gracefullbirthing:

You have to be a real birth junkie to appreciate this video.  Gloria Lemay gives a guided tour of a fantastic twin placenta.

This is so cool!

(via longforthis-deactivated20120531)

I am a HUGE advocate of breastfeeding. But I am also a HUGE advocate of being nice and understanding. (I, btw, hate the term “breastfeeding nazi”).

5 Things That Make You a Breastfeeding Nazi … And 5 Things That Don’t

Posted by Miriam Axel-Lute

Ah, breastfeeding and formula. It seems like forever since we’ve been able to talk about infant feeding without immediately getting sidetracked into the explosive meta discussion about how we should talk about it, or, more often, how we shouldn’t.

The ability to discern between truth-telling and guilt-tripping seems to get a little hazy to all involved sometimes. In the interest of lancing the boil I present the following cheatsheet on how not to become a breastfeeding Nazi—and how not to see them where they are not.

Part 1: 5 Things That Make You a Breastfeeding Nazi

1.    Making disparaging comments to parents giving bottles to their kids.
I shouldn’t even have to say that this is Not OK, and I think it is rarer than some on the defensive would like to make out, but apparently strangers hissing “Shame on you, you should be breastfeeding” does happen. So let’s just get this straight: You don’t know what the story of that parent/caregiver and baby are (or even what’s in that bottle), so shut the eff up. Besides, even if you somehow knew that someone really could be breastfeeding, do you really think that being mean is the way to change their mind?

2.    Refusing to acknowledge that sometimes breastfeeding is hard and sometimes it sucks.
I’m well convinced that with the right post-partum protocols (baby to breast within an hour of birth, for example), support, and information (and maternity leave) that breastfeeding could be a lot easier for a lot of people than it is. But the fact is that (a) most mothers aren’t in that ideal situation and (b) even in ideal cases sometimes milk comes in late, latches aren’t formed right, infections happen, medical conditions lower milk supply, etc. and those things can be miserable. Pretending this isn’t the case is rude to the women who’ve struggled really hard—both the ones who persevered through it and the ones who eventually prioritized other things.

3.    Quoting discredited studies.
Guess what? Breastfeeding doesn’t raise your baby’s IQ. That finding failed to control for parental IQ and when they did, the difference went away. I didn’t know that until recently either, but now that you know, have the integrity to drop it from the plenty-long list of advantages to breastfeeding.

4.    Confusing lactivism with promoting one-right-way-to-parent.
I will never forget reading an otherwise decent article critiquing all the subtle ways in which our culture promotes bottle feeding when suddenly the author was on a condescending tangent about the insufficiently committed mothers who had this selfish need to occasionally have a little time to themselves without their kids. I could just hear a thousand undecided pregnant women saying “Well, if that’s what breastfeeding is about, forget it.”

5.    Blaming individuals, not systems.
The major cause with low breastfeeding rates in the United States is not selfish parents. It’s a stew of bad hospital protocols, bad family leave policy, misleading formula marketing, badly crafted parental education, overworked and undertrained labor and delivery nurses, unsupportive workplaces, and on and on. If we all keep that in mind we might even be able to work together.

Part 2: … And 5 Things That Don’t

1.    Encouraging an uncertain or undecided mother to give it a try/keep trying.
This is different from berating someone who has already made a decision and it doesn’t count if it’s done in such a way as to fall under #2 or #4 above. But if someone truly isn’t sure, offering encouragement, suggestions, information, data, or contacts that might help them succeed in something this big is a service not a judgment. This extends to critiquing misinformation or “balanced” pro-con literature that parents have been given or offering to talk to an uncertain spouse.

2.    Trying to get the word out about how some common breastfeeding problems can be alleviated by different nursing patterns.
Talking about breastfeeding “management” tactics to address problems like lactose overload in no way blames mothers for the problems. It certainly sucks to learn afterward that there might have been something in your control that might have helped make breastfeeding work better, but we all know this isn’t inborn knowledge. You can’t withhold the information from those who want it so you don’t offend those who didn’t have it when they could have used it.

