Letter from a Mother

In addition to being a lactation consultant, I also teach childbirth classes.  Once in a while, I receive a note or letter from a mom whose life God allowed me to impact through my work.  It reminds me of why it is important to do the work He has prepared me to do over the years.

Penny Simkin, a well known and highly respected childbirth educator, did a study about three decades ago.  When she teaches a class, she gives them a "birth report" to fill out and mail back in.  Curious to see how much women remembered about their first birth experiences, she mailed a blank birth report to women who had delivered their babies twenty years previously.

What she found was astonishing.  She concluded that the memory of that first birth experience significantly impacted the psyche of the mother.  Women remembered with great detail their experience, calling up emotions long dormant.  Some again felt joy and empowerment.  Others again felt anger at the actions of a health care provider whose actions and words did not respect the mothers' desires for her birth experience.  Some felt sadness over a loss (not being able to deliver vaginally, husband not being able to be present, and, of course, the loss of a baby.)  The memories were detailed; the emotions were powerful.

Simkin concluded that those who are with a woman in labor should do everything they can to support her desires for her birth experience,   The "coach" (I prefer to say "labor support person") needs to know how she wants to approach her birth experience and do whatever he or she can to provide comfort measures or to be an advocate for the mother.

In order to help the women in her classes to have a more positive birth experience -- whatever that might mean to each woman -- Simkin discusses pros, cons, and possible alternatives to each procedure or intervention, including medications.  She also teaches natural techniques and positions which provide comfort and also facilitate the normal birth process. Some of her work can be found at www.PCNGuide.com.

Simkin has been an influence on how I approach my own classes.  It is not always easy.  Sometimes I get a "request" from a physician to explain why a patient of that physician is wanting a certain option, or what I am teaching and why I am teaching it.  To be honest, I sometimes want to respond, "Please, just Google it".  They will get the answers to their question quickly.  Instead, I will spend time pulling research to give to that physician.

Recently, an OB said her patients who had attended by class were telling her they could not have an epidural if they were planning to breastfeed.  Nope, that is NOT what I taught (and I doubt they put it this way to that OB).  So, I compiled a stack of research about one and a half inches thick to give to my supervisor to send to her.  (In reality, I am glad to get the research to physicians if that is what is required to help some of them understand that there is more than one way, and sometimes with better outcomes, to approach care for the pregnant, labor, and newly delivered woman and her baby.)

By the way, epidurals have been found to impact the duration of breastfeeding.  More women who had an epidural in labor tend to have more problems with the baby latching and thus give up than women who had an unmedicated labor and birth.  The good news, and part of one of the better studies, is that if the baby has difficulties with latching and/or suckling, if the mother received good lactation support during the first few days, she is less likely to wean.  Most latching problems where the epidural is the cause are transient.  They resolve in a few days.  However, if the mother is left to figure out what to do on her own, or incorrect advice is given by her care providers ("Here, give the baby a bottle"), weaning is usually the outcome.

But, let me get back to the main subject of this blog.  I received a letter which reinforced Simkin's findings.  This woman found her birth experience very positive even though it was different in some ways than what she had planned.   Having worked with many, many moms, I understand the emotional impact on her life as a result of her birth experience. Her feelings about it are strong.  They are positive because she had support in what she wanted to do.  She had learned that she did have options.  She learned ways to promote the natural course of labor (she chose to not rush off to the hospital  once she realized she was in labor).  She chose ways to remain comfortable until she knew it really was time to go.  When her plans for managing pain in labor did not materialize, she learned she was capable of giving birth without medications.  She experienced the God-designed effects of the hormones of labor -- hormones which are often disrupted by common interventions.  Knowing and being able to incorporate her options into this very important event in her life produced joy, a sense of fulfillment, and what I often see, a desire for other women to know they are not helpless in childbirth.

I have replaced names and other identifiers with general terms in brackets.  She has given me permission to send her letter to our department head who might, in turn, send it to the OBs.  The goal of this would be for the physicians to better understand how their practice impacts their patient's view of their birth experience.  I apologize for the references in the letter to my part.  However, I leave them in so readers can see that women want to know their choices in childbirth --even if they don't realize it at first -- just like they do in making a decision of what to feed their babies.  Other than the replacement of direct identifiers, the letter is unedited.

