An Unexpected Waterbirth

October 14th, 2015 (37 weeks and 3 days)

As I mentioned earlier, I just had a feeling that the baby was coming soon. At my appointment that day, I asked my midwife to check me… normally I wouldn’t have asked, but I felt like I needed to know in order to make a plan for the rest of the day.  80% effaced, 2-3 cm, and -1 station.  She felt his head RIGHT THERE.  No wonder I felt like he was going to fall out every time I stood up.  I went home and took a short nap, and then a shower.  I picked up my daughter from school, we played for a while in the playroom, and then decided to go out to dinner instead of making anything.  On the way home from dinner, she said “When baby brother is born tomorrow, we can play with him.”  Somehow, she must have sensed it too.

Throughout the evening, I was having very sporadic contractions… one every 30 minutes to 1 hour.  Nothing very regular, and certainly very far apart.  I thought that I probably had at least another day before things actually got going.  Normally when putting my daughter to bed, I cuddle with her for a bit… and this late in pregnancy, I had gotten into the habit of falling asleep with her as a way to sneak in a little cat nap each day.  Well today, I turned the light out in her room, and started feeling some pelvic pressure.  I said goodnight in a hurry, left her room, and closed the door behind me.  And right there in the hallway outside her door, I had a strong, intense, contraction. It’s as if my body had just been waiting to put my daughter to bed before allowing itself to move forward with labor.

To be absoContractions1lutely certain that labor was starting (and that it wasn’t just wishful thinking), I went into my room and laid down in the dark.  I opened my eyes with every contraction, long enough to hit the timer, and then tried to snooze in between.  After about an hour of regular contractions, I decided it was time to call the in-laws and ask them to go ahead and start the 2.5 hour drive to our house.

ContraContractions2ctions started to get closer together and more intense over the next hour.  I spent this time sitting on my yoga ball right next to my bed, with my iPad open to my Kindle app, reading birth stories from Ina May’s Guide to Childbirth. 

After seeing those 7-minute apart contractions, I panicked a little bit.  There was no way my in-laws would be here in time.  At 10:38, I texted our babysitter and asked her to come over.  At 10:46, I called my midwife.  She told me to come in once my contractions were 4 minutes apart.  But I knew I needed to go in sooner, based on how intense these contractions were.  My husband loaded all of our bags into the car, our babysitter was here at 10:55, and we were out the door.

Contractions3Normally, you hear about labor slowing down while in the car.  Well, the peaceful night drive with no traffic made mine speed up.  All I remember about the drive was hearing Mike and the Mechanics All I Need is a Miracle on the radio.

The last contraction I recorded on my app at 11:20 was experienced leaning on the car door in the parking lot of the hospital.  Once in labor & delivery, they had me change into a gown & pee in a cup.  In the admitting room, 2 nurses worked on strapping me to a fetal monitor – they require a continuous 30 minute strip upon admittance.  But at this point, my contractions were really close together, so they quickly took me off the monitor and decided to check me.  6 cm dilated – I was glad we had left the house when we did.  They decided to go ahead and put me in a labor & delivery room and put me on the monitor in there while they filled the birth pool.

Because BaView More: http://bella-birth.pass.us/kavithabirthby B was already so low, it was difficult to keep the monitor in the right place to get a continuous strip.  It kept slipping down, and we’d lose the signal.  I eventually had to hold the monitor in place to get a continuous 30 minutes.  I sat with my legs off the side of the bed, so that my husband had access to my back to provide counter-pressure during each contraction.  I was counting down the minutes until I could get into the tub; I had intended for it to be a tool to use during labor, but fully planned on getting out of the water for the pushing stage. Finally, at 12:30 am, I was allowed off the monitor.  I changed, and slipped into the water.

holdinghands

The overhead lights were low, and a strand of Christmas lights twinkled across the windows.  Across one of the windows, we had hung a bunting of birth affirmations I had made.  I had used my daughter’s finger paintings from when she was an infant; I had cut them into pendants, strung them together, and written phrases like “I trust my body” and “I am strong” on them.  These were my focal points during each contraction.  In between contractions, I breathed in lavender oil from a washcloth.  The water felt like a warm hug, and allowed me to truly relax in between contractions.

However, the contractions were still intense – the water and breathing wasn’t enough, I still needed the counter-pressure on my back.  For a few contractions, I attempted to swing my back to an edge of the tub, and my husband leaned over to help me.  But positioning myself that way and moving all around the tub was not working for me… so I finally asked my husband to get into the tub with me.  Once he did that, I was able to get into a rhythm.  In between contractions, I leaned over the edge of the tub.  During contractions, I was on my knees while my husband pushed on my lower back.  Soon it all blurred together; the contractions were on top of each other.  I remember thinking to myself – I must be going through transition.  Already?  At this rate, I’m not going to have time to get out of the tub. The nurse flitted in for a moment, and told me to call her if I started feeling the urge to push.

labor3

Almost immediately after she left, I felt that urge.  Nope, not getting out of the tub.  Guess I’m having a waterbirth! After 2 more contractions, we called the nurse, and asked her to get my midwife (she was already at the hospital, she just wasn’t in my room yet).  She walked in, accompanied by 3 labor & delivery nurses.

Now, this is the part that is the most vivid in my mind.  The room was filled with people: my midwife, my doula, and 3 nurses.  But at the same time, they weren’t there.  I was in the little bubble of my birth tub.  I was in control.  No one was directing me, no one was interfering.  They were just observers.

This is when I allowed myself to get primal.  To access that most instinctive part of my brain, and do whatever my body told me to.  And my body told me to get vocal.  Very vocal.  I emitted a long, low, guttural moan during each contraction.  I could feel it make my pushing more effective, opening me up.  After each contraction, there was silence, unless I initiated conversation with my midwife & doula, which I did.  I’ll say that again, because I found it remarkable: there was silence whenever I wanted there to be silence.

Contraction-

In case you didn’t know, that’s the sound of me pushing. {Laughter}.

It’s a testament to the women in that room, who made me feel comfortable enough to vocalize the way I was.  I was letting go completely.  Of all fears, of all inhibitions.

Contraction-

I feel something, can you see anything?  {No, we can’t see anything}.

This is when I realized – no one else is going to be able to get me through this.  No one can tell me if I’m pushing the right way, or if I’m making progress.  I have to do this myself.  And that’s okay.  In fact, it’s more than okay.  I trusted myself.

-Contraction-

Why can’t I be one of those women who gets a baby out in 1 push?  {Well, that might be difficult since your water hasn’t broken yet}.

This revelation motivated me not to hold back anymore.  I was going to give the next push my all.  My water needed to break before my baby could descend.

