wasn't going to get any sleep. We decided to start timing my contractions. The weird thing was that all my contractions were back contractions...which are just lower back pain that comes and goes. I wasn't expecting that. My contractions were about 8 and a half minutes apart, lasting about 2 minutes each. They were bearable but very uncomfortable

11:00 pm: I got in the bath to ease my contractions. John shaved and had a shower in the guest room (A few months ago I requested that John be clean shaven for the birth. I didn't want him looking like a hobo and I was so glad he agreed!)

12:30 pm: My contractions were now about 5.5 minutes apart and getting stronger. My doctor told me to come to the hospital when my contractions were 5 minutes apart. We decided to just go since we live about 45 minutes from the hospital. I showered, blow dried my hair and got ready to go. I remember telling John that I couldn't believe I wanted a natural labour because there was NO way I could do it if this was only the beginning. In the car I threw up SO many times. Luckily we had a reusable grocery bag in there (we threw it out after).

1:30 am: We arrived at the hospital. Laboring in the car was horrible. It wasn't busy at all in the Labour and Delivery Ward. They took us into triage and I changed into a hospital gown. I was in SO much pain at this point, but since it was back pain I'm pretty sure no one there believed me. The nurse left me to labour laying on the bed, which is not ideal at all. John rubbed my back the entire time because it was the only thing that made me feel a bit better.

2:30 am: They checked me and told me that I wasn't dilated AT ALL. I have trouble believing this, since in order to have my cervix rimmed as was done the previous morning, I needed to be dilated at least 1 cm. The nurse gave me a birth ball and left me to labour again for 2 hours. John continued to rub my back. I threw up many more times. I can't believe how much I threw up in total.

4:30 am: A doctor from my clinic came to check me. He said I was only dilated 2 cm. I don't know but 2 cm in 2 hours seems right on track. However, he told me I was progressing too slowly and that we should go home and GET SOME SLEEP. Because I bet all laboring ladies get a good nights sleep right in the middle of labour. We told him we lived out of town, but he was sure that going home was the best idea for us. We were not happy at all.

5:00 am: We arrived home. I forced John to get into bed and take a nap. I decided to have another bath, since laying down was the worse position for me. I slept in between my contractions but stayed in the bath until 8:00am. When I had a contraction, I would vocalize my way through it. Apparently I was really loud and my brother (who came over to watch our dog) was up all night in the guest room. John however slept right through it.

8:00 am-9:00 am: I got out of the bath and tried some other positions. They didn't work at all and I soon missed the bath. I woke John up vocalizing my way through the contractions on the floor beside the bed. This entire time I had been timing my contractions on John's iPhone and when he got up and looked at them, he was shocked to see that they were 2.5 minutes apart. I had no idea how far apart they were until he told me. I decided to get back into the bath. Since my clinic was now open John called them and asked what to do since we didn't want to be sent home from the hospital again. They told him that first babies are slow and we should probably wait it out at home. When John told me that, I made him call them back because I felt like I was dying. I couldn't last much longer. I think I actually said I wanted them to cut the baby out of me because I couldn't do this anymore. The pain was crazy! The nurse asked to speak with me and when she realized how much pain I was in, she told us to go back to the hospital.

9:30 am: John snapped into action to get us back to the hospital. I however did not want to get out of the bath. While John was trying to get me out of the bath, my water broke. At the time I didn't know it was my water breaking, I just knew something was happening. John had to basically dress me since I couldn't really function at all. Then, I felt the urge to push. What an odd feeling. Your body just pushes and you can't really stop it.

10:00 am: Before I know it John has loaded me into the car and off we go, in a BLIZZARD to the hospital. I was scared that I was going to have the baby in the car. There was so much traffic because of the weather. It felt like we would never get there. The entire time I was chanting "don't push, don't push don't push!"

11:00 am: We arrived at the hospital and there was a traffic jam. We couldn't get to a parking lot, we couldn't even get to the main entrance. John finally just drove into the Ambulance bay and parked. He grabbed me and we ran into the hospital. I didn't want a wheel chair because sitting was impossible. We needed to get to the 5th floor and there was a line for the elevators. A LINE. Luckily a lady at the front saw how much pain I was in and let us go in first.