3.    Talking about the statistical risks of routine formula feeding.
This is the hot, wet heart of it all. Yes, there are plenty of perfectly healthy formula-fed kids. They are just statistically less common. Yes, fear of illness doesn’t have to trump every other consideration.

But neither of those things mean we should stop talking about the real and stark differences in health between the two options on a statistical level: Two to five times the rate of SIDS, twice the death rate from diarrhea, six to ten times the rate of necrotizing enterocolitis, higher rates of respiratory illness, leukemia, asthma … Post neonatal infant mortality rates in the United States 26.6 percent higher. We’re not actually just talking about fewer annoying ear infections here.

We need to talk about these numbers not in order to make anyone feel bad, but in order to organize for the systemic changes that would actually make breastfeeding a viable option for more people.

4.    Opposing formula marketing in hospitals.
Formula is an important option to have on hand when breastfeeding doesn’t work for many reasons. In that way it’s a little like a drug, or at least a nutritional supplement. Hospitals don’t hand out anti-cholesterol meds to people with healthy hearts; they shouldn’t hand out formula as a matter of course either. It’s misleading and it implies that doctors think it is a medically equivalent option and it isn’t. (Same goes for opposing misleading formula ads.)

5.    Disliking the term “breastfeeding Nazi.”
Aside from this being yet another case of the term Nazi being tossed around like the Nazis were merely cross-patches, not mass murderers, it implies that there is an organized movement to be horrible and judging to all parents who don’t toe the line, instead of a loosely-knit network of people and organizations trying to advocate for a public health measure, some small minority of which sometimes behave in mean or counterproductive ways. The same can be said of both sides of nearly any cause people get passionate about. It’s time we got back to having the real conversation.

dexees-mom:

By Tracy G. Cassels

“100 years of rapidly changing infant-care fashions cannot alter several million years of evolutionarily derived infant physiology”

̴ Dr. Helen Ball

Sleep and feeding have become some of the most discussed and disseminated topics in parenting today.  How much sleep are you getting?  Do you use formula or just the breast?  When should a child sleep through the night?  Do you pump?  Does dad feed the little one at all?  Do you room-share, bedshare, or put the little one alone in his room?  What about sex?   There is an endless array of questions and judgments and ‘should’s associated with both infant sleep and feeding.  But this hasn’t always been the case.  It used to be a simple matter of mother breastfeeding and mother and infant sleeping together with no judgment and no questions about quality or quantity of sleep.  For this reason, breastfeeding and co-sleeping are huge parts of evolutionary parenting; they facilitate the bond between mother and infant via skin-to-skin contact[1], co-sleeping works to keep baby’s temperature and breathing regulated[2][3] and it seems to provide parents and baby with better sleep[4], while breastfeeding offers vital immune protection to infants necessary for survival[5].

For most mothers in contemporary Western societies, breastfeeding and infant sleeping arrangements are two distinct parenting practices with little or no relation to one another.  To talk about one is not to talk about the other.  Biologically, however, the two are inextricably intertwined.  For much of human history, hunter-gatherer societies dominated and in this domain, women were as central to the survival of the clan as men.  There were no maternity leaves, but the work done by women was of the less-dangerous gatherer type, meaning they were able to do their work with children and infants in tow.  But with this came the necessity for women to sleep well as a woman who is sleep-deprived does not serve anyone well in any capacity (it is truly strange that we have adopted the modern view that sleep deprivation is a “normal” state of affairs with a newborn).  As for the infant, without any alternatives, they required their mother’s breastmilk to survive, much less thrive.  And thus we reach the point at which breastfeeding and co-sleeping collide – in order to breastfeed continuously without immense sleep interruption mothers must co-sleep; and on the flipside, co-sleeping allows mothers to breastfeed more often providing more nutrition for a developing infant.  Biologically, our bodies have evolved to both breastfeed and co-sleep and each seems to have helped facilitate the other.  So how did this separation occur and what does it mean for infant well-being and parenting practices in Western societies?