-Contraction- (Pop)

I felt it! My water just broke! That was so weird! 

Contraction-

Oh it’s burning. 

Contraction-

Ahhhhhhh it burns.  {That means it’s almost over!}  You’re right!  Keep telling me that!  Please, keep telling me that. 

At this point, I felt like I had been pushing forever.  They told me later that it was I was probably only pushing for 15 minutes total.  But in the moment, it felt. Like. Forever.  The subtle reminder that it would be over soon was just what I needed to hear.  I knew exactly how I needed to push during the next contraction.

-Contraction-

OH MY GOD, I’m holding his head.  His head is in my hands… and it’s perfect. {Laughter}.  Hi Baby!  Hi!  You’re almost here! 

In that moment, when I was holding my son’s head in my hands, I have never felt more alive.  Maybe it was the huge oxytocin & endorphin rush, but I felt every sensation and emotion right into my fingertips and toes.  I was elated that I was moments away from meeting him; relieved that labor was almost over; amazed that my body had grown this perfect little head; empowered by the trust of my care providers to do this on my own; humbled by the privilege of catching him myself; and a dozen other emotions I can’t even begin to describe.  I’ll let my face at that moment tell the story:

View More: http://bella-birth.pass.us/kavithabirth

 

Contraction-

And with that last one, at 1:37 am on October 15th, just one short hour after I had entered the tub, he slipped right out and I pulled him up out of the water and met my little boy.

MeetingBaby

*MeetingBaby2

He was alert and calm.  The entire room swears that he cried “hey” to me right after I said “hey” to him.  After that, he didn’t really cry; we just settled into a calm state of being while we studied each other.  He’d squint and open his eyes a tiny bit, and then shut them again.  And then he’d open them for a tiny bit longer before shutting them again.  I just stared at this perfect little being for as long as I could.  I was on a hormonal high.  I was in disbelief about how fast he had arrived, and so grateful for how smoothly it had all gone.

After the cord stopped pulsing, my husband cut it, and held him skin-to-skin for a few minutes while I got out of the tub and got dried off.

cordcutting

I recounted the 3rd stage of labor and the initiation of breastfeeding in a previous post.  But here are some pictures from this amazing time we had together:

breastfeeding

*warmingtable

*daddyholding

I hadn’t planned on giving birth in the water; but sometimes when you stray from your plan, life’s most amazing moments can happen.

This is the best season of my life.

*Photos by Bella Birth

View my birth video here

 

 

 

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Breastfeeding: The first week

nursing
It’s the question I’ve been asking myself for so long… how will breastfeeding go with my second?  Well let’s start at the beginning.

After a most amazing and unexpected waterbirth (to be recounted in a separate post), Baby B spent a few minutes on daddy’s chest while I got dried off and into bed.  Then he was on my chest for the next 2 hours, uninterrupted.  I cannot tell you how amazing it was to have this time with him.  No one was whisking him away to get him measured, no one was swaddling him up like a burrito or putting mittens on him.  It was just as it was meant to be – on mama’s chest, skin-to-skin.

The first and most important task was obviously to deliver my placenta and prevent another postpartum hemorrhage like I had with my last birth.  Oxytocin is required to produce the contractions necessary to expel the placenta, and nipple stimulation is a key component of producing oxytocin.  Given my history, and with a larger-than-average placenta, it seems I might need more than a typical amount. Many babies don’t breastfeed well until closer to the end of the “golden hour,” and that was certainly the case with Baby B.  However, I came prepared.  When my midwife told me I was on the verge of having excessive bleeding, we pulled out my manual breast pump and got to work.  Within minutes, the bleeding stopped.  When it started again 10 minutes later, we used the manual pump again, and it stopped the bleeding once more.  The plan had worked.  No postpartum hemorrhage.  No synthetic Pitocin necessary.  And the icing on the cake – no stitches needed either!

Even though Baby B had been on my chest this whole time, and I had been trying to get him to latch, I think all of the commotion had been too distracting.  With nurses pushing on my abdomen, me shrieking every time they did, and the imminent threat of hemorrhage, it was probably too much to expect a perfect latch at this time too.

After about 45 minutes, everyone had cleared out of the room. I was exhausted and ravenous – my husband and doula supplied me with a constant rotation of juices and crackers to help keep my energy (and blood pressure) up.  And now we were finally able to focus on breastfeeding.  We had collected a little bit of colostrum using the manual pump, so we put some on a spoon and dripped it into Baby B’s mouth to get him interested.  It seemed to grab his attention, and we were able to finally get a good latch in a laid-back breastfeeding position.  He nursed on and off for about an hour.  At first blush, it felt like it was going better than it did with my daughter, but I was wary.  We’d see how the next 24 hours went.

The next 2 feeds in our postpartum room were not great.  My heart sank.  My attempts to get him to latch in a laid-back position were not working.  They had worked the first time, why weren’t they working now?  I always heard about friends saying immediately after their own births, he nursed like a champ. I’ve always hated this expression.  What does it mean?  Does it mean that if my baby doesn’t nurse well right away, like a champ, that we’ll never get there?  Does it mean that it’s an innate behavior, not a learned one?

Now, I’ll admit it.  I had a moment of panic.  A moment of I-just-had-a-baby-8-hours-ago-and-the-hormones-are-making-me-crazy. A moment of what if this is like the last time.  I looked around in his mouth.  I’m not a professional, and I can’t diagnose tongue-tie and lip-tie.  But my first instinct was to call the pediatric ENT and make an appointment, just in case.  I knew it’d be a 2-week wait anyways, so there was no harm in making the appointment for a consultation.

And next, I pulled out my trusty old double-electric pump.  As soon as the colostrum began flowing, I relaxed.  It would be okay.  We’d get through it, we’d figure it out.

The lactation consultant happened to come in while I was pumping.  Baby B was fast asleep, so she couldn’t look in his mouth.  But she stayed and gave me some tips for the next feeding (cross-cradle position works well for newborns, here’s how to do the c-hold, etc.).

And… it worked.  Maybe it was the tips the LC had given me. Maybe I was more relaxed. Maybe my technique was better this time. Maybe I was more relaxed. Maybe he was more awake.  Maybe I was more relaxed. Maybe it was the little bit of colostrum I had dribbled into his mouth right before the feed to get him interested. Maybe I was more relaxed. I had set aside the great expectations of the perfect first latch, focused on the here and now, and let the panic subside.  His fourth time nursing after birth, and we were finally on our way.

The LC stopped by again before our fifth feeding.  And she said all the right things.

You have great technique.  He doesn’t look tied.  He has a nice, broad palate.  Keep doing what you’re doing.