We get onto the floor and I needed to lean against the wall and breath through a contraction. John went up to the desk to tell the nurses about me, and then he had to go back and move his truck. A nurse came and took me into triage. I was panicking. I told her I was Strep B positive and had the urge to push but I hadn't had any antibiotics yet! She tried to get me into a hospital  gown but the effort to change into one was too much. She got me onto the bed and I took my PJ pants off and almost immediately she told me I was 10 cm and +2 station and yelled for someone to get me some penicillin (for the group B strep, you're supposed to get 2 doses, the first 4 hours before delivery). But I'm allergic to penicillin so I started freaking out about that. All the while they are wheeling me into a delivery room. Before I know it I'm on a new bed, no pants on, still with my PJ shirt on, they are yelling about antibiotics and trying to get an IV in me. John was still moving the truck and I was worried he was going to miss the entire thing! But he showed up pretty quickly after.

Hello Henry!

He walks in and see my legs up and he almost passes out. He gets to the stool beside my bed and keeps it together. Pushing was so great. After not pushing for 1 hour, it felt so good to push. With each push I tried to push gently, so I wouldn't tear. John thought they had given me an epidural because I was so peaceful. I fell asleep between each contraction. I pushed gently for 45 minutes. Henry was born at 11:48am. The cord was wrapped around his neck and he had a bowel movement while I pushed him out. Just to be safe they rushed him to the warmer and suctioned him out. Then he finally cried. I made John go over and watch as they examined him. He was perfectly healthy!

Brand new Henry!

On Ethics and Beliefs

Hello, Readers!  I realize it has been some time since we've posted to the blog.  We hope you all had a wonderful holiday season and are now enjoying spending joyful winter days with your family.  The following post is based upon recent concerns I have had in practice as well as in the birth profession overall.  Enjoy!

On Ethics

In September 2011, we authored a post pertaining to the distribution of product samples and coupons to our clients.  Mothers-to-be are often given samples of baby lotions, diapers, coupons for private ultrasound companies, etc. from a variety of sources including doctors offices, formula companies, and maternity stores.  We, too, have provided certain sample products to mothers in our client packages which we hand out at our initial consultations.  Our primary sources had been from companies such as Lansinoh, Medela and Seventh Generation.  We are revamping our policy on samples for the following reasons:

1. Medela is no longer compliant with the WHO/UNICEF Code of Marketing of Breast Milk Substitutes; therefore, we cannot in good conscience distribute their product(s).
2. While we support companies that are WHO Code Compliant, we will no longer distribute samples of their products unless requested by our clients.
3. We feel that we have a responsibility to families to provide them with excellent care, support, and evidence-based information that is not coloured by commercial sources.

On Beliefs

Please note: The following are my personal beliefs and are not necessarily the opinions of my colleagues.

As I grow and continue to learn in my role as a doula, and through my personal life experiences, my beliefs regarding pregnancy, birth, breastfeeding and parenting continue to evolve and become more clarified.  Therefore, I wanted to share with you what is in my heart.

1. I believe that woman were created to birth without unnecessary interventions.
2. I believe that women are strong.
3. I believe that pain is subjective, yet also that fear and tension exacerbate pain.  See The Fear Tension Pain Cycle - based on the research of Dr. Grantly Dick-Read.
4. I believe that families deserve complete evidence-based information on all potential interventions in pregnancy, birth and breastfeeding in order to make truly informed decisions.  I believe I would be remiss if I did not assist them with finding this accurate information.
5. I believe that birth is safer and healthier for mothers and babies when medications are not used.
6. I believe that babies are active participants in their own births.
7. I believe that babies are born wired to be breastfed.
8. I believe in the WHO Hierarchy of Infant Feeding Choices.
9. I believe breastfeeding is possible for the majority of mothers and infants with knowledgeable and compassionate support.
10. I believe birth belongs to mothers and babies, not to any caregiver or system.
11. I believe mothers will birth in their own time.
12. I believe babies will be born when they are ready.
13. I respect technology and medical interventions, as they have their place in emergency situations.
14. I believe birth is a natural process, not a medical event.
15. I believe that I do not empower women, rather they empower themselves with strength, trust in their bodies and the process of birth, and knowledge of the benefits and risks of all of their options.
16. I trust women!

I believe this list is not finished and that I will be continuously learning and evolving.  I am so thankful to all of the families I work with as it is they who truly teach me.