There seem to be distinct reasons for the reduction in breastfeeding and co-sleeping in Western societies, yet they obviously affect each other.  With respect to breastfeeding, we see the rise of the industrial society, which sent women to work, and science with all its might creating formula which was believed to be superior to breastmilk by doctors for quite some time (for a full summary of this, see Why Is Saving Babies’ Lives Not Enough?).  These two factors alone had a huge impact on reducing breastfeeding rates in Western societies.  This reduction of breastfeeding meant that sleeping arrangements were also free to change, but in addition there was an even greater impetus for change – the belief in fostering independence.

The juxtaposition of a baby’s dependence/interconnectedness and independence/autonomy has dictated parenting practices around the world, though not always in the same manner.  For example, in America the newborn is viewed as entirely dependent upon its mother, yet the desired end-goal is for that baby to be an independent and autonomous individual.  Thus our practices are geared towards that end-goal; we put babies alone in their own room, we don’t touch them very often, and we’ve even removed the dependence on mom for breastfeeding through the use of formula.  In contrast, the Japanese view the newborn as an autonomous, independence being who must be held, breastfed, and touched regularly (co-sleeping is the norm there) in order to build the feelings of interconnectedness they value[6].  Similarly, research from New Zealand has found that cultural groups that share the Western independence view rarely sleep with their infants, while Pacific cultural groups demonstrate lots of sleep contact because they believe that interconnectedness is the way to foster a child’s development[7].  So while there are myriad factors why any one individual would choose to co-sleep or not, or breastfeed or not, culturally this notion of independence has played a very large role in shaping our collective views on the issue.

The problem for Western cultures is that the Western assumptions of what fosters independence seem to be, well, wrong.  Research has demonstrated that the Eastern interconnectedness model fosters independence and well-being to a much greater degree than simply forcing children to try and be independent.  One such example is the case of the Sami and Norwegian children.  Sami individuals are more likely to co-sleep with their children and their children were found to be more independent and demand less attention from their parents than Norwegian children who typically sleep alone[8].  (For a full summary of the link between independence and co-sleeping, see Co-Sleeping: Fostering Independence.)  Interestingly, thanks to a push to increase breastfeeding rates in Norway, co-sleeping has also become a more common sleeping arrangement[9] and children are reaping the benefits.  Similar relationships have also been found in Sweden where breastfed infants were much more likely to sleep with their parents than formula-fed infants[10].

I have mentioned some of the logistical reasons for breastfeeding and co-sleeping to go together, but is there more than that?  After all, if it’s a matter of pure logistics, wouldn’t it simply be a matter of whatever works to separate the two?  Turns out there are a couple rather important effects that each practice has on the other and we’ll start with the effects of co-sleeping on breastfeeding.  As previously mentioned, co-sleeping is greater amongst breastfeeding mothers[11], and while increasing breastfeeding has increased co-sleeping rates[9][10], the fact it that co-sleeping actually facilitates more breastfeeding.  If you compare mothers who breastfeed, those who co-sleep breastfeed up to twice as much at night over those who do not co-sleep[12].

Why is this important?  Dr. Helen Ball has done research on the effects of sleep location on breastfeeding and come to some rather interesting (though expected) conclusions.  Namely, co-sleeping right from the start reduces the chances of having breastfeeding problems.  Specifically, Dr. Ball looked at sleep locations for new mothers and their infants and randomly assigned women to one of three location types – either those that facilitated mother-infant access (i.e., bed-sharing or putting the infant in a three-sided crib that was attached the parent bed, much like an official Co-Sleeper) or those that did not (i.e., a standalone bassinette next to the mother’s bed).  Mother-infant dyads who had sleeping arrangements that facilitated mother-infant access showed greater successful suckling than those who were in the standalone bassinette group[13].  Upon follow-up with these same mothers, it was found that these effects of early co-sleeping continued at 16 weeks, with twice as many mothers in the unhindered access groups both breastfeeding and exclusively breastfeeding[14].  Note that this doesn’t even cover women who may have their newborns in a separate room from themselves as all three groups were at the very least room-sharing, but it was the bed-sharing (or three-sided crib) that facilitated breastfeeding.  Why does this happen?  As previously mentioned, infants who co-sleep tend to feed (or at least suckle) for twice the amount of time as non-co-sleeping infants[11].  Stimulation of the nipple is necessary for the production of prolactin, the hormone that allows for milk secretion, and thus the reduction in suckling or nursing can lead to deleterious effects on milk production or the maintenance of a mother’s milk supply[15].  In short, by getting your baby into bed with you right away, you reduce the chances of having supply issues when breastfeeding.