It was exactly what I needed to hear in that moment.  And then more people told me what I needed to hear.

From my postpartum nurses: The first 24 hours they’re really sleepy, don’t worry about the number of times he nurses. It’s the second day that they really wake up. 

From my pediatrician: His tongue and lip look fine, there’s nothing here that I see that needs to be addressed. 

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We made it through the first 24 hours, nursing and spoon-feeding the pumped colostrum.  Maybe we would have been fine if I hadn’t panicked and pumped.  But it did 2 things for me: 1. Gave me a tool to help wake him up for more productive nursing sessions. 2. Gave me the reassurance and confidence that he was going to get what he needed, and keep his blood sugar up.

And I can’t over-emphasize that confidence enough.  The reassuring words from my healthcare providers and the confidence that we could figure this out is what has carried us through this first week.

The first week of nursing is different every single day.  There’s the way you nurse when it’s just colostrum.  There’s the way you nurse when your milk comes in and makes your breasts engorged, making it difficult for baby to latch on.  There’s the way you nurse when your milk is flowing fast, and you have to angle your baby just so, so that they don’t sputter and choke.  There’s the way you nurse when your breasts have softened during a long cluster feed, and you have to use compression to keep the milk flowing.  There’s the way you nurse when you have a clogged duct, and you have to massage it out while keeping baby latched.  There’s the way you nurse in the middle of the night, when you’re trying to figure out a side-lying position so that you can get some sleep.  There’s the way you nurse when you’re in the Target parking lot, without your nursing pillow.  There’s the way you nurse on your left breast vs. your right breast.  There’s the way you nurse when your baby is sleepy vs. wide awake.

And most importantly, there’s the way you nurse when you’re panicked vs. relaxed.

My point is, the first week is a huge learning curve. It’s not about nursing like a champ; it’s about learning like one.  And it takes a lot of confidence and support to get through it. It’s about not watching the clock, and watching your unique baby. It’s about learning their cues, listening to their sounds, and understanding their needs. It’s about your family never questioning is the baby eating again or didn’t he just eat. It’s about feeding on demand, even if that looks like this:

first week nursing

I stopped using the tracking app right after Baby B’s first pediatrician appointment, on day 4.  His birth weight was 8 lbs 10 oz, his discharge weight was 8 lbs 3 oz, and his first weight at the ped was 8 lbs 8 oz.  He was doing great.  And I was confident.

There’s still a long way to go.  Breastfeeding is a journey, and it’s going to change from week to week.  I’m sure there will be other challenges. But we survived the first week.  More than survived, thrived.  We laid in bed all day, we cuddled, and we snoozed.  I listened to his quiet breathing, his sweet gulping, and all of the other uniquely newborn sounds that will soon fade away.  I breathed in his hair, stroked his feet, and kissed his cheeks.  I soaked in everything I could about this moment in time that I’ll never get back. I’ve learned so much this week, this first week of my baby’s life.  I’ve learned the power of a reassuring word and some confidence.  If you can provide that to a mother and her new babe, please do.

 

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Build up to Birth

I decided to record my stream-of-consciousness feelings in a memo on my phone for a few weeks before my due date.  Little did I know that I’d only have 1 week recorded before I gave birth!

Wednesday, October 7
Nested to the max tonight, all while having mild contractions on and off for 5 hours.  I knew it wasn’t the real thing, but it still revved me up about getting things done around the house.  HB finished making some meatballs for the freezer, while I portioned and sealed the gumbo and jambalaya he made a few days ago.  I stopped occasionally to rest on the yoga ball when my belly was getting too tight to walk around.

Thursday, October 8
He was moving a ton last night, and now appears to be making my belly a bit crooked.  He seems to be more active than Asha.  Or maybe he’s just longer / bigger, so I feel it more.

Friday, October 9
Woohooooo – negative for Group B Strep!  What a relief.

Saturday, October 10
Literally every time I stand up, I feel like he is going to fall out.  My hips are clicking a little bit when I walk waddle.  It got better by the time we went out to dinner, but as we were leaving, I had 1 really strong contraction… and then nothing.

Sunday, October 11
37 weeks!  I’ve officially crossed over the mark where I’m allowed to get in the tub to labor, so it feels like I’m free to have this baby whenever he wants to arrive!  I’d love for him to make it until 39 weeks, but I just have a hunch he’ll be earlier based on how I’m feeling…

Asha’s on the same page.  This morning she woke up and announced, “Mommy, I want Bennett to come out right now.”  HB’s got some meetings in town the next few days, so I made a deal with him that I’d try to wait until at least Wednesday to have this baby.

Monday, October 12th
I was up most of last night with intense back pain.  The kind that throbs enough to keep you awake, switching from side to side, hoping that one position is better than another.  I kept waiting for contractions to come along with it, but they were far apart, too far apart to mean anything.  The only thing that relieved the pain was getting on my elbows and knees on the bed.  I think that helped dislodge him from my pelvis enough to rotate him back to a more comfortable position.

Now it’s the evening, and I have the opposite problem.  Instead of intense back pain, I have intense pelvic pain.  He clearly flipped, but is still lodged down low.  Guess that’s where he’s going to stay until labor kicks in.

Waiting.

Tuesday, October 13th
A mostly uneventful day.  I had to suddenly stand up from my desk twice this morning because of the intense pelvic pressure, but then it subsided. Yoga was pretty uncomfortable today, but I pushed through.

Wednesday, October 14th
I had some “signs” this morning. It could mean nothing, but last time this happened, I went into labor 3 hours later.  Just to be safe, I decided to work from home, and I moved my packed bags from upstairs to downstairs.  I was ravenous, so actually ended up eating 2 breakfasts.  He’s been really active all morning.  More than he’s ever been, actually.  Really large and frequent movements.  I’m going to ask the midwife to check me today at my appointment… I just want to know if there’s been any progress yet so I can make a plan…

Midwife checked me. 80% effaced, 2-3 cm, and -1 station.  She felt his head RIGHT THERE. I’m going to call it a day and take a nap just in case…

…..

Birth story to come in a few weeks when I have the pictures back!

 

A year since loss

A year since loss

A year ago, I was pregnant.  I am today, too.  What a difference a year makes.

A year ago, I was nervous about every twinge I felt in my belly.  Something didn’t feel right.  It didn’t feel like the first time.

Today… when was the last time I felt him kick? I try to jostle him awake for my own peace of mind.  C’mon little buddy, tell me you’re there.  I know you were hiccupping last night.  And I felt you move this morning.  But have you moved since?  Sometimes I get distracted and forget to pay attention.  That fear creeps in every so often.  It’s hard to push it away, especially today.  It consumes me… Tick tock, tick tock.  7 minutes later – there you are.  A sigh of relief.  There you are again.  Sweet, sweet kicks.  I cherish them all.  But especially the ones today, on this day.