What Kind of a Doula am I? ~ Sherel's Philosophy

You may have noticed over the past couple weeks my colleagues have each written a blog post about what their philosophy is of being a doula and supporting birthing families. It is our goal to each contribute on a regular basis to bring our readers information on birth and to help you to get to know us a little better. I guess that I am the procrastinator of our group because I volunteered to go last and I am still down to the deadline trying to get my thoughts down in print.
I think that the most wonderful thing about doulas is that each one is different and has their own philosophy on how they support parents during pregnancy and the birth experience. I think this is wonderful because each family has their own ideas of what kind of birth they will have and what kind of support they will need along the journey. It is so important that expectant parents get the kind of support that works best for them.


I feel that my main role as a doula is education. I have learned from my own births and those that I have attended that good preparation makes a world of difference when a woman is deep in the throes of labor. Even with good preparation there comes a point where having loving and gentle support is the one thing that keeps many women going.

I often wonder when I read the research on birth why so many doctors choose to use so many medical interventions when many studies show the harm of them such as induction and epidurals. Then I hear mothers speak of their own births and how they scheduled an induction because then all of their family could be there and wouldn’t miss work or how mothers would never give birth without an epidural because they are “not that brave”. I have heard this over and over again from mothers who have no enthusiasm about the birth event and are only grateful to have it passed and receive their beautiful healthy babies. I realized that doctors all too often hear this version of birth from the expectant mothers they work with. Expectant mothers who approach birth with fear and trepidation wanting only to be rescued from the pain are the norm in our society. Whereas, those who educate themselves about how they can birth peacefully and beautifully with their bodies doing the work to bring their newborn into the world, are looked at as strange and even crazy.


Birth can be beautiful and peaceful and mothers can show the medical providers that there is another way to give birth without the pain medication and the lithotomy position for pushing. However, it isn’t about educating the doctors and OBs, the research is out there for them to see, it is about educating mothers so that they can choose other options besides medication. Mothers need to be informed that they can birth without fear. If the majority of mothers asked for births without medication and asked to be upright during pushing and for freedom to move during labor, the medical system would change. The evidence would be there for all doctors and L & D nurses to see and mothers would go on to be advocates for natural, un-medicated birth.


This is why I feel that as a doula I need to make the option available for all women to have the resources to be in charge of their own births. I feel that pregnant mothers are given 9 + months to prepare themselves and their minds and bodies for the birth event. My role is to help families to educate themselves in choosing the best birth for them and to choose the right support people. I do not feel that I need to be present for every woman’s birth as birth is very sacred and women need people surrounding them that they are comfortable with. I have seen firsthand the difference that a doula can make who is sensitive to the needs and comfort of all who are present. I know that having a doula at birth in the hospital can keep a woman from fighting her body and help birth to progress more smoothly. However, I feel that birth in the hospital can change if enough women are educated about their bodies before entering the hospital. That is my goal as a doula and someday as a midwife, my desire is to see mothers who ask for change in birth and reject medication for themselves and their babies.

My birth philosophy is that I want to be there for all women of all ages and with all histories and give them the tools that they need to experience a beautiful and fulfilling birth experience so that they will share their stories with those around them so that someday the landscape of birth will change and babies will come into the world free of fear and ready for the adventure that is life.

It's the "Pits"

We just had to share this informative blog entry with you from Nurturing Hearts Birth Services in Mesa, Arizona.  Pitocin has become a standard in many hospitals and information is not always readily shared with expectant families.  Here is what you need to know:

Pit of Dispair

Zoe's Birth Story

Zoe’s Birth Story

On November 9th I was sent for an ultrasound to see how baby Zoe was doing since my belly was measuring small. This ultrasound was called a biophysical profile ultrasound; it tested the baby on 5 different things to see how she was doing. According to the ultrasound Zoe scored a 10/10. This was great news.