Now, what of the effects of breastfeeding on co-sleeping?  First you must remember that the biggest argument against co-sleeping is to do with infant deaths.  Many people argue that co-sleeping increases the risk of death via suffocation or SIDS.  While there is no direct evidence that breastfeeding causes a reduction in SIDS for co-sleeping babies, there is ample circumstantial evidence to suggest this is the case.  Most prominently, cross-cultural data shows that cultures in which co-sleeping and breastfeeding are the norm have substantially lower SIDS rates than cultures in which they are not the norm[16][17][18].  For example, Japan has long been considered the pinnacle of success with respect to SIDS deaths as their rates are generally half of other industrialized nations and co-sleeping is also the norm there (see Bedsharing and SIDS: The Whole Truth for a full review of their practices and SIDS rates).  It is possible that breastfeeding has nothing to do with their lower SIDS rates, except that we know breastfed babies are at a much lower risk for SIDS more generally[19][20][21][22][23].  Breastfeeding in and of itself reduces the risk of SIDS; in a meta-analysis on the relationship between breastfeeding and SIDS, it was found that while any breastfeeding more than halves the risk of SIDS, exclusive breastfeeding has an ever greater effect[24].  Furthermore, duration and intensity of breastfeeding have also been found to relate to SIDS levels, with greater duration and intensity leading to a lower risk of SIDS[3].  If you recall, it has also been found that co-sleeping babies breastfeed up to twice as long as non-co-sleeping babies.  It is therefore reasonable to assume that the extra breastfeeding during co-sleeping serves as added protection against SIDS.

An additional hypothesis for how breastfeeding may reduce the risk of SIDS for co-sleeping infants comes from Dr. James McKenna who has posited that the arousals from breastfeeding keep the infant from falling into a deeper sleep which may lead to a “failure to rouse” [25].  This “failure to rouse” has been discussed as a potential mechanism behind SIDS – infants reach too deep a level of sleep and they are simply incapable of coming out of it, kind of like entering a coma.  Breastfeeding thus increases the number of infant arousals (though not full wakings) and this is greater during co-sleeping and is especially true for breastfeeding dyads not only because of mom’s movements, but because of the frequency of feedings.

Another way in which breastfeeding may help reduce the risk of SIDS (and did for many years) is by the position in which the infant sleeps.  Breastfeeding infants are less likely to sleep prone because it doesn’t facilitate breastfeeding as easily; in order for an infant to breastfeed, he or she needs to be on his or her back or side.  An infant in the prone position simply cannot reach or latch onto the breast (unless the prone position is on mom).  This also helps reduce the chances of infants suffocating, as a baby in the prone position who cannot roll over is at greater risk for suffocation.

Indeed, breastfeeding also seems to be related to practices that reduce the risk for suffocation.  Research has found that maternal-infant behaviour in bed is different amongst breastfeeding mothers than formula-fed infants[26] with certain behaviours, like facing the infant and having the infant lie at chest level, being much more prominent in breastfeeding dyads.  Dr. Helen Ball has done this work and while some of these behaviours may seem trivial, they can be imperative for keeping an infant safe.  For example, a child who lies at chest level (as opposed to head level, which is what Dr. Ball found to be more common in formula-fed infants who co-slept) is less likely to be surrounded by pillows which are considered dangers for suffocation.  They are also less likely to be too close to a headboard which is a known hazard as babies have fallen between the headboard and mattress and suffocated.

I would also like to add my own hypothesis here.  There is evidence that bonding is generally greater for breastfeeding dyads – the reason being that there seems to be more eye contact between mom and baby during a breastfeeding session than a bottle-feeding session[27].  I believe that the bonding that occurs during daytime feedings serve to heighten mom’s awareness of and about her baby, leading her to be intuitively safer at night.  That is, a mother who has bonded with her child is more aware of her child’s presence at any given point and I believe this extends to when we are sleeping (barring the use of any illicit substances).  Of course, research needs to be done to test this – it’s just educated speculation at this point, but I struggle with the idea that all this bonding doesn’t extend its effects into the evening hours.

