To all the beautiful women in my life; my mother whose legacy continues to live on in my heart and children's single-dimpled sneaky grin.

To my aunts and cousins who are constant reminders of her love for me.

To my mother in-law who graciously and lovingly tries to love enough for two grandmothers and who has adopted me into her heart as her own.

To my dear friends who are more like sisters and encourage me to be a better mother and wife.

To my clients, who I've had the honor of witnessing become mothers for the first time or who have welcomed their seventh with still the same awe and wonder as their first.

To mothers who held their babies briefly in their wombs or arms, but forever in their hearts.

To the mother who has only seen her baby on the computer screen, adoption binder, or in her dream.

My prayer for you no matter if your baby is still being knitted safely and secretly in your womb, or growing in your heart across the globe, keeping you up at night as an infant or a teenager, through the icky and sticky, the heartaches and disappointments, the terrible twos and the tumultuous teens, the prodigal son (or daughter), or the boomerang kid who can't seem to find his way-
  is that you will feel encouraged, love, joy, support, hope and peace in your heart and in your mind.

Blessings,
Natalia

“Induction of labor is like pushing a parked car up a hill. It requires a lot of help, hands and/or machine (tow truck). ”

There are many reasons a woman may be admitted to the hospital for an induction; past expected due date, pregnancy-induced hypertension, spontaneous rupture of membranes without labor and just because. As you can see most of these reasons are perfectly valid and are most likely for the best interest of the mother and baby. However, there are 2 reasons in particular I have seen take place for convenience or according to the doctors or hospital policy, not necessarily because the mother and baby were in any danger.

The Estimated Due Date Myth

Most women do not know when they ovulated, therefore conceived so the common method is based on your LMP (last menstrual period). The problem with this method  is you may have been told that you ovulate or are most fertile on day 14 of your menstrual cycle, mid-cycle or even 14 days before your period is expected. These are myths. While this may be the case for some women, it may not be true for you, even if your cycles are regular. Your own fertility pattern is unique to you and unless you observe and chart your cycles your estimated due date can be off by as much as 2-3 weeks.

When we are given a due date (even on the basis of it being just an estimate) we hold on to it as if it is in stone. We watch the calendar and check days off and the closer we get to it with no sign of labor starting we panic. Not to mention the annoying phone calls, emails and now texts from well meaning and loving family and friends asking, “Have you had the baby yet?” If you happen to have a doctor who has a vacation coming up or who “doesn’t like to see their patients so uncomfortable”, that’s a lot of pressure for an expectant mother.

“One of the biggest obstacles to natural birth is misunderstanding your "due date." A due date does not mean there is only one safe day for your baby to be born. It is meant to establish a range of time that your baby is mature and safe to be born. Because modern obstetrics narrows this to a specific day, unnecessary interventions, like inducing labor, come into practice.” Mothers Naturally

“Is this baby ever going to come?”

These words and thoughts may start to be uttered days before the estimated due date. But we have forgotten one thing, it’s an estimation.

Sometime we are literally evicting the baby before he/she is ready. There are many things that need to come together for true labor to begin. It is not just about jump starting contractions. When we begin to play with nature and its timing there is no wonder the snowball effect of interventions begin. It’s almost like our bodies are saying, “I wasn’t ready but since you are trying to make it happen you are going to have to finish it”. That is exactly what happens.

 “Pitocin is like normal contractions on steroids”

Oxytocin is a natural hormone produced by a woman's body that cause uterine contractions, when her body and baby are ready. Pitocin is the synthetic form of oxytocin. Pitocin is generally used in two ways: 1) to induce labor, and 2) to augment (speed up) labor. Pitocin is supposed to be used to induce labor or increase the strength or duration of contractions for the health of mother or baby.

Oxytocin, your body's natural hormone, is secreted in bursts. However, when you are given pitocin you are placed on a regulated intravenous pump, to regulate the amount of pitocin to a steady flow. Therefore, pitocin induced contractions are different from your body's natural contractions, in strength and effect. (For more detailed information on Pitocin FAQ )

This domino effect, I have unfortunately seen more than once, has a higher chance of ending with a c-section. The mother wonders; how did I get to this point, what went wrong, did my body fail me? I have been in these moments; it can break your heart to witness.

Are there times when inductions are needed? Absolutely, and when they are done during those times can give a mother and child the best outcome. However, similar to c-sections, it can be a matter of convenience and control and less about a woman’s ability to labor successfully on her own.  “In a well-nourished, low risk pregnancy it is normal for your baby to be born between 37 and 42 weeks gestation*. Many natural events take place within your body during the last weeks of pregnancy to prepare you for labor. Allow time for the natural process to occur.”

I would like to encourage mothers to-be and their providers to 1) allow nature to take its course which will require some patience, 2) if assistance is needed to consider all the options, pros and cons of induction, 3) consider alternatives to start and augment labor.

To induce labor:

• Walking
• Nipple Stimulation
• Intercourse (Only if the bag of water is intact.)
• Enemas
• Castor Oil

Augmenting Labor:

• Walking
• Change positions
• Avoid exhaustion
• Nipple stimulation
• Employ a professional labor support person

Do not be afraid or intimated.