On November 15th my doctor called me at home and said “How does November 16th sound as a birth day?” I half laughed to this and said “Sounds great to me.” He then went on to tell me that after reviewing my ultrasound and talking it over with the radiologist and another doctor in Medicine Hat they decided it would be best for Zoe to be born as soon as possible. They found the umbilical cord was restricting the blood flow to her and her abdomen had actually shrunk since our last ultrasound. This concerned me but I was so excited to know that I would soon have my baby in my arms. He told me I would need to be admitted into the Medicine Hat hospital by 4:00pm that day and my induction would start on the 16th. Although an induction was not in my birth plan and it was something I really wanted to avoid my instinct told me that it would be better for my daughter to come if she was no longer striving inside of me.
David, my husband, and I packed our bags, told our parents what was going on and headed to Medicine Hat. My mom followed us to Medicine Hat. Once admitted they monitored Zoe for two hours. They said she was doing great and the doctor would be in to see me in a bit. At about 6:00pm the doctor came into the room and checked me for any signs of dilation or effacement. She said I was 0cm dilated and 0% effaced. She also said my pelvis area would only allow her to get two fingers in. She then proceeded to tell me that chances of me having a c-section were very high because my pelvis area was so small and also because I needed to be induced. As the words came out of her mouth a lump in my throat formed. I was devastated about this because I had planned for a natural vaginal birth and was not yet willing to have a c-section. I looked at my husband and then turned to my doctor and told her I would still like to try a vaginal birth. She then said that if baby showed any signs of stress that I would be sent for an emergency c-section right away. I was okay with the fact that if my baby was under stress I would have a c-section. I wanted to do what was best for my baby.

She then told me she was going to insert cervidil to start the induction process. Chances of the cervidil ripening my cervix and starting dilation were only 10% so it would probably take a couple days for anything to start happening. I went to sleep that night but tossed and turned all night. At about 4:00am I could no longer sleep because I was having pains every 2-3 minutes; which I later realized were contractions. The pain was not too bad but there was no way I could sleep or talk through them. I let David continue to sleep since he didn’t actually fall asleep until about 2:00am. At 4:30am my cervidil fell out so I called my nurse in. She said we would have to wait for the doctor to come in but she said chances were the doctor would just insert more cervidil.

At 6:30am my doctor and a resident came in to check how I was doing. They said they would see if the cervidil did anything but they doubted it. The doctors checked me and found I was now 100% effaced and 3cm dilated. This was exciting for me! They told me that we would start pitocin later that afternoon so at this time I was free to labor throughout the hospital.

David, my mom, and I walked through the hospital and I stopped every 2-3 minutes when a contraction came. My contractions were getting more intense and I really needed to focus on breathing. David was amazing at keeping me calm while my mom was there to support us both whenever we needed her. During each contraction I would stop and lean on David as he held me. I focused on breathing until the contraction passed.

At about 10:30am my nurse came to my room and told me she was transferring me to the delivery room and she would start the pitocin. Since my chances of having a c-section were high and I was being put on pitocin they would be monitoring the baby during my labor and delivery. Brandi went over my birth plan and knew I wanted to move during labor but this was not possible since Zoe needed to be monitored. Although I was disappointed that my labor and delivery wasn’t going to go exactly as I planned Brandi, David, and my mom all did a great job at helping me through each contraction. Brandi also assured me that we would do as many position changes as I wanted and she would help me make this possible.

Once I was hooked up to pitocin and they were monitoring Zoe I sat upright in the bed. David and my mom put cold cloths on my head between contractions and on my ears. David helped me breathe through each contraction and told me what a great job I was doing. My mom stood behind David passing him cloths to put on my head and also kept telling me how great I was doing. My contractions started getting more and more intense. As each contraction came I focused on the contraction. I visualized my pelvis widening so my baby could fit through. Each contraction brought a "good pain". A pain with a purpose. Although the break between each contraction was nice I was waiting for the next one to begin, knowing that each contraction meant I was closer to meeting my baby girl. Brandi noticed my contractions getting closer and closer together and getting more intense so she asked if she could check me for dilation. I agreed to this hoping that it would be good news. She said I was at about 6-7cm dilated. I looked at David and said “I don’t know how much longer I can do this.” He told me I was doing amazing and that I was strong and I could do this. He told me to get through a couple more contractions and I would be at 10cm. His encouragement is what got me through. The pain in my back was intense and seemed to be getting worse. My back ached even between contractions. Zoe stayed posterior throughout the labour which caused this severe back pressure.

