By Alyssa Johns
“The more I learn the more I really want to have my baby out of hospital, but I feel like it’s too late to switch.” I hear this sentiment quite frequently when I am teaching childbirth classes. These women have just learned about how well equipped their bodies are for birthing and they have gained confidence in the process of giving birth. I see many women begin to question whether or not they really want to give birth at a hospital and possibly have to defend their choices through labor when they could give birth outside the hospital where the type of birth they wish for is the norm. We watch videos of calm water births, peaceful home births, and families start to recognize that there is another safe option available.
I remember when I was pregnant with my son 8 years ago, I had planned for an unmedicated birth at the hospital until I became friends with a doula who was very involved with out of hospital birth. She showed me pictures of her home birth and I remember staring at them in awe. I literally had no idea birth could look like that. It was private, peaceful, cozy, and joyful. The complete lack of machines and tubes and wires was such a stark contrast to the hospital scenes with gowns and metal poles and beeping machinery. I clearly remember having the thought, “If birth can look like this, why would I want anything else?” The fact that it was my first baby didn’t deter me from choosing home. The more I researched the more I found evidence that home was a safe option for low risk women and that I would likely be able to avoid that downward spiral that happens when one intervention is given and a cascade of others often follow. I was around 28 weeks pregnant when I found my home birth midwife, changed directions, and I never looked back.
As a midwife now, I have the privilege to sit with women and hear their stories when they begin care. If they have had a previous hospital birth I always ask what made them choose out of hospital for this pregnancy. Their stories often have a common theme. Usually the story is that their first birth in the hospital did not go at all how they had hoped. They felt pressured to accept interventions, they felt disrespected, sometimes it was just as simple as they don't want to be in a hospital overnight being interrupted while they try to rest. Some tell horrific stories, some tell stories of more mild disappointments. Some speak of the fact that they just want to be somewhere that feels comfortable where they can let down their guard. The reasons are many, but the common thread is that they are seeking a chance for a better birth.
I hear women who are considering switching late in their pregnancy worry about the stress of finding a new provider and about possibly offending their doctor. The choice weighs heavily on them and they often set aside the idea of switching and stick to their current path. Let me give you two things to consider if you are thinking about switching to your out of hospital birth, but feel like it’s too late:
1) Do you trust your current provider?
Trust is hugely important in easing the labor process. We don't tend to labor well with our guard up or while we are having to defend our choices. Makes biological sense right? Stress hormones directly oppose labor hormones. That is a protective factor so our bodies won’t be as likely to go into labor during times of impending danger. Everyone needs a provider that understands and respects your wishes. If your birth plan is totally derailed because of special circumstances in your labor, you want to be able to just take a deep breath and trust that your provider is doing what’s needed in those moments.
2) What environment makes you feel safe?
We give birth more easily in a location where we feel safe. If we don’t feel safe, our bodies will begin to enter fight or flight mode which is not at all conducive to labor, in fact it can completely stall a labor. For some people, the hospital is the place that gives them a sense of safety. For some, the idea of birthing in the hospital creates anxiety and out of hospital sounds comfortable and safe. Know that your labor will be affected if you have a provider you don’t trust or a location that makes you feel anxious.
If you’re not currently in labor, it is not too late to make a change if you are unhappy with your current situation. I encourage you to be honest with yourself on those two questions and seek a change if needed. Set yourself up well for your current pregnancy and upcoming labor, don’t wait for the next one to trust your instincts.
By Alyssa Johns
Have you heard all those sayings about how you manifest the thing on which you focus your energy? Like if you spend all your time focusing on the thing you’re afraid of, you tend to act in a way that makes that thing more likely to come true? Believe that idea or not, let’s talk a little bit about how it may look in labor and birth.
We all have fears when it comes to labor and birthing, whether it’s our first baby or our fifth. There is a fear of the unknown, the thought that this time we may not be able to do it. We are aware of all the variables and how unpredictable labor can be, so we cannot help but have fears and doubts pop up in our minds in the time leading up to labor. As common as those fears are, we have to avoid falling into the trap of focusing on those fears as our labors approach.
