Tag Archives: being a mother

Breeching Protocol (a birth story)

Breeching Protocol

by Rebecca Kuder

(An abbreviated version of this essay was published in Midwifery Today, Issue Number 106, Summer 2013.  Following is the essay in its entirety.)  

The nurse couldn’t find my cervix.

What was I doing here, in this medical factory?  The Plan had been to have a natural birth, at a birth center, assisted by a midwife, with support from my husband and doula.  But circumstances changed the plan.

I was 41 and pregnant for the first time.  Forty-one is considered advanced maternal age (AMA) by the AMA (American Medical Association).  AMA also means “against medical advice.”  Like, for example, when someone leaves the asylum without benediction of the medicos.

Convention pushes against natural birth.  When I told my previous obstetrician I was interested in the natural birth center connected to the hospital where he worked, mentioning water birth, he laughed and said, “I don’t have waders!”  So I left him and met the birth center midwives, who were in practice with an enlightened OB, Dr. Stephen Guy, and hired a doula named Amy Chavez.

* * *

Pregnant women are fed on fear.  Browsing at Barnes and Noble, I saw more books about miscarriage and loss than about healthy, natural pregnancies and birth.  Anxious and mildly obsessive by nature, now I was pregnant with the scarlet “AMA.”  But instinct told me to avoid too many books and late-night Internet searches.  After reading a few customer reviews of What to Expect When You’re Expecting, I saw a reference to Ina May Gaskin’s books.  Spiritual Midwifery eclipsed the scary images of birth that are splattered across mainstream TV and film.

* * *

Against type, I cultivated the ability to relax, indulging in massage and prenatal yoga.  I paid attention to my thoughts, challenged my fear and negativity.  With my doula, I acknowledged terrors, dispelled some anxiety.  I wanted to prepare for anything, but knew I had to quiet my obsessions about how things could go wrong.

That year, I was taking a class called conscious living/conscious dying, which was about preparing to die, and how to live more fully.  We discussed pessimism: the way people assume something will be hard, or impossible.  Instead of approaching birth with the assumption of difficulty, the teacher suggested I consider, “how easy this will be.”  I drew a ten-centimeter circle and focused on it, visualized opening.  I read that