Ask questions about what is being suggested. Ask why, are there any alternatives and what are the pros and cons. When we want someone to do something we tend to glorify the benefits and downplay the risks. This is a time you want to know (equally) both sides of the coin. If your doctor seems impatient or acts as if your questions are stupid or annoying (I’ve seen it) in the middle of labor (especially an induced one) is not the best time to address your concerns. You may feel vulnerable, afraid and as if you do not have any choices, or that you can’t make the right one.

 

Resources:

Childbirth.org

The Doula Book

mothersnaturally.com

There are also times when when induction may be safer than waiting for labor to start on its own. Watch this informative video so that you can determine what is best for you and your baby. I'd love to hear your thoughts.

Last week my husband and I learned that the baby whose fall arrival we had so anxiously anticipated will not be. The process was all too familiar as we had just experienced it for the first time earlier this year. It was hard to be optimistic as we noticed the same pattern as our first loss. You notice some spotting, or maybe bleeding with or without  cramping and make the alarmed call to the doctor (or nurse) who tries to reassure you that it is not uncommon in the first trimester to have some bleeding. Their advice; try to relax, put your feet up, get some rest and try not to worry. Something doesn’t feel right, not just with your body but in your spirit. By the time you see your doctor you already know in your heart but it stings all the same to hear that what you are experiencing is most likely the end of your pregnancy. They run tests to be sure and tell you not to give up. Your symptoms are fading along with all of your hopes and dreams. All optimism is lost as you learn that the “pregnancy wasn’t progressing” or has ended.

“Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists (ACOG). Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage…Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed about miscarriage, in the unfortunate event that you find yourself or someone you know faced with one.” American Pregnancy Association

This is a loss, a real loss. Whether you had just conceived (chemical pregnancy), in your first trimester (miscarriage) or were in a later stage in your pregnancy (stillborn) the loss is as real as having had a newborn baby in your arms and to later lose them.

With every loss there is a grieving period. The length of the grieving doesn’t necessary depend on how far along a woman may have been and every woman will grieve in different ways as well. One thing that they will all share is the different stages of grief.

Stages of Grief:

·         Denial

·         Anger

·         Guilt

·         Bargaining

·         Acceptance

“A miscarriage takes away the pure innocence of pregnancy”. I read this comment on a pregnancy loss website the other night. The young lady who wrote it pretty much summed up how other women (including myself) may describe the emotional aftershock of a pregnancy loss.  This short sentence says so much and I didn’t understand it until I experienced it myself.

Instead of the heart racing excitement that once was, future pregnancies will be held frigidly in the heart. The “I won’t get excited until after the safe zone (first trimester)” technique will be applied for self protection. Every twinge, spot or loss of symptoms will be cause for anxiety. Fear lingers and every ultrasound appointment ends with a sigh of relief.  Between each doctors visit it feels as if you have been holding your breath since the last. Some may (try) to with hold any love toward the new babe as to lessen the impact of a potential loss. As if we can really do that. Yes, it is true that a mother and a baby are two individuals but as soon as we see the little “+” sign or “pregnant”, or the doctor confirms what your womanly intuition told you, you are hooked. From that moment the heart strings become entangled to this little one.

It’s not that the mother who hasn’t had a loss doesn’t experience some level of anxiety. On the contraire, when I was pregnant with my two daughters who are 3 and 12 years old now, both times I was so afraid of miscarrying them. I pretty much walked around as if I was holding china that I was afraid would easily break. What I am describing above is different. A previous miscarriage can almost rob the joy expectation of being pregnant from a woman.

Ironically enough after our news I have been contacted by two new potential clients for doula services. My daughter asked me if I was going to be okay with my two deliveries I have coming up in the next few weeks. She’s also observed me still researching and practicing my doula skills in between minor melt downs when the reality of what we are experiencing hits me like a tsunami. It’s a fair question that I didn’t mind her asking. The truth is, I’m not sure how I will feel in the next few weeks, next few months or due dates. When you consider that each month a woman has only a 20% chance of conceiving (who is purposely trying) it is pretty amazing. The fact that there is a about a 24 hour timeframe for a sperm to meet the egg and the uterine environment has to be just right, I still believe that every conception and birth is a miracle. I attended a birth a week after our first loss and it was almost therapeutic to take my mind off of myself and our loss and give someone else 100% to help them to bring forth their miracle.

 

(Authors note: This post was really written to encourage women out there who have and who will experience a pregnancy loss but also those who aren’t sure how to comfort them.)

Websites:

http://pregnancyloss.info/

http://www.americanpregnancy.org/pregnancyloss/mcsupportingothers.html

Books:

Empty Cradle, Broken Heart

Pregnancy After a Loss: A Guide to Pregnancy After a Miscarriage, Stillbirth, or Infant Death

Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss

A Silent Sorrow: Pregnancy Loss - Guidance and Support for You and Your Family

Grieving the Child I Never Knew

Something Happened: 
A book for children and parents who have experienced pregnancy loss.

We Were Gonna Have a Baby, But We Had an Angel Instead by Pat Schwiebert.