Let me give you an example. Say I am extremely worried about tearing during the birth of my baby. If I am focusing on that fear, what is likely to happen in my labor? At the moment of all that pressure that I need to move through, I will tense up because I’m afraid of moving my baby out. A mother birthing a baby through tense tight muscles is much more likely to tear than a mother that is focusing on relaxing every part of herself around that baby’s head. I’ve seen this be the case at births I’ve attended. So in this instance, by focusing on my fear, I tense up, and I actually increase the chance that my fear will come true.
So what do we do with these fears? How do we keep from focusing our energy on them? There is a beautiful opposite that we can focus on instead. The opposite of everything we are afraid of is everything we want. A fear of tearing might pop up in your head, but what you really want is for your tissues to stay intact through the birth. A fear of a home birth turning into a hospital transfer is really just about the desire to birth at home. The opposite of focusing on fear, is focusing on what you want.
Take your fear, and turn it around:
By Alyssa Johns, LM, CPM
“Because I should have this figured out by now!” I snipped at my husband as he asked me why I didn’t ask for help when there were so many people offering to help me. I had run out of food I could eat when he was on a 48-hour shift at the fire station and the thought of loading up two kids to go to the store when I was already exhausted was too much that day. I made sure my kids were fed and I skipped dinner. I often either forget to eat or skip meals for reasons like this and both my husband and I know that it is not helping my postpartum mood. “You could ask someone to run to the store for you, lots of people would be happy to,” he reminded me. But I really felt like that was just too much to ask. I am 4 months postpartum and I feel like by now I should have figured out how to take care of something so simple as feeding myself. Asking someone who has their own busy life to pick up my groceries because I am wiped out just seems wimpy and like it’s not something I should do.
I should know by now. I should have it together by now. I should be able to do this. I should not be so tired. I should have gotten more done today. I should get out of bed. I should put my baby down and do the dishes. I should be enjoying each moment. My house should be cleaner. I should have gotten back into a routine. I should be going to the gym. I should be finding time to shower more than twice a week. I should be able to balance being back at work and being a mom.
Should is the word that is haunting me postpartum. Telling me that I’m not doing it right or well enough or as good as other moms. Telling me that I make it look way harder than it is supposed to be. Should is an awful word of judgment that I use on myself far too much. I am trying to dismiss that word from my vocabulary. It is never used in a way that builds me up. It tells me what I should have done and what I should be doing. I read once long ago that “should” needs to exit our vocabularies, both telling other people what they should be doing and telling ourselves what we should be. It’s a word that says “There is something wrong with you. You’re not good enough just as you are.”
I believe “should” is a big part of what is damaging us during the postpartum period. I flip through social media and see a mom smiling with her baby. I instantly think, “I should be enjoying this time with my baby more.” I see pictures of a mom taking her kids to the park. “I should be getting my kids outside instead of hiding at home and just trying to survive.” A mom making a project with her kids equals “I should be spending more time doing fun things with my kids.” I just had to stop writing to go stop my puppy from peeing all over a pile of laundry. My instant thought was “Ugh! I should have put him out sooner! I should have finished that laundry by now.” We use that word to reprimand ourselves and make ourselves wrong for who we are and what we are or are not doing.
The truth is that “should” is doing us in. What if instead of laying in bed snuggling my baby in the morning, thinking that I should get up and be productive, I just thought “There is no should. There is no road map, no rules for how to live this life and be a parent. What do I WANT or NEED to do?” What if instead of beating ourselves up over what we should have done, we gave ourselves some grace and said “Oops. I’ll remember that for next time,” and just gently moved on with our lives…. If I had taken this approach, I would have asked for someone to drop me off some groceries or would have ordered to have them delivered instead of getting down on myself for not having it all figured out. I would have had food and nourishment which would also probably have improved my grumpy mood and kept my milk supply from tanking the next day.
We are so harsh with ourselves. So judgmental with our expectations of how things are supposed to be. The thing is that living this way only puts us in a constant state of discontent. A state of being wrong. We all have strengths and weaknesses, we all have good days and bad days. My wish is to strive to accept where I am and what is instead of trying to make my life match the things I think it “should” be. I hope the same for all of you as you navigate this wild territory of motherhood.