A year ago, I was googling my symptoms.  Trying to find women who maybe felt what I did, but then had everything turn out okay.  Maybe all of this tugging and cramping was normal?  Maybe I was being paranoid?

Today… I’m googling birth affirmations. I’m working on getting in the mental space I need to for birth.  That place where I feel relaxed yet powerful.  Where everything will come on its own time, in its own way.  Where I trust my body, and I trust my baby, and I know we can do it together.  My excitement about meeting this next little love of mine grows and grows each day.

A year ago, I saw red.  So. Much. Red.

Today… I see my daughter’s face.  I find myself trying to memorize it.  Like I’ll forget what she’s like in this moment, this last time that she’ll be my only child.  I’m falling more and more in love with her every day, which I didn’t even think was possible.  This morning, unprompted, she threw her tiny arms around my neck, squeezed, and exclaimed I love you so much.  How do I make room for 1 more in my heart when it’s already bursting?  I know I will, I already have.  But I’m memorizing her face, all the same.

A year ago, I laid curled up, sobbing in my bed.  The tears were fat and hot and salty.  There was no more what if.  The wondering was replaced with a solid, firm, resounding, yes, this is a miscarriage.  My husband held me until I had nothing left to say, until my throat was hoarse from the crying, until I wanted to be left alone again.

Today… I sit here proudly rubbing my round belly.  Astonished by the miracle growing inside.  Bewildered that it can and does keep getting bigger.  Soaking up this last time that my body will be a vessel for another life.  Swaying my hips back and forth to make my back more comfortable, but careful to not outwardly complain too much, because I’m lucky.  So very, very lucky.  And the feeling is not lost on me today.

A year ago, I searched for stories like mine.  Once the tears had dried up, I looked for comfort in the words of friends who had shared their own losses publicly.  I was just looking to not be alone that night.  What I found was that I was far from alone… this secret world became unearthed.  I was flooded with stories of loss.  And of rainbows after the storm.  These women had survived… maybe I could too.

Today… I’m searching for tiny socks.  Sorting the smallest ones from the bigger ones, matching them all up into pairs.  Organizing them into drawers, ready to grab a new pair the moment one falls off and is lost forever in the depths of my house.  I’m preparing for the chaos I know is about to ensue, despite the fact that I know it’s pointless.  I’m already in the chaos. There’s a little shadow following me around, pulling neatly folded blankets out of drawers and using them for her baby dolls.  She’s trying to climb into the baby swing I took out of storage, and it’s creaking under her weight.  She’s littering baby wipes everywhere as she pretends to be Cinderella wiping the floor. But then she has her lips on my belly, singing sweetly to her baby brother. Chaos can be lovely sometimes, if you just let it happen.

A year ago, I saw an empty womb on the ultrasound, confirming what I already knew.  I felt numb, like I was in a trance.  There were pregnant ladies everywhere in the doctor’s office; I was not one of them.  I was empty.

Today… I heard my sweet baby’s heartbeat.  He predictably always hangs out on my left side – and while that’s predictable, I never take that heartbeat for granted.  It’s the sweetest sound in all the world.  It fills me up; today I am full.  Full of life, full of calm, full of gratitude.

See you in a few weeks, little one.  It’s been quite a journey.

A Downloadable Visual Birth Plan

Confession time: I didn’t even write a birth plan for my first birth.  I know, shocking considering the fact that I’m extremely Type A and like to be in control of things.  But I was skeptical that anyone would even read it.  I was also acutely sensitive to being that mom who was dismissed & made fun of by the nurses for having too prescriptive a plan.  I thought that maybe having it all written out would set us off on the wrong foot.  And I naively thought I’d be able to remember and communicate my preferences at the time each step came up (I couldn’t.  Labor requires focus).

But now, I’m not afraid of that anymore.  I don’t care what the nurses think.  Well, that’s a lie, I do.  I want them to think – okay, I’m not going to mess with this momma, she has an opinion, and won’t be pushed around.  I demand evidence-based decisions and informed consent, and I’m not going to apologize for that.  And actually, the nurse on my hospital tour specifically mentioned that during admission, they’d review our birth plan with us.  And then the nurses decide which cases they want to be on, they’re not just randomly assigned.  So theoretically, going in with a well-laid plan means I’ll get a nurse who wants to be a part of that plan.

So, this time around, I wrote a birth plan that requires minimal reading.  I also separated it into stages so that it’s more digestible.

Birth Plan from thebestseasonofmylife.wordpress.com

I posted my plan in a local birth group that I’m in, and everyone immediately wanted a copy that they could use. So, to help other mommas out, I’m providing the plan here so you can edit it to fit your needs.

Download the PPT file so you can customize your own plan

*I recommend printing and cutting out the postpartum newborn care plan and taping it to the inside of the bassinet, so that every nurse can see it.  Note that the plan does not contain items that would be pediatrician-related.  These things are more likely to be a direct conversation with your pediatrician the morning after your birth.

Everyone has different needs for their birth – so it won’t offend me in the least if you just use my format and completely change all of the content because your plan is the opposite of mine.  It’s a good idea to run your plan by your provider and make sure that they support it, and that you haven’t put conflicting information on there.  It’s also a good opportunity to find out if you’re going to butt heads with your hospital… and might make you re-think where you give birth.

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In case you’re interested at all, and doing the research for your own birth plan, here are links to just a fraction of the evidence I’ve used along the way to make my decisions.  Note that a lot of these links have more supporting evidence and links cited at the end of the articles; I’ve read many of them.

My particular plan includes things that are concerns for me based on my last birth. For example, most might not think it’s important to put reminders on there about emptying your bladder before pushing & slowing down when crowning, since these are technically things that you’re doing.  But you might forget, and your delivery team might let you down.  

Obviously, much of your birth plan will flow from how you plan to manage labor pain, and it’s obviously a decision each individual has to make based on weighing the effectiveness vs. safety of each option.  My goal is to avoid anything that could result in a further cascade of intervention, like an epidural or artificial induction or acceleration of labor. This can be tricky, as I know that an epidural can sometimes prevent a c-section, or sometimes be the cause of it.  For example, my own mother received an epidural after she had already been pushing for 2 hours with me, because I was stuck (apparently my family just grows big babies), and if she didn’t get help, she wasn’t going to have the energy to be able to push me out on her own (and they ended up needing to use forceps on me).  In that case, it prevented a c-section.  On the other hand, an epidural can cause a drop in blood pressure that puts stress on the baby, and can result in a totally unnecessary and avoidable c-section.  It’s a slippery slope, and every woman has to make the choice that’s right for them in the moment – and if things don’t go according to your plan, you are not a failure.  Don’t even think like that.  Birth is unpredictable – it’s okay to have a plan, and even more okay to adjust that plan if you need to (but it’s NOT okay if you’re being coerced to change your plan without informed consent).  