At 2:20pm I told my nurse that I had to go to the bathroom. She said that it was probably my baby’s head causing me to feel that way and that she was going to check me again for dilation because chances were I was almost fully dilated if I felt the need to have a bowel movement. Brandi checked and said I was at 9cm almost 10 and during my next contractions she was going to make me 10cm. At 2:25pm she announced I was now at 10cm and I could start pushing on my next contraction. The pain at this point was intense but I felt great knowing I had made it to 10cm without any pain medication. This was the one thing that was in my birth plan that I had complete control over. During my next contraction she told me to pull my knees towards my chest and push down into my bottom as if I was going to the bathroom. She coached me through my first contraction telling me how to push and also telling me to get three good pushes during each contraction. After a couple contractions and pushes she yelled out the door and told another nurse to call the doctor. I got to a point where I could no longer feel my contractions so I just let my body take over. I pushed whenever I felt the need to. Sometimes three pushes at a time and sometimes four. My body would start pushing on its own; it was as if I didn’t have a choice. The doctor arrived and told me she wanted each push to be at least 10seconds long. David counted to 10 for me during each push. I could feel Dr. Hoffman stretching my perenium. This bothered me so I tried to block the feeling out of my head. She was also telling a resident doctor what she was doing every time she did something. There voices is something I tried to block out during each contraction. After one of my pushes I remember saying “Oh no I’m peeing.” This was devastating to me. Brandi then told me not to worry that I wasn’t peeing it was my water breaking. I was relieved to hear this; the last thing I wanted to do is pee on my doctor. During labour these things just came out of my mouth, I didn’t even think before I talked.

Brandi said to me during a push that I needed to keep pushing and hard because she could see my baby’s hair. I remember thinking to my self “Thank god I’m almost done.” David later mentioned that he did not believe Brandi when she said this so he looked him self and was shocked to see our baby’s hair. David also said to me “I see her hair hun” with a smile on his face. At one point Brandi asked me if I wanted to see my baby coming out. I remember just saying no and keeping my eyes shut during this time. The pain was intense and I had to stay focused. The doctor said to me “Amanda is it okay if I give you a small episiotomy? You’re ripping a lot and it will make it easier.” I told her to go ahead but this was also something that I did not want. But at that point I just wanted what ever would make it easier for me and my baby.
At 3:09pm my baby girl was put on my chest. I was crying with her and said “Hi my baby girl.” She looked up at me for the first time and my mom took our first picture. It was amazing to see her, hear her, and hold her. At this point the pain and discomfort was gone. I held Zoe while the nurses cleaned her off and then covered us both with a warm blanket. David stood beside us. This was by far the most amazing moment in my life. To have our baby girl with us was amazing. After I held her for a while they took her to be weighed and measured. Zoe was 5lbs 2.7oz and measured 18inches long. She was perfect. David then held her and carried her back to me. I began breastfeeding right after that.

Reflecting back on my labor and the birth of my daughter I realize that very few things in my birth plan were followed. I feel that some of the things were necessary, like the induction. Although I am not sure an episiotomy was necessary it happened and I would like to try and avoid this next time. I have a huge sense of accomplishment that I went through the labour and birth process with no pain medication. November 16th will be a day I will remember for the rest of my life, a day that brought me more joy then I could ever imagine.

A note to myself and my daughter Zoe. Labor is painful, but it is pain with a purpose. As women our bodies are meant to do this without any form of pain medication. Nature and God will not give you more pain then you can handle. You will not die from the pain of labor, so learn to breathe through the pain and just get through each contraction one at a time. Labor without the pain medication is worth the discomfort. Once your baby is born and you see him/her for the first time the pain disappears. Have a great support team and you can have a labor and birth that you will enjoy looking back on.

~Amanda

Lamaze Healthy Birth Practices - #2: Walk, Move, and Change Positions

Continuing our series on the Lamaze Healthy Birth Practices, here is practice #2: Walk, Move, and Change Positions.  Research shows that compared to those birthing in centres whose policies restrict movement during labor, women who are free to move and change positions throughout the birthing process are more apt to experience the following:

• shorter labors
• more efficient contractions
• greater comfort, and
• less need for pharmaceutical pain relief during labor

(See The Journal of Perinatal Education 2007 Summer; 16(3): 21-34 "Care Practice #2: Freedom of Movement Throughout Labor" Shilling, Romano, DiFranco, et al) 

For more information, please download the pdf. file - Walk, Move, and Change Positions Throughout Labor

~ Michelle

Stay on your feet!