Hopefully the link between breastfeeding and co-sleeping is now clear.  The benefits they offer each other are neither superfluous nor easily available by other means.  In changing our parenting practices, we have developed other problems.  Western countries have alarmingly high rates of breastfeeding problems and much higher rates of infant mortality (notably SIDS) than other countries who have similar medical advancements but also breastfeed and co-sleep on a regular basis.  Interestingly, we also have a high rate of sleeplessness by new mothers – so much so that we joke about never sleeping again when people have a new baby – and our children have unusually strong attachments to objects for sleep (e.g., security blankets, stuffed animals).  Neither of these are universal.  In fact, research has shown that breastfeeding mothers who co-sleep get more sleep than both bottle-feeding mothers and mothers who breastfeed, but do not co-sleep[28].  Additionally, children who are solitary sleepers show a greater need and use for security objects and sleep aids[29].  So not only do our sleep and feeding practices have significant consequences (i.e., breastfeeding troubles and infant death), we see smaller consequences in the majority of new moms and their children.  Isn’t it time we recognized not only the benefits of co-sleeping and breastfeeding, but the symbiotic nature of the two?

Did you co-sleep?  Breastfeed?  Did you experience any of the deficits/benefits associated with your particular feeding and sleeping style?

dexees-mom:

Stages of Pregnancy

Stage 1: You just found out you’re pregnant. You’re excited (or horrified) and you can’t believe you’re going to be a mother. You may be scared to give birth and wonder how you’re going to do it. Everywhere you look you see pregnant women. You’re tired. Like really tired. Every pain and twinge you wonder if it’s because you’re pregnant. You wonder if people can tell that you’re pregnant – sort of like when you wonder if people can tell if you’re drunk (hopefully, you aren’t wondering this at the same time).

Stage 2: You look fat but not pregnant. You can see people kind of looking at you wondering but it seems weird to blurt out “I’m pregnant!”  You may or may not have told people by now. The people you’ve told ask you how you’re feeling all the time. You may have bought a couple of maternity things that you think you can wear after the baby comes. You may be tired, sick, have sore boobs and have to pee constantly. It’s a delicious luck of the draw.

Stage 3: You’re really cute and could be an ad for a maternity store. Everyone can see that you’re pregnant and congratulate you and tell you how wonderful you look. You feel great. Nothing hurts and you don’t feel sick anymore. This stage usually lasts for about 27 minutes.

Stage 4: You’re starting to find it hard to breathe and things are starting to swell. You’re sick of people asking you if you know what you’re having, when you’re due and if you’ve decided on a name. You’re tired of wearing the same maternity clothes but you don’t want to buy new stuff because you’re almost done. Shaving your legs, putting shoes and tending to your lady bits is becoming difficult.

Stage 5: You feel enormous and none of your maternity clothes fit. You want to crash through walls and shout “oh yeah!” like the KoolAid man. People keep saying “Haven’t you had that baby yet?” You have a new appreciation for how difficult it is for the elderly and morbidly obese to get around and swear you’re going to become an advocate for their rights once you catch your breath. You’re no longer scared of birth you just want this kid out of you and if that means pulling it through your right nostril, so be it.

Stage 6: The baby is here. You want to burn your maternity clothes on the front lawn. You’re no longer pregnant and you’re looking forward to getting your body back, a full night’s sleep and eating a nice, hot meal. Wait. What?

Did I miss one? What stage are you at?

http://www.yourfhbc.org/staff.html#intern

The other day I emailed this to the Family Health and Birth Center in Washington D.C. (I live in the Northern Virginia Suburbs):

Hello!