Here is the letter:

Hi Sandra (my "hospital email name"),

My husband (name) and I attended your class on (recent date).  I just wanted to say thank you for doing a wonderful job. I was kinda skeptical going in to the class. I thought it was going to be a bunch of breathing techniques I wasn't going to use. I was pretty set on getting an epidural and not "worrying" about having to breathe. I also just assumed that I would be told how to deliver my child and that's what everyone does. I was definitely mistaken.
After leaving that day, (my husband) and I has discussed many of the childbirth options that we were unfamiliar with. I didn't think I had a choice in the position of delivery, or how long I wanted to "wait" for an epidural. I never knew using the birthing ball was an option also. It was a great "first time" parent class. I would recommend this class to all of my pregnant friends.
I had my son on Sunday (recent date) at 1752 (military time for 5:52 p.m).   I remembered some of the signs of labor and realized at 4 am Sunday morning I was in fact in labor. I was contracting but walking and talking through them. They were not close together or had a pattern yet so I just kept track of intensity. I had gotten my husband up about 8am and told him I was in early labor ( I had been 2cm for over a week already) and just be ready. I was scheduled for induction on Monday so we packed up the car and ran errands. I really wanted to walk so we went to (a shopping area) where we live and walked. Around 3pm I was having a couple hard contractions but we had just left one of the local restaurants where we were watching the Redskins game. Got home, and in 30 mins my water broke and 10 mins after that we were on the way to (the hospital) I was 5cm when we arrived and very soon after that I was at 10cm. I had a completely natural childbirth and was able to deliver on my side. It was one of the scariest, exciting and rewarding things I have ever done in my life. I have delivered other peoples children through my work and watched other women go through labor and c-sections. Everyone has a different experiences we all know, but knowing I had options made the experience wonderful. I didn't want natural childbirth. In fact, when we arrived at the hospital the first thing I asked for was an IV and Labs because I knew I'd get "drugs" faster. I barely got an IV before delivering my child. I felt very prepared even though nothing was going as I expected. The doctor walked in just in time to deliver me also. He is a good friend of mine and I was happy he made it.
I just wanted to send you this picture of  (our son)  to thank you for opening my eyes to childbirth and see that I didn't have to just do what they told me. To do what I wanted to do and deliver my way. Hopefully I didn't take too much of your time with this email. I hope, and know, others will get the same helpful information and use it for a positive experience. I hope my story, much like all of yours, will help those that saw childbirth "my way" choose options appropriate for them and their experience. Thank you for your hard work as a community educator and advocate.

Sincerly,

(This mom)

This mother had her baby twelve hours after she realized she was in labor.  This is more the real "norm" for the length of labor for most first time mothers who are handling their labors by not lying in a hospital bed during the early phase.  Of course, each labor is different, but the highly medicalized approach to labor can add hours.  It can also increase the chance of operative deliveries like forceps, vacuum extraction, and Cesarean sections.


If you are expecting, remember that if you don't know your options, you don't have any. Locate a consumer oriented childbirth class.  Do some research on your own so you can better explain why you want to do what you are discussing with your physician or midwife.  Penny Simkin's material is a good place to start.  You can even find her on YouTube.  Don't be afraid to let your wishes about how you want to approach your birth experience be made know to your care providers.  Do this in a non-confrontational way.  Remember you are still representing the Lord in your conversations. 

Most choices will be part of the "routine" approach in many hospitals, but some might not.  While, in most cases, a plan can be agreed upon, sometimes you may need to switch to another physician or place of delivery which supports you desires.

Approach your pregnancy and labor decisions with prayer for wisdom and for God's direction.  Once you have done everything you want to do to prepare, when labor begins, implement what you have learned. Most importantly, trust the sovereign loving God --who gave this special, precious gift to you -- to be with you throughout the experience.  Find ways to bring glory to Him as you go through childbirth with Him. There is an online resource for women who desire to do this:  www.redeemingchildbirth.com.   

There are not many experiences in a woman's life where God can feel so close.

Nowhere to HIde

My daughter in law, mother to three children ages 5, 3, and almost 2, reposted this on Facebook today.  I think it can be a great encouragement to mothers, especially of young children. 

When my boys were young, like many women, I felt like there was no place to hide.  They would bang on the bathroom door, and even hang over the side of the tub when I was trying to take a bath.  You know how that goes!

But, the writer of this article reminds us there IS a place to hide . . . in God's love and care.

 http://www.incourage.me/2013/11/for-the-mom-who-feels-weary.html

The Breast Fed Brain

Several studies have indicated that children and adults who had been breast fed had higher IQ scores, performed better in school, and had better mental development, including cognition ability, than those who had been formula fed.

A recent study provided visual proof of differences in the brain development of babies fed breastmilk, breastmilk and formula, and formula alone.


To read the published study itself, click here.

To read a lay person synopsis of the study, click here.

One thing I found interesting, but not surprising, is that the researchers cited a study which noted that the addition of AA and DHA to formula (as touted by the formula companies) did not provide the same benefits as breastmilk, partly because of the lack of cholesterol in formula as compared to breastmilk:

"In contrast to breast milk, formula milk contains only the precursors to DHA and AA, and thus must be synthesized by the infant, and has limited cholesterol content (Reynolds, 2001)." 