Ina May’s Guide to Childbirth: Seriously, this book is amazing.  I’ve read it at least 6 times, and it taught me so much.  Even if you’re not planning on having an un-medicated birth, I think it’s an important read to understand how birth works, and what types of things can interfere with the process.  A little confidence can go a long way for everyone.

At my last hospital, they forced me to be in the bed while I was having back labor so that I could get my initial fetal monitoring strip – being in the bed on my back was painful.  Most hospitals are going to require a strip upon admission. But I’ve cleared it with my new hospital that I’ll be able to do it on a ball, and not on the bed.  After that, intermittent monitoring will be used every 4 hours. Thankfully, no continuous monitoring like my previous hospital required during the 2nd stage of labor.

During my last birth, a hep-lock was a compromise I had to make; it was just in case I needed it.  My new midwife says there’s no reason for needing one, as I can receive intramuscular pitocin in the case of postpartum hemorrhage.  This was not provided as an option to me previously, so I’m super excited about not needing a needle in my hand, and having another way to manage bleeding.

Since I declined IV fluids, I had to bring my own food & drink to the hospital for my last labor.  I’m pumped that my new hospital actually provides food & drink to women during labor! Seriously, how are you supposed to keep your energy up without it?

I plan on at least laboring in water, as taking several showers while I labored at home last time helped immensely.  It may or may not end in a waterbirth, depending on how I feel at the time, but I’m glad it’s an option for me.

Last time I waited until I was 10 cm before allowing my doctor to break my water – and unfortunately, I did discover a small scratch on my daughter’s head from the amnihook. This time, I’m just going to let it happen it when it happens, to avoid any of the risks.

Delayed cord clamping is a huge priority for me, and it’s thankfully standard of care at my new hospital. (If you have time, this Ted Talk is great.)

The plan for placental delivery and postpartum hemorrhage is fairly fluid for me, given the fact that I had a major one during my last birth.  The main reason cited for this was the fact that I had a large baby; this means it’s harder for the uterus to clamp down fast enough.  I also think it wasn’t helped by the fact that my daughter wasn’t able to breastfeed right after birth – without enough oxytocin release, the placenta may not be delivered easily.  I’ve learned that my full bladder was also probably a factor, which is why it’s explicitly on my birth plan (women with epidurals have catheters in, and I think my birth team just forgot that I didn’t have one).  We’re prepared for what might happen again, but are not going to preemptively interrupt the natural process of the 3rd stage until and unless it becomes necessary – in which case, most things are fair game.  At that point, my baby’s out, so I’m not concerned about the effects of pitocin on him.

Regarding newborn care, the World Health Organization has pretty clear guidelines (that many hospitals don’t follow).  All of the measurements can wait until after the golden hour.  We are going to give the Vitamin K Shot, but are declining eye ointment.  We’ll give the Hep B vaccine, but are just delaying it to happen at the pediatrician’s office instead of at the hospital; all other vaccines we do on schedule.  And I’m a huge believer in protecting a baby’s microbiome at birth, so we will be delaying baby’s first bath.  If for some reason I had an emergency c-section, I’d totally be jumping on board to seed my baby’s microbiome in this new way.

My biggest surprise after doing all of my research was that very few maternity providers and hospitals practice evidence-based care.  Just another example of how you have to be your own advocate.  As long as you put more research into your birth than you do the fancy stroller you registered for, you’ll be on the right track.  You’ve got this, momma.

“If you don’t know your options, you don’t have any.” -Diane Korte

No is a complete sentence: An un-medicated hospital birth story, and why I switched providers

I want to preface this post with this: I know women who have had great experiences with my former OB’s practice, and the hospital I delivered my daughter at.  This not a general statement about either of them, but rather, my own personal experience.  If you had a great experience with them, then I’m truly happy for you.

My pregnancy with my daughter was unexpected; I hadn’t done any research, and was sort of thrown into the whole thing the second I saw that plus sign staring back at me. When it came to making my first appointment, I went with the easiest option: the OB I had already been seeing for my annual exam for the last 5 years.  I knew a few people who had delivered with his practice, so I figured it was a good choice.

My prenatal appointments were nothing like I expected.  I thought we’d spend a lot of time talking about pregnancy, about what to do and what not to do, etc.  But for the most part, I was sent home with a bag of handouts after my first visit, and we discussed the pregnancy very little.  Most of each appointment was spent doing an ultrasound, talking about what he saw, and then what we’d do at the next appointment.  Reflecting back, I realize that my OB was what I’d call “ultrasound-happy.”  I had ultrasounds at 9, 12, 16, 20, 28, and 37 weeks.  At the time, I didn’t know that these were mostly unnecessary ultrasounds – of course I wanted to see my baby.  But these were 3D ultrasounds, and that much exposure is really not recommended unless there’s a reason for them; ultrasounds do heat tissue slightly.  They haven’t been proven to be harmful, but unless medically necessary, there’s no reason to do something that has unknown long-term risks.  But they were never presented as optional, or as an option with any potential risks.  It was just something they did, and I didn’t know any different at the time.

I always wondered if the next appointment would finally be the one where we’d start talking about my birth plan; he hadn’t asked me about it yet.  It made me nervous that he hadn’t brought it up – I felt deep down that it was probably a bad sign.  By the time my 24 week appointment rolled around, I finally asked if we could discuss it.  I told him I wanted to plan for an un-medicated, low-intervention birth.  His response?  Um, okay.  Most women don’t tell me they’re doing an un-medicated birth until they show up and it’s too late for an epidural anyways.  Just be prepared for the chance that it might not turn out the way you want. 

Not the response I was expecting or hoped for.  Where was the support?  Where was the encouragement?  Instead, he chose to immediately cast doubt on my plan?  I had no illusions, I knew that birth doesn’t necessarily always go to plan; but that didn’t mean that I didn’t have the right to express my preferences.

As I was leaving that appointment, he felt the need to tell me a birth story about a woman who wanted a natural birth, refused induction, and had grand ideas about the baby just falling out of her.  But then she of course had to have a really high intervention birth that resulted in a c-section.  “She had wanted to be like an animal in the wild, like some sort of cow,” he smirked.  Is he really making fun of another patient right now to me? 