My name is Marina and I plan to seek postpartum doula certification within the next year. (The only reason I’m not signing up right this very second is because I have a baby of my own right now so I’m waiting until the time is right). I’m trying to find a place or places that would allow me to receive hands on experience for my certification and I’ve heard that you sometimes help those looking to be certified! I so passionately want to make this my life. I believe that there is nothing more exhausting, emotional, intense, and magnificent than the initial couple of weeks after childbirth (okay…maybe childbirth itself). Any information on whether or not you help doula wannabees, or if you know anyone who does, I would greatly appreciate.

Thank you,

Marina

No joke, a day after I decide that I am going to go for my postpartum doula certification through CBI I get a call from a friend of mine asking if I could talk to one of his friends, who I have met  a couple times, and help her out.

For the sake of anonymity I’ll call this friend of a friend Jane. Here is Jane’s Dilema:

Jane got pregnant 9 months ago and decided that she was going to give her baby up for adoption. I do not know the details behind the decision, only that she made it.

Last Friday Jane had her C-Section and after spending a few days in the hospital with the beautiful baby girl (including and extra day at her request) she fell in love. What she told me on the phone was that she didn’t expect to feel anything. Now she is in shambles, the baby is currently with the adoptive parents but Jane thinks she wants it back and doesn’t know what to do. She has a few days to claim custody before the baby legally becomes the child of the adoptive parents.

I feel for Jane I really do. The reason her friend had her get in contact with me is because I am only a year older than her (I am 20, Jane is 19) and a mother as well, according to our mutual friend I’m a fantastic mom at that (always nice to here in a world where young moms are viewed as incapable). I asked her about her situation. She lives with her parents who say they are supportive of her keeping the baby. She isn’t sure about insurance but says she would do what she needed to, including get a job almost right away. I told her to try and get medicaid. I think it would be extremely stressful on a single mom with a brand new baby to work all day and stay up all night AND try to maintain a proper bond. I told her that if she decides to get her baby back I will help her as much as I can. Even with a baby of my own I know I could do.

I didn’t want to make a decision for her though so I told her to really think about, to consider that her hormone drop after pregnancy has a very large effect on her emotions, but at the same time, not make her feel like that’s the only reason she is having these feelings. Basically I just want her to consider EVERYTHING.

After that the phone died. I messaged her lateron on facebook and let her know that in the event she decided to get her baby back she should do it as fast as possible because the first few weeks are critical for mother/baby bonding and attachment. I told her she shouldn’t fret though, that there are ways to resume close bonding that I could help her with if she wanted to (I’m thinking baby wearing, I have a co-sleeper she can use if she wants it, infant message, certain ways of bottle feeding and more…I also plan to research more ways). I also let her know that I have more than enough baby clothes that I’ve been meaning to give away that would last her baby months along with some other things like a baby bouncer that my daughter doesn’t use and some miscellaneous things.

If she doesn’t get the baby back I don’t think she will need me, though I will offer my support. She has very caring friends that have been by her side this entire time. If she does decide to get her baby back I would be more than happy to help her out in every way that I can. I am limited a bit because I have a 5 and half month old but with a sling and the right toys I can continue to be the mom I have been.

I can’t imagine what Jane is going through, I really can’t.

If she decides it’s best not to take the baby back than I’m sure the baby will have a good family.

If she decides to take the baby back…well than I’m sure the baby will have a good family…that I can help.

We shall see!

By the way.

Does anyone else have any good ideas on bonding non breast feeding mothers who have been unable to be with their newborns for a few days?

Edit: I’m positive the adoptive parents are having a terrible time and for that I feel bad but my focus right now is on the biological mother.

(Source: )

http://www.birthingway.com/footling_breech.htm

These are pictures of a planned breech homebirth. Every effort was made to change the position of the baby and a hospital delivery was considered. The parents, understanding the risks involved, decided to continue with the plan to birth at home rather than have a cesarean in the hospital. It was only after labor had started that it was discovered that a foot was the presenting part rather than the baby’s bottom. Two midwives attended the mom during delivery, another was present and unless otherwise needed was free to take pictures. All three were experienced in breech delivery and in maternal and newborn resuscitation.

