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.