I left the appointment uneasy.  Uneasy about how this doctor had reacted to my plan, uneasy about how he had laughed about another patient’s “ideas”, and uneasy about what I was going to do next.  I knew one thing for certain: I couldn’t stay with this doctor. He had shown me his true colors.

However, for some reason, I was scared to switch practices.  Call it inertia, or fear of the unknown. So I took the easiest step I could: started seeing the other doctor in the practice.  I was relieved to find out that he was supportive of my birth plan.  He was open to doing delayed cord clamping, and said I could labor however I wanted to.  The rest of the pregnancy went smoothly, and I felt like I was in good hands.

However, what I didn’t realize was that there is a difference between being supportive and knowledgeable about natural birth.  When it came right down to it, my husband and I were on our own to make this happen.  (In hindsight, a doula would have been extremely helpful, but we were naïve in thinking we wanted this experience to be about just us.  Little did we know that a hospital birth involves very little privacy anyways).

And your doctor is only one part of the equation; the other part is the hospital they deliver at.  He happened to deliver at what is locally known as the “baby factory.”  At the time, this felt like a comforting idea – man, they deliver so many babies, they must know what they’re doing.  Reflecting back, the idea of a factory is exactly what it sounds like – high efficiency, high intervention.  I had no idea that I was walking into a situation where the nurses rarely see physiologic birth.  When I tell people now that I had an un-medicated birth there, they look at me like I’m a unicorn with 2 heads.  Here’s an abbreviated version of the story:

I labored peacefully at home for 9 hours before going to the hospital, as I knew that was my best chance for sticking to my birth plan – I was already dilated 6 cm by the time I arrived, and was in active labor.  When being admitted, I asked the charge nurse if I could be paired with a nurse who was experienced with natural birth.  Oh all our nurses are supportive of natural birth, she chirped.  Not so.  My labor & delivery nurse was the opposite of natural birth friendly.  She immediately offered me an epidural, even though I had explicitly told her I wasn’t interested.  I was wary of how my time with her was going to go based on this very first interaction.

After some time on the monitor and getting admitted, she finally left. I began alternating between 3 positions:  sitting on the edge of the bed, sitting on my yoga ball, and on my hands and knees on the bed.  This is when my husband became a HUGE help to me, and really stepped up.  As the contractions became closer and closer together, my needs were changing by the minute.  He provided my back with much needed counter-pressure, fetched me water and juice, got me a cold washcloth with my lavender oil, and helped me through each and every contraction.  I truly couldn’t have done it without him.

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And then the nurse came back.  She doubted me when I said I was progressing quickly – oh you’re a first time mom, you have at least a few more hours before we need to call your doctor again.  I insisted again that things were moving quickly.  She reluctantly checked me, and she did so roughly; she was clearly used to women on epidurals who couldn’t feel it.  She was shocked to find that I was right, that I knew what my body was doing, and she sprang into action, getting the room ready for delivery and called my doctor again.  She pushed the epidural idea at me one more time, as it’d be my last chance – I told you lady, it’s not on the menu for me. Leave. Me. Alone.

I was about to go through transition – what most people call the hardest part of labor.  Thankfully, the nurse left the room again, so I got to do this in peace.  Slow-paced breathing and focal points were no longer enough to manage the pain, so I changed my breathing pattern a few times, using the He-Blow breath and the fast-patterned breathing techniques we had learned.  I never thought that vocalization would be a useful technique for me – I always thought it was cheesy when I saw it in the birthing videos, but it turned out to be extremely helpful.  Repeating phrases like “I can do it” and “I trust my body” were essential in distracting me.  When I could no longer say these phrases myself, I asked my husband to talk to me throughout each contraction, repeating the phrase “You’re doing it.”

My doctor arrived to check in on my progress.  My water still hadn’t broken yet, so he provided me with two options:  Either he could break it for me, or he could go do a c-section he needed to do, be back in 1 hour, and see if it had broken on its own and if I was ready to push when he got back.  I knew I’d have my doctor’s undivided attention if I waited the hour, so that’s what I opted to do.

The next hour was pretty hard – and this is what helped me understand why many women choose to get an epidural.  If I hadn’t been prepared with all of the breathing, visualization, vocalization, and comfort techniques, it would have been scary.  But the preparation allowed me to remain confident, and take everything 1 contraction at a time, with my husband’s help.  I don’t think I’ve ever been so focused in my life – and I don’t think I’ve ever felt so powerful.  I remember thinking of the word “power” in my head, convincing myself that my body had the power to do this.  I did everything I could to relax my body and my muscles in between every contraction.  Near the end of this hour, the contractions were practically on top of each other – sometimes I only got a 15 second break in between them.

When my doctor showed back up, he said I was at 10 cm, and he broke my water. Now there were 3 nurses in the room, and I was supposed to start pushing.  All of a sudden my quiet, peaceful labor bubble was filled with people telling me what to do.

The 2 new nurses were supportive, as was my doctor.  But like I said, supportive is not the same as knowledgeable.  They weren’t used to women eating and drinking during labor – so they didn’t to remind me to empty my bladder before pushing, resulting in some pretty ineffective pushing for a while.  They also fell into the norm of directed pushing, where they’d yell out when to push, and count to 10 loudly 2-3 times per contraction, until I was pushing so hard that veins were popping out of my head.  All of these things are unnecessary and counterproductive when having an un-medicated birth – they weren’t allowing me to listen to my body. And they’re actually damaging to your body and pelvic floor. I knew that holding my breath during pushing wasn’t good (a relaxed jaw means a relaxed body and cervix), but they kept telling me to do it that way. I didn’t think my body was ready to push – all I wanted was to take a little break before starting again.  But they were yelling at me to push during every contraction.  And when everyone in the room is telling you what to do, it’s extremely hard to stop the show and get off the stage.  I know I didn’t feel comfortable with what was happening, but I was too swept up in the moment to know how to make it stop or ask for anything else.  Their direction had taken my power away.

Going back to my first negative nurse: apparently the position I was pushing in wasn’t “convenient” for her, because the monitor kept slipping off of my belly.  She repeatedly told me it’d be easier for her if I was on my back.  I refused, I wasn’t comfortable in that position.  She asked if she could use internal fetal monitoring, since I was moving around so much.  I’m sorry, you want to screw an unnecessary electrode into my perfectly healthy baby’s head because I’m moving around while in labor and you have better things to do than to hold the monitor still on my belly?  Never mind the fact that continuous fetal monitoring isn’t evidence-based?   Her negativity was just too much for me, it was shutting my body down.  I don’t consider it a coincidence at all that my daughter was born 15 minutes after this nurse’s shift ended and she had left the room.