By: Alyssa Johns, LM, CPM
Midwives are a special breed and the care they provide is vastly different than the style of care typical in the western world. Here are some things that set us apart:
1. We believe your birth is normal until proven otherwise.
Pregnancy and birth are natural functions of the body, they are not illnesses or medical conditions. Yes, of course there are times that medical intervention is needed and times when complications arise. We are so thankful for the many things other providers can do when needed to keep us and our babies safe. Midwives are experts in what is normal in birth, and our job is to recognize when things are not in the range of normal and act from there. As long as you and baby are doing well through pregnancy and birth, there is no reason for us to do anything. We have seen that when we give you ample time and support that the process will work the majority of the time.
2. We believe in your ability to birth your baby.We have seen women do incredible things. We have seen their strength displayed time and time again. This knowledge gives us an unquestionable belief in your power. We know that whatever course your birth takes, you will display a depth of strength you never knew you had.
3.We care about the emotional aspects of your pregnancy, birth, and postpartum, not just the physical.
There is much more to pregnancy, birth, and postpartum than vital signs. Who you are and how you feel is incredibly important to us. We know that the emotional state you are in will affect your pregnancy, birth, and postpartum period. Our appointments with you reflect this belief as we offer long appointments so we can discuss your wishes, your life, your struggles, and your fears. We are close by throughout your labor to support you. We see you often in your postpartum period and make sure you are supported, coping with changes, and are feeling well emotionally.
4. We believe a relationship with you makes your birth safer and more comfortable.We work to make sure you feel comfortable and safe with us. We understand that having a strong sense of trust allows you to let go and labor more freely. Women do not tend to labor well when they are on guard. They labor well when they feel safe and supported.
5.We support your informed choices.Your body, your baby, your birth. We are here to inform you, support you, and keep you safe. We do everything we can to make sure you know what your options are, to inform you of the risks and benefits of the options available, and then allow you to choose what you feel is best for you.
6. We want you to feel respected and empowered. Our first priority is to keep you safe, but we also want you to have a great birth. It’s important to us that you feel respected throughout your labor, that you feel informed, and that you feel empowered to make the choices that are right for you. We want you to know that giving birth was done by your power, not ours. Birth is something you do, not something that should happen to you. We find that when our mothers feel respected and empowered, they feel positively about their birth experience no matter what turns it may take.
This quote from the Tao Te Ching says it best: ‘You are a midwife, You are helping at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must lead, lead so the woman is helped, yet still free and in charge. When the baby is born, the woman will rightly say,"We did it ourselves."
7. Our support doesn’t end at the birth.The Midwives Alliance of North America’s latest statistics say that 97% of women in the care of midwives are still breastfeeding at 6 weeks. We offer you support after your baby comes with caring for yourself, newborn care, and breastfeeding. If you go home and support is cut off 2-3 days postpartum, it is very hard to feel successful at these things. We are here to make sure you have resources and the support needed to have the best postpartum period possible.
8. We practice patience. A midwife’s motto is often “I sit on my hands.” We consciously choose not to act as long as all is well. We avoid the temptation to try to guide what’s happening if that is not needed. Labor can take time and when we are patient and allow the time needed, the body usually works things out. Pregnancy can take time too, so as long as you and baby are doing well, we don’t send you for induction before 42 weeks. When induction is out of the picture and we aren’t trying to rush the process, it usually goes much smoother.
By Alyssa Johns, LM, CPM
I’m a midwife. I thought I knew things. Pregnant with my second baby, I was sure breastfeeding was going to be easier than with my first, because I have learned things as a midwife that I didn’t know when my son was born. Breastfeeding him felt like breastfeeding an angry piranha. He chomped, screamed, but would not suck. After two weeks of my six week maternity leave had passed, I was marked with cracked and bleeding nipples and the feeling of defeat. I decided I was done spending my short leave crying and stressing over breastfeeding and I decided to just pump for as long as I could before switching to formula. That was 7 years ago. Since then, I have become a doula, a HypnoBirthing instructor, and a midwife. I have seen so much in the breastfeeding world. This time, I was sure I would be able to bypass the difficulties I faced with my son because of the experience I had.
Right after my baby girl was born, she latched on and ate and I felt elated at the thought that this time it was going to be smooth sailing. But 36 hours later, my nipples were damaged and flattened after every feeding. No problem, I thought, I have resources and support. So I called them in. I took her to see a consultant at three days old to have her tongue tie revised. It turned out she also had a lip tie and a cheek tie which I had never even heard of. So much for me knowing things! She was tiny, at 6lbs 4oz and those restrictions were making it so hard for her to open her already small mouth wide enough to eat. I had all three ties lasered and she latched on beautifully immediately after the procedure. I felt that relief and elation again. It lasted until the next day, when suddenly she wouldn’t latch at all, instead just screaming at me. Turns out some babies really take a long time to recover from those revisions. All of her muscles were now working differently and she was too sore and weak to breastfeed.