The mother labored very well for around 17 hours. At that point she wanted to push and no cervix could be felt in an exam. To ensure that the cervix was fully dilated, the midwives had the mom breathe through her contractions for 1 hour before pushing. Note: One of the reasons breech births are considered too dangerous is that the cervix is said to “clamp down” before the delivery of the head. It is possible that in these situations the cervix was never fully dilated. The baby’s body could work it’s way through a cervix that was not completely open. The practice of waiting an hour helps to ensure that this doesn’t happen. A hands and knees or kneeling position is chosen as this is the best position for breech delivery.

While unusual for a breech birth, the amniotic sac did not break during labor. Once the mom began pushing it ballooned out of her as shown in the first picture below. The midwife broke the sac to reveal tiny little toes. After a few pushes it became apparent that both feet were presenting.

In the second picture you can see the other leg is coming through. At this point the baby has its back to the mother’s right side (RST). Watch as she spirals herself out. The little mini skirt is the remnant of the amniotic sac.

Some midwives believe that it is best not to touch the baby during the delivery because the touch may cause the baby to startle and raise its arms. Others believe that a little support would help to reassure the baby that it was being pushed into a loving place. Most agree that under no circumstances should the baby be pulled.

By the last picture the baby has turned to a posterior position with her back to her mother’s back and left (LSP). This is not an optimal position for a breech (or any) delivery.

While the baby is in a posterior position the assistant midwife applies some pressure above the mother’s pubic bone to help prevent the baby’s arms or head from getting hung up there. She also keeps nearly constant assessment of the baby’s heartbeat with a doppler. In the pictures below she is seen applying some support to the mother’s perineum as the baby comes down.

Some meconium is usually squeezed out during a breech birth. It is not seen as the sign of possible distress as it is in a vertex birth. This is actually a very small amount. When the butt comes out first there is a lot more meconium pushed out. The baby continues to rotate. (What cute chubby little legs!)

Because the baby has been rotating to the right the cord is now between the baby and the mother’s pubic bone. This is a problem because it is almost completely compressed. In the first picture below, the midwife is supporting the baby with her right hand while she attempts to shift the cord away from the pubic bone to the baby’s belly to relieve the pressure.

The baby has turned to the opposite side she was on when she first presented. Her back is now (almost) to her mother’s left side (LST).

In the second picture the midwife is feeling for an arm. She can’t feel either arm meaning they are not against the baby’s chest under her chin as hoped. She is not pulling on the baby or applying any force. She waits for the arms to become accessible.

The baby needs to be delivered quickly once born to the umbilicus because of the pressure on the cord. To assist the descent, the midwife is reaching for the baby’s right arm in the first picture and pulls it down. She then reaches for the left arm and frees it as well.

The baby was born after about 30 minutes of pushing.

While she didn’t seem to enjoy her celebration bath very much, this beautiful baby girl has settled right in to her loving new home. These pictures were used with the permission of the parents although they wish to remain anonymous. They wanted to share their story to show others that babies can be born safely at home even when they don’t come out head first.

Silas’s birth story. Born April 12th, 2010 at 42 weeks 2 days. A VBA2C.

On Saturday, April 10th (42 weeks exactly), I started having contractions around 20 minutes apart but they were not strong or painful. By that night they were 10 to 15 minutes apart, but still not feeling like labor. I went to bed and slept through the night waking up every 10 to 20 minutes with contractions.

I had had lots of prodromal labor the weekend before that felt much stronger so I really did not expect much to happen with these contractions. As the day went on the contractions never stopped but most felt really mild.

I had some friends over on Sunday(4/11) and we timed the contractions for awhile and they seemed to be getting closer and were around 8-10 minutes apart at this point. I ended up cooking a big dinner and was eating when I felt a slight trickle. For a split second I thought I was leaking urine, but then I felt a funny pop near my belly button and this huge gush came out(this was at 7:15 pm). It was so shocking since I’ve never had my water break naturally.

My husband helped me up and I went into the bathroom and called my midwife. I went about 15 minutes with no contractions, but my midwife and I decided someone should come out and check me.

I had a midwife team that consisted of two midwives and an apprentice(she’s one month away from finishing), so the apprentice was sent out. I live far out, but she still got to my house within an hour. By that time my contractions were anywhere from 8 to 5 minutes apart and I was worried I was just wasting everyone’s time.