(NeuroImage. Volume 82, 15 November 2013, Pages 77–86)

Most likely, the formula fed babies and children studied had been fed formula to which DHA and AA had been added, as these have been "prescribed" by physicians for the past few years.  Yet, the brain of babies fed these formulas is clearly less developed than those fed human milk only.  I wonder how they formula companies will spin this study?

It was also interesting to note that the authors supported the World Health Organization's recommendation for breastfeeding for at least two years because of the benefits to the toddler brain. 

Yep.  I guess since God makes the brain, He know how to grow it right!

"Blessed are the Breasts . . . "

"Blessed are the Breasts . . . "

Yes, these words, in essence, are in the Bible (Luke 11:27).  Let's look at how they are used -- and a lesson we can learn or revisit.

Jesus Christ was preaching and teaching "in a certain place".  This chapter started out with one of his disciples asking Him to "teach us to pray".  He did so by teaching what we now call "The Lord's Prayer".  He continued with other topics.  At one point, a woman shouted from the crowd.

"As he (Jesus) said these things, a woman in the crowd raised her voice and said to him, 'Blessed is the womb that bore you, and the breasts at which you nursed!'”  (Luke 11:27   English Standard Version)

By the way, if anyone has ever wondered, Jesus WAS breastfed.  The One who created the biological design which provides the sweetest milk on Earth, Himself tasted and was nourished by that milk.  God, as an infant, was sustained by the very thing He had created for those whom He created in His own image.  Breast milk was good enough for the God of the universe! 

But, back to the passage.  For some reason, this woman was moved by what she heard.  She responded by offering a blessing for his mother, Mary.   Perhaps she was saying something like "Your mother must be special to raise a child to become a man like you."  Perhaps it was simply a cultural expression to say "You mother would be proud of you".

Jesus' response, recorded in verse 28 is interesting:

28But he said, “Blessed rather are those who hear the word of God and keep it!” ( Luke 11:27- 28 English Standard Version).

Let's briefly look at Mary's position as Jesus' human mother.  In reality, the created had carried the Creator in her womb.  A virgin, Mary knew she was carrying a baby conceived by the Holy Spirit.  She gave birth and nursed this unique baby.  She watched this special child grow.  He always obeyed.  He never sinned.  He was wise enough at age 12 to interact with the teachers in the temple, yet submissive to the authority of His parents to leave "His Father's business" and return home with Joseph and Mary.  As far as we can tell from Scripture, He continued His submission until the appropriate time.

As Mary tenderly cared for Jesus, she may have wondered how much of her instruction to her special child actually influenced Whom He was to become.  This would be especially true if she understood He had always been, and that this God-Child, would develop into the God-Man, and that His essence was God.

When the woman listening to Jesus in this passage blessed Mary, Jesus responded with a profound truth.  While no one else could better appreciate human milk, breastfeeding, and Godly mothering than the Creator, Jesus pointed out something much more important -- and more life sustaining. 

As God incarnate, Jesus' true life essence was, and is, Divine.  It is eternal.  The book of John Chapter 1 describes Jesus as the Word.  He spoke the world into existence with His Word.  He and His Word are the source of true blessing.  He, as the living Word, became flesh (i.e. "human") for the purpose of reconciling us to God. 

Obviously, I am very supportive of breastfeeding.  It is part of my life's work to do what I can to educate women, health care professionals, and others about the health benefits for mother and baby.  It's impact on our health, the health care system, and society is enormous.  God, in His sovereignty, has raised up people from all walks of life to serve in volunteer organizations, health care professions, and on a one to one basis to "promote, support and protect" breastfeeding.  It is a necessary work.  It is a good work.

However, a verse like this puts it into perspective.  Human milk supports optimal physical growth and health.  Babies and women are blessed through breastfeeding.  Babies are also blessed by good mothering, no matter how the baby is fed. 

The Word of God supports the spiritual growth God wants for us.  The greater blessing comes from our obedience to God's Word.  Breastfeeding, along with good mothering, blesses our lives on Earth alone.  Knowing and obeying God's Word blesses our lives on Earth and for eternity in Heaven and on the New Earth.

Does this mean that, as Christians, we will always obey God because we are "good"?  The answer is "no".  As long as we are on this Earth we will be fighting the sinful desires of what Scripture calls the "flesh". (Romans 6 and 7).  Yes, God makes us "new creatures" in Christ at the time of our salvation (2 Corinthians 5:17).  God, the Holy Spirit comes to live within us.  God's Spirit enables us to follow Him and obey Him when we submit to that enabling.  But so many times we don't submit, and we disobey God.

The difference with Christians is that sin bothers us.  We don't like it. We are enticed to sin, but we don’t like sinning.  True believers will at some point turn back to the Father and confess that sin.  Sometimes it is immediate; sometimes it takes much longer.