That was the beginning of a five-week journey involving chiropractic appointments, lactation consultant appointments, pumping, bottles, and tears. Why was breastfeeding so hard?! Every feeding involved my latching her and nursing her for as long as she could handle, then bottle feeding her and pumping. I felt like I was on a rollercoaster, with some days taking two steps forward and the next day one step back. It was practically impossible to go anywhere, it was hard to handle visitors with all of that feeding business, and I was quickly beginning to struggle mentally and emotionally with this challenge. The first consultant I saw who revised the tongue tie gave me a very interesting thought to ponder when I asked her why so many babies struggle to breastfeed and have tongue ties. She said she had read some research that suggested that formula, bottles, and pumps have kept alive many babies that would not have survived in the past due to their struggles to eat. As a result, these poor little eaters have survived and passed on their genetics. For the first time I stopped cursing my breast pump and gave thanks for it and for the formula that had kept my babies alive.
I had many days where I felt ready to give up. I grew so frustrated at the idea that I was a midwife that couldn’t get breastfeeding to work. My husband reassured me time and time again and reminded me not to put that extra pressure on myself to breastfeed just because of my job. Either way, I just couldn’t give up when I was always telling women not to give up! Working in the field that I do, I had many knowledgeable women checking on me, supporting me, and encouraging me. I had a wonderful, compassionate lactation consultant friend reminding me that it wasn’t me doing anything wrong and that it would eventually come together. One particularly low day, where I was really struggling and trying to decide how long to keep trying, I posted on my facebook page that I was struggling and asked for success stories. So many women posted about the similar struggles they had of having to pump, spoon feed, syringe feed, or supplement while facing issues like bad latches, tongue ties, and supply issues.
I realized that breastfeeding struggles are so incredibly common. These women had stuck it out and they said to give it six weeks. If they could do it, I knew I could too. So that day I decided that as long as I was seeing forward progress, no matter how slow, I would stick with it for at least six weeks. People encouraged me, but also reminded me the importance of my sanity. They reminded me that fed is best and that whatever happened, it wouldn’t make me any less of a mom if I decided to stop and switch to formula. Breastfeeding problems can feel so big when you are already exhausted, overwhelmed, and unsure. My friends wanted to make sure I knew that my mental and physical health mattered too.
At the end of week four, I noticed that my baby was starting to take more gulps and breastfeed for longer periods. I slowly started letting her just nurse and started weaning off the bottles. By the middle of the fifth week, she was eating exclusively by breastfeeding and my heart was soaring.
The ease of breastfeeding without having to worry about pumping, bottles, and carting around so much gear was astounding to me. I had never had the experience of being able to just pack myself and my baby and a couple of diapers and know that we were set not matter what rolled our way. The struggle we had to go through to get there was rought and I do not ever fault a single mom for giving up during that struggle. Our sanity is important and thanks to our modern times, our babies can be fed in many ways. But support is out there. Every mom I talked to that had successfully breastfed had words of wisdom and support for me. They had empathy for my struggle. There is so much lost breastfeeding wisdom that we are slowly regaining. I don’t know how many times I tearfully said I wanted to give up. It would have been ok if I had, but I am so glad I didn’t.
For the mothers out there struggling, if you want to breastfeed, reach out. If I hadn’t, I am confident I would have quit. There are caring consultants, support groups, and mothers that have been there and can help. I still don’t know why breastfeeding can be so complex and difficult, but I also know that leaning on the support from others made all the difference for me and my little one.
For many years, women either didn’t know much about choices and options in childbirth, or by virtue of location, didn’t have many options. The world for birthing choices has never been wider. But how do you choose what is right for you?
What is the evidence behind the safety of freestanding birth centers? The American Association of Birthing Centers has published a study on the safety of birthing centers for low risk women.
The world of children’s literature is vast once you embark. And going to the book store with a newborn or toddler? That can make even the most experienced mom a little hesitant. We have compiled just a few of our favorite baby books for the crunchy mama. Well, any parent and baby really! We hope you love them as much as we do.