When she arrived she asked if she could check me and I was dilated to 6 cm all the way through my cervix(I had been 4-5 on the outside and 2 on the inside during my last visit) and she could feel babies head! At this point the contractions still felt pretty mild to me, but I had to breathe through them and was focused on relaxing when they hit.

I sat in a rocking chair in my room and watched the midwife set up up all the birthing supplies. We talked and I was still smiling and laughing between the contractions. I think an hour or so went by and the two other midwives arrived. One of them checked me again and I was 7 cm so they started filling the birth tub. I was so excited to get in the tub after hearing how wonderful its supposed to be for labor.

When the tub was full I got in and although it was very relaxing between contractions, I had a hard time feeling grounded to focus during them. After trying some different positions I found something that worked and decided to stay in the tub.

At this point time is blurry, but I think it was around 10:30 pm when I got into the tub and my water had broke at 7:15 pm. I remember the contractions were getting more intense, but I felt in control and could focus to get through them. I know my best friend arrived around midnight and I was relived to see her since she lives 3 hours away.

I remember worrying because it seemed my contractions were not regular and I still felt I was having long breaks between them. Also some were very intense and other felt more mild. They never felt super painful, but they were still intense and I started praying during the worst of them. I started to get really nervous because they were strong, but I kept waiting for the transition feeling you read about.

I told my midwife that I did not think I could do it, because I figured I had hours and hours left to go. I also got very restless and could not find a comfortable spot. I even started to get out of the tub, but when I stood up the gravity on my body felt overwhelming after being in the water.

Shortly after that I felt a contraction coming on and suddenly my body arched on it’s own and pushed. It was the most shocking sensation and I felt the baby coming down. There was no urge, it was just like my body took over and I had no control. It felt like the baby was coming out my bottom instead of where he was supposed to and it scared me like everything was going to rip open.

I had another contraction where I felt like I had no control and then they changed or else I figured out how to work with them. The midwife really wanted to check me to make sure my cervix was out of the way, but when she tried I could not handle the feeling of her touching me so she stopped. She got a mirror and a flash light to see (since I was in the tub) and during the next contraction it was apparent he was coming and nothing was in the way.

My other two midwives had been sleeping in the living room thinking I had a ways to go so the one rushed out to tell them I was pushing. Everyone came in and I felt very secure and not scared by this point. I remember that during each contraction I felt like pushing, but would feel a burning sensation that would make me let up. I kept saying I was worried he was going back up when I would stop, but they assured me I was doing great. My body just knew to ease him out with small pushes instead of trying to bear down through the burning.

After a few more pushes they told me I could feel his head and it was so strange to feel!

Finally I was told to keep pushing even with the burning feeling and his head came out. I kept waiting for him to slide out, but I ended up having to push each part of his body out. He never slid out after the shoulders and I had to push his chest out too. It was weird to even feel his legs and feet come through, I thought I would just have a sliding sensation after the head.

After he was out my midwife laid him on my chest and it was so amazing to see him and know that I just pushed him out myself! I felt so relived that it was so much easier that I had pictured and worried about. It really was not painful for him to come out like I had thought it would be.

Once he was on my chest he did not want to breathe right away so they had to suction him and rub him. They did all that on my chest and he started to pink up after a bit. Then he just looked around and I looked at him and it was wonderful. I was so amazed by him and it was so surreal that I actually did it. I gave birth to him right then just the way nature meant it to be.

By this time the cord had stopped pulsing and my husband was able to cut it. Then I handed the baby to my husband while the midwives helped me deliver the placenta.

Once that happened they helped me out of the tub, dried me off and tucked me into bed. I got Silas back and we cuddled skin to skin and nursed for the first time. He latched right on and was a natural little nurser.

My midwives cleaned up everything and fed me a snack and then examined Silas. He was weighed and measured and examined all right there with me. I was also checked for tears at this point and luckily I just had a small skid mark and abrasion, but no real tears!

After we were both checked they tucked us both into bed and we were left to bond in our own h