Even though I tried pushing in different positions, they eventually pressured me onto my back (which is the most convenient position for them to see what’s going on, but unfortunately happens to be the position that your pelvis is the smallest in.)  Gravity was no longer helping me, and my daughter was stuck for a while behind my pubic bone.  By the time my daughter was crowning, an hour and 45 minutes into pushing (which, by the way, is a perfectly normal amount of time to push as a first time mom), they should have told me to slow down to protect my perineum; instead, their impatience made them tell me to push harder, making my 10 lb. 1 oz. daughter come barreling out of me.

Yes, at the end of the day, I accomplished my goal of having an un-medicated birth.  But it didn’t mean that it was the birth experience I desired.  It doesn’t mean that I was respected during it.  I had to fight for it.  I had to refuse unnecessary IV fluids, I had to demand wireless monitoring, I had to turn down continuous pressure to get an epidural; I had to simultaneously stand up for myself while trying to relax and focus on the hard work of labor.

Yet when I became pregnant again, I still debated whether it was worth switching practices & hospitals just to potentially have a better experience.  Once again, I was scared of the unknown.  Was it better to go with the devil I knew?  Could I be better prepared this time?  I think you create a strange emotional connection to the person who assisted in delivering your baby, even if it wasn’t the perfect experience.  They were there with you in your most intimate and vulnerable of moments.  You were high on birth hormones.  And after all, he did save me from bleeding to death of a postpartum hemorrhage.  All of these things gave me pause.

But I was making excuses.  At the end of the day, we all deserve to be treated with respect in childbirth.  Regardless of the type of birth: homebirth, hospital birth, epidural, induction, c-section, VBAC – whatever.  We all deserve care providers who practice evidence-based medicine.  We deserve informed consent.  I know too many women who had unnecessary c-sections because of a cascade of interventions that were done without their consent.   You ever want a reality check about the current state of maternity care, go read some birth stories on ImprovingBirth.org’s Facebook page.  Birth trauma is real – up to a third of mothers describe their birth as traumatic.  These stories have literally made me sob myself to sleep because they are so distressing.  Too many providers are ignoring the role the mother has in her own birth. This is so hard to explain to a first time mom – you assume that your providers practice evidence-based care, you assume that everything they do is the best thing for you.  But maternity care has become so screwed up – so few providers even know what a normal birth looks like.  You have to be your own advocate. My birth wasn’t traumatic; but it wasn’t respectful care.

So I made the leap.  I’m now with a midwifery practice that delivers at a hospital with the lowest c-section rate in the state (less than half the rate of my first hospital).  It’s the opposite of a baby factory – there are only 6 labor and delivery rooms, and they offer water birth.  I’ve also chosen to use a doula for this birth.  And I finally feel supported.

After our first midwife appointment, and then again after our hospital tour, my husband looked at me bewildered.  You mean everything you had to fight for before is just standard of care here?  Limited ultrasounds. Food & drink during labor.  Low lighting, showers, and tubs in labor & delivery rooms.  Non-directed pushing.  Delayed cord clamping.  All of it standard and supported.

And more than just support – knowledge. I asked the first midwife I saw about non-directed pushing.  She immediately started giving me examples of how women naturally push, and even started making low guttural sounds to demonstrate how it helps open you up.  (Basically the opposite of holding your breath and pushing until you’re purple in the face.)  Every appointment involves talking about birth, answering every question I have, and coming up with a plan.  They understand and trust physiologic birth, and the default is no intervention.

And more than just knowledge – respect.  I’ve heard the same message over and over again from this practice: you’re in charge of your own healthcare.  You have the right to refuse anything.  I’ve been given options with everything that has come up.  There’s this test you can do, here are the pros and cons, it’s your choice if you want to do it or not.  No thanks, I don’t need a test with a high false positive rate,  I already have enough anxiety about this pregnancy.  You can choose 1 of 3 options for gestational diabetes testing.  Awesome, I choose jelly beans over that gross glucose drink any day.  Your baby is measuring big, so you’re eligible for another ultrasound at 37 weeks if you’d prefer.  But you can also decline it.  Sweet, I’ll decline it, because I’m not scared of a big baby, my body’s done it before, and I won’t do anything different (e.g. get induced early) even if he is big.

At my most recent appointment, I was chatting with my midwife about the hospital policies for postpartum care.  Even though this new-to-me hospital purports to be more baby-friendly, you never know which nurse you’re going to run into.  She said something that no healthcare provider has ever said to me: No is a complete sentence. 

If they want to take the baby off your chest to do footprints and measurements?  No is a complete sentence. They can do those things while he’s still on your belly.

If they want to take your baby to the nursery to do the admissions process?  No is a complete sentence. They can do that process in the room.

If they say that they have to do an exam in the nursery because they don’t have the staff to do it in the room?  The staffing isn’t your problem.  No is a complete sentence.

I was amazed.  Here my midwife was, handing me back my power.  Telling me to stand up for my choices.   And telling me that she would support me.

I don’t know how my birth will go – but I feel confident that I’ve chosen a provider who will give me the respect that I deserve, and involve me in decisions.  And if I wasn’t confident of that, then I wouldn’t be afraid to switch providers again, even late into my pregnancy.  It took me a while to get to this place.  I know a midwife isn’t right for everyone’s situation – I know you can find respectful care with an OB too if that’s what you need.  But it means you have to raise your expectations.  If you’re not receiving the care you deserve – find someone else.  It’s never too late.

No is a complete sentence.

Breastfeeding Success: Shaming or Inspiring? Formula-Feeding: Guilt or Anger?

Breastfeeding Shame

World Breastfeeding Week is technically over, but it’s still National Breastfeeding Month, so I’m writing one last post on the subject.  There was one particular article going around this past week that really rubbed me the wrong way – it was in TIME, and it was written by a doctor.  I refuse to actually link to it because it’s filled with gross inaccuracies and twisted data.  But the main message was that World Breastfeeding Week shouldn’t be celebrated because it makes mothers feel guilty if they weren’t able to breastfeed.

Hold up.

Since when is celebrating one person’s success shaming someone else?  That’s like saying “I refuse to support The Biggest Loser because it makes others feel guilty that they’re sitting on the couch, not losing weight.”

Who decides if something is shaming or inspiring?

Because I know I’ve been inspired by other women’s breastfeeding stories.  At 6 weeks postpartum I met another woman who had exclusively pumped for a year, and thought wow, maybe I can do this.  I’m inspired by mother-and-baby duos who were able to move on to a successful nursing relationship after having a tongue-tie revised.  I’m inspired by friends who struggled with their first baby but had a smooth journey with their second baby.  None of their success shames me or makes me feel guilty.