Both of my children were born in a hospital setting.  My first child was born after nearly every intervention possible and never breastfed.  My second child, with a doula in attendance, was a natural birth in hospital and I took as much of the following advice as I could - interestingly enough, before I had even read it!

Thank you to http://homebirthwaterbirth.com/home.html for this insight!

If the hospital is your choice...and you want a natural birth.... This will be helpful to know.

STAY ON YOUR FEET In the hospital the first thing they do is issue you one of those ugly backless nightgown-things, and show you to a bed, like any other patient. But you are not "sick" when you are in labour, you are doing a job--an important job, that of bringing forth a new life.

STAY ON YOUR FEET, then, because you have an important job to do.

STAY ON YOUR FEET and keep walking because sick, weak people are the ones who need to be in bed. Try to think of yourself as a client, using a service, not a patient. Keep upright and keep walking, so you feel freedom to move and not confinement.

STAY ON YOUR FEET, because that raises you up to eye level, where you won’t be looked down upon.

STAY ON YOUR FEET like a capable, healthy person, confident and in control.

STAY ON YOUR FEET, because gravity helps the baby to move down, pressing on the cervix, shortening your labour.

STAY ON YOUR FEET because there is less pain when the weight of the uterus is not pressing on your back.

STAY ON YOUR FEET, because when you lie down, the very bed you lie upon offers resistance to your pelvis, which is doing its best to open up for the baby.

STAY ON YOUR FEET, walking, walking, walking through the contractions, rocking, rocking, easing your baby lower and deeper into the birth canal.

STAY ON YOUR FEET so the doctors and nurses can't keep invading your body with their painful vaginal exams. They have to ask you to lie down for them, and that puts you in control!

If you STAY ON YOUR FEET they'll only be able to do things when you're ready to let them.

If you STAY ON YOUR FEET, you can look them in the eye, say no, and walk away.

STAY ON YOUR FEET, walking, refusing a lot of unnecessary vaginal exams, until you realize your body is pushing.

How long can you stay on your feet? Well, if you like, you can push while you are standing, or you can go down into a squat, and deliver your baby like that. You don't need to lie down to have a baby!

Does that surprise you? Did you know that lying on your back, with your legs in stirrups is the WORST position to be in when giving birth? It’s bad for the mother and bad for the baby, but the doctor needs you on your back because it makes his job easier.

Hey, wait a minute! Whose job should be made easier? There are three very important players in this birth scene: There’s the woman in labour, in pain, struggling to give birth to a new life, pushing with all her might to get a human being through her pelvic bones. No, we won't worry about her discomfort, we can give her some drugs. There’s the baby, who may be oxygen-deprived if the mother lies on her back causing fetal distress. No, don't worry about him, we'll resuscitate if we have to. Then there’s the doctor, who is being paid --well-paid --to catch the baby. Let’s make sure he’s comfortable! Does this make sense?

Staying on your feet and walking isn't just good sense physiologically - working with gravity instead of against it - more importantly being up and about affects how you feel about yourself. A simple thing like staying out of bed makes you feel more capable, confident, and ready to take on the challenge! Lying in bed makes you feel more like a weak, sick person; like a little girl, dependent upon others instead of an adult doing the most grown-up, womanly thing she can do.

Pick up any book on childbirth that shows you the inside view of the baby’s birth. It shows the mother on her back. Now turn the book sideways, and note the angle at which the baby emerges when the mother is upright. Which would be easier?

The doctor likes it better that you are on your back because it makes it easier for him:

to do an episiotomy -- which he won’t need to do if you are upright, because the weight of the baby is not resting on the perineum;

to use forceps to pull the baby out -- which he won't need to do if you are upright because you will be able to push more effectively;

to get the baby out faster -- which he won’t need to do because the baby won’t be distressed from the lack of oxygen it would experience if you were on your back;

to keep close watch on the mother’s blood pressure -- which isn't as much of a concern when she is upright and in control and not exhausting herself from ineffective pushing, or getting dizzy from the weight of the baby pressing on the major blood vessels.

It may not seem like a big deal, pushing the baby upwards, but think how hard it is to work against gravity for easy things. Yesterday I was hammering a nail up above my head, and I found it hard pushing that 16 ounce hammer up into the air each time, much more tiring than nailing something lower.

In fact, if your doctor thinks it doesn’t make that much difference in pushing against gravity, agree with him: since he says it’s no big deal, let him work against gravity, catching the baby from beneath while you give birth comfortably low, reclined in an armchair.