Our spirits are grieved when we sin. We can go back to God in prayer and tell Him we are sorry that we sinned and ask for help in breaking that habit or tendency, or not repeating a single offense.  We are sinners by birth, but we are saved by grace alone.  We don't deserve it.  We did nothing to earn it.  It is only by God's grace, or mercy, that we have come to understand that we even needed a Savior.

Now, when we disobey God's Word, we have the privilege of knowing that when we confess it to the Lord, He assures us of His forgiveness and the sweet father-child relationship is restored.

My son, a minister, describes it like this.  In a way, Christians are like three year olds.  We are trying to do things our way, yet we are being told by our loving Father not to do some things.  Sometimes we are told TO do some things.   Both are for our own good.  When we disobey, God lets us know we did not obey, as a caring father of a three year old would do.  If we continue to rebel, loving discipline will follow.  If we go to Him with remorse and desire to "do better", He, like a good Earthly father, will assure us that He understands.  He shows us He will help us.  He confirms that He loves us.  We are assured of His forgiveness.  As we continue to grow toward spiritual maturity, we will struggle less with the “former”  things.  Our lives will begin to look more like that of His Son, Jesus.

Sometimes, God allows us to see just what we are capable of doing, and just how much we really need Him to help us not succumb to temptation.  We can even be surprised at what we might do in a certain situation.  King David would never have thought he would commit adultery and murder . . . but he did.  He tried to hide it, but God finally forced David to deal with it.  At that point, fellowship between King David and his God was restored.  Still, there were natural consequences which afflicted David the rest of his life.

Sometimes, God extends great mercy.  We learned our lesson.  We abandoned the sin and are determined to never do it again.  God may deem that the guilt and stress we suffered because of that sin is enough punishment or consequence of the action.  We can rejoice in mercy.  Our love for Him grows because we recognize that special mercy.

Sometimes, however, God must provide a discipline so great that it breaks any and all allure that sin holds for us.  Such discipline can be very painful.  Yet, even then, God is available to forgive and comfort.  He can, and often does, use that failure to accomplish His plan in our lives and in the lives of others.  He is able to use our failures and restoration to bring blessing to others and to bring glory to Himself.  This, too, can cause us to love Him more.

God knows that His way is best for us.  We receive the most blessing in life when we obey Him.   There is no guilt.  There is no stress which results from the disobedience.  There are no unwanted consequences.  On the positive side, we experience joy and even tangible blessing because of our obedience.

Finally, in heaven, there will be reward for how we served our King based on the motives for our service and obedience to Him. 

The effect of breastfeeding for the baby and the mother is lifelong.  The effect of obeying the Word of God is eternity long.

That is why Jesus told this woman "Blessed rather are those who hear the word of God and keep it!". 

Duped

"I feel like I was duped."  This is what my friend, now retired, told me.  We had been discussing this blog, her birth experience, and her experience with infant feeding. 

She was a pioneer for her time with regard to childbirth.  Even with a posterior presentation, which caused a very long "back labor", she waited for a couple of days before she had an epidural and forceps delivery.  She had told the nurse and doctor she was going to walk during labor, and all those things which were pretty radical back in the 70's, after the advent of the fetal heart monitor.  She did not know about positions which would encourage the baby to rotate.  She just did what she could until the doctor told her "it's time".

Her decision of formula feed was due to the fact that she was educated by the health care professionals that formula was just as good, if not better, than breast milk.  This woman has, throughout her life, done everything possible for her son.  I have no doubt she would have breastfed after returning to work had she known it was even possible.

We discussed the health care system in general and the changes (good and bad) which have occurred over the years.  I, too, was not told of the long term consequences of epidurals which led to forcep deliveries.  Knowing what I know now, I would avoid one unless it was proven to provide much more benefit than risk in the situation.  Others may choose differently.  All of us deserved and deserve to know the pros and cons of any medical intervention.

My friend has rheumatoid arthritis.  Of course we did not know way back then that breastfeeding reduces a woman's risk of developing this auto immune disease.  I deal with physical issues resulting from the forceps delivery.   We can not say we would NOT have any of these health problems if we had made different choices . . . but we still wonder what life would be like if we had known the risks and benefits of those choices and took a different path.  Might things have been different?

But, as "old" women, and as believers, we have learned to leave the decisions we made, and their short and long term outcomes in God's hands.  We can not change the past.  We can trust God to use the results of those decisions to His glory.  We have learned to depend on Him for strength through the tough physical times and the surgeries. 

And, we now tell younger women about the risks of routine medical interventions and of formula feeding.  We do not want other women to say at some point in the future "I feel like I have been duped!"

 http://www.scienceworldreport.com/articles/11993/20140107/study-links-breastfeeding-to-lower-risk-of-rheumatoid-arthritis.htm