And if it did make me feel guilty, is the answer to walk around with my hands over my ears in an effort to avoid hearing anything that might hurt my feelings?  How do we ever hope to learn new things if we allow our guilt to get in the way?  And why should 1 person’s guilt prevent others from hearing the message?  I don’t feel guilty when I learn about the benefits of directly nursing over exclusively pumping; I know that the way I did it wasn’t the ideal, and I’m glad to know that information.  Do you really want to live your life in the dark?

Like I said in my first post on this topic, 85% of new mothers want to breastfeed exclusively for 3 months or more, yet only 32% meet their goal.  If you’re in that 53% who didn’t meet your goal, it’s not my place to tell you how to feel about it; you’re entitled to your feelings.  But I do want to tell you how I’d feel about it.

Maybe you feel guilty because you thought you couldn’t make enough milk to satisfy your baby during those early weeks, because they wanted to eat all the time.  I’d feel angry that we live in a culture that teaches women that our babies need to be on schedules right away.  That we don’t educate women about cluster feeding and about growth spurts and about how milk production actually works.  That we don’t encourage on-demand breastfeeding.  That we don’t set the expectation that every mother-baby duo is different, and will feed at different intervals.  I’m angry that an un-educated relative casually suggested a formula top-off because your baby seemed hungry.  That person didn’t know that the formula would cause your baby to suckle less, thus demanding less milk from your breast, thus reducing your milk supply, and fulfilling the issue that you didn’t have to begin with.  I’m angry that someone didn’t tell you that how much you pump isn’t an indication of how much milk you are making or how much your baby is getting.  Breastfeeding is an age-old biologic process, not one that listens to our 21st century clock or technology.  These are all cultural problems; we’ve gotten so far away from breastfeeding that we’ve lost our knowledge about it, and our expectations are all out of whack.  So I wouldn’t feel guilty, I’d feel angry.

Maybe you feel guilty because you were pressured to start giving formula in public, because someone stared at you or sneered at you or had the gall to actually say something ugly to you when you tried nursing your hungry baby while (gasp) living your life.  I’d feel angry that we live in a culture that has over-sexualized breasts to the point that everyone has forgotten about their function.  That mothers have to fear being wrongfully kicked out of an establishment because some employee doesn’t know the laws protecting a mother’s right to breastfeed in public.  That we even need laws protecting our right to feed a hungry child.  That most of the laws don’t have enforcement provisions, so you have no legal recourse if you are kicked out of somewhere.  I wouldn’t feel guilt, I’d feel angry.

Maybe you feel guilty because you couldn’t keep up with your baby’s demands when you went back to work.  I’d feel angry that we force women back to work before they’ve even had a chance to establish their milk supply.  That we’re the only industrialized nation in the world that doesn’t mandate paid maternity leave.  That despite new laws requiring employers to provide reasonable break times and a place to pump at work, not everyone is on board yet.  That many mothers still have to pump in a bathroom, are forced to pump at times that don’t match their body’s needs, and are discriminated against and have hours cut because of their requests.  That as a nation, we have so little respect for women and children that we don’t do everything we can to support this critical time (we can’t all work at Netflix).  I wouldn’t feel guilty, I’d feel angry.

Maybe you feel guilty because you listened to bad advice from a professional you trusted.  I’d feel angry that the American Academy of Pediatrics recommends 1 year of breastfeeding but then does very little to actually support it.  That I constantly hear about pediatricians making recommendations about infant feeding that aren’t evidence-based.  That we still have to worry about postpartum nurses “sneaking” formula bottles to our babies in the nursery, when their stomachs are still the size of a cherry. That the billion-dollar formula industry is the one actually pulling the strings; they’re in our doctors’ ears, in our hospital discharge bags, filling our shelves with samples before our babies are even born, preying on a mother’s worst insecurities at her most vulnerable moment.  That they cast a cloud of doubt on our abilities, that they make us lose trust in our bodies.  I wouldn’t feel guilty, I’d feel angry.

Or maybe you did everything you could, and despite your best efforts and doing everything right, you truly couldn’t produce enough milk.  Or your baby was born prematurely and wasn’t coordinated or strong enough to make breastfeeding successful.  Or you had to take a medication that prevented you from breastfeeding, or your child had some other medical complication.  Nature dealt you an unlucky hand.  You got a raw deal.  Guilt isn’t the right emotion here; it might make you feel sad, but I hope it never makes you feel guilty.

Maybe you feel guilty because you’re done having kids and won’t have the opportunity for another “do-over.”  Maybe you don’t have an opportunity to find inspiration from others’ success.  But don’t you care about what the experience is going to be like for your daughters?  For your granddaughters?  I know you do care, because you’re a good mother, regardless of how you fed your children.  Please let go of your guilt for their sake, for progress sake.

Or maybe none of these roadblocks were in your way.  Maybe the decision was entirely yours from the get-go not to breastfeed.  Or life circumstances meant you made a decision to stop when you were ready.  These things are all your prerogative.  Breastfeeding is a relationship, which means it has to work for both partiesNo one is impeding on your freedom to make your own decisions – I just hope that it was truly your decision, and not one made for you by our society’s cultural expectations.  And a decision you make of your own free will should never make you feel guilty.  If you were confident in your decision, then there’s no reason that World Breastfeeding Week should offend you.  I’ll support you if you support me. And I’m sorry about all of those ugly people who do actually directly shame you for formula-feeding.  They undermine the entire cause.

There’s a million and one other scenarios that I didn’t cover.  But as you can see, I’m of the mindset that guilt has no place here.  How will we ever improve our breastfeeding rates if we’re too afraid to share information for fear of making someone feel guilty?  In just a decade, Cambodia was able to increase their exclusive breastfeeding rates in the first 6 months from 11% to 74% through the use of a national media campaign, extensive health-worker training, and establishment of mother support groups.  It takes educating an entire society, not just the mothers.  They certainly wouldn’t have accomplished this if they were too afraid of offending a few people.

So it’s your choice.  You can either feel shamed by stories of breastfeeding success, or you can feel inspired.  You can either feel guilty about what happened to you, or you can feel angry toward the system and culture that is failing so many of us.  Although it’s not enough to stop at anger, it’s not a good emotion to dwell in; it has to be turned into positive action.  Become a more active participant in your healthcare, and have more meaningful conversations with your doctors. Demand more from our lawmakers and our employers.  Normalize breastfeeding so that some day, our daughters won’t have to fight for where they can feed their children.  I can’t wait to see that day.