So, the moral is -- Stay on your feet!

Whose birth is it anyway?

Last spring, an obstetrician gave the following letter to his patient
An OB's Birth Plan - Nursing for Nurses:

Dr. ________ "Birth Plan"
Dear Patient:
As your obstetrician, it is my goal and responsibility to ensure your safety and your baby's safety during your pregnancy, delivery, and the postpartum period. My practice approach is to use the latest advances in modern obstetrics. There is no doubt that modern obstetrical advances have significantly decreased the incidence of maternal and fetal complications. The following information should clarify my position and is meant to address some commonly asked questions. Please review this information carefully and let me know if you feel uncomfortable in any way with my approach as outlined below.
* Home delivery, underwater delivery, and delivery in a dark room is not allowed.
* I do not accept birth plans. Many birth plans conflict with approved modern obstetrical techniques and guidelines. I follow the guidelines of the American College of Obstetrics and Gynecology which is the organization responsible for setting the standard of care in the United States. Certain organizations, under the guise of "Natural Birth" promote practices that are outdated and unsafe. You should notify me immediately, if you are enrolled in courses that encourage a specific birth plan. Conflicts should be resolved long before we approach your due date. Please note that I do not accept the Bradley Birth Plan. You may ask my office staff for our list of recommended childbirth classes.
* Doulas and labor coaches are allowed and will be treated like other visitors. However, like other visitors, they may be asked to leave if their presence or recommendations hinder my ability to monitor your labor or your baby's well-being.
* IV access during labor is mandatory. Even though labor usually progresses well, not too infrequently, emergencies arise suddenly, necessitating an emergency c-section. The precious few minutes wasted trying to start an IV in an emergency may be crucial to your and your baby's well being.
* Continuous monitoring of your baby's heart rate during the active phase (usually when your cervix is dilated 4cm) is mandatory. This may be done using external belts or if not adequate, by using internal monitors at my discretion. This is the only way I can be sure that your baby is tolerating every contraction. Labor positions that hinder my ability to continuously monitor your baby's heart rate are not allowed.
* Rupture of membranes may become helpful or necessary during your labor. The decision as whether and when to perform this procedure is made at my discretion.
* Epidural anesthesia is optional and available at all times. The most recent scientific data suggest that epidurals are safe and do not interfere with labor in anyway even if administered very early in labor.
* I perform all vaginal deliveries on a standard labor and delivery bed. Your legs will be positioned in the standard delivery stirrups. This is the most comfortable position for you. It also provides maximum space in your pelvis, minimizing the risk of trauma to you and your baby during delivery.
* Episiotomy is a surgical incision made at the vaginal opening just before the baby's head is delivered. I routinely perform other standard techniques such as massage and stretching to decrease the need for episiotomies. However, depending on the size of the baby's head and the degree of flexibility of the vaginal tissue, an episiotomy may become necessary at my discretion to minimize the risk of trauma to you and your baby.
* I will clamp the umbilical cord shortly after I deliver your baby. Delaying this procedure is not beneficial and can potentially be harmful to your baby.
* If your pregnancy is normal, it should not extend much beyond your due date. The rate of maternal and fetal complications increases rapidly after 39 weeks. For this reason, I recommend delivering your baby at around 39-40 weeks of pregnancy. This may happen through spontaneous onset of labor or by inducing labor. Contrary to many outdated beliefs, inducing labor, when done appropriately and at the right time, is safe, and does not increase the amount of pain or the risk of complications or the need for a c-section.
* Compared to the national average, I have a very low c-section rate. However, a c-section may become necessary at any time during labor due to maternal or fetal concerns. The decision as to whether and when to perform this procedure is made at my discretion and it is not negotiable, especially when done for fetal concerns.

I can argue against many of the physicians points, but all research aside, the most important question that remains is – Whose birth is it anyway?  The physician isn’t giving birth to the baby, he is merely a facilitator in the process: a process that is natural and has been working well for the majority of women for centuries.  In the end the birth experience belongs to the mother, her baby and her partner.  The choices made by the mother require the respect of all of her caregivers – doctors, midwives, doulas, nurses, partner, family, friends, etc.  She will remember her birth experience for the rest of her life and we, as her caregivers, are there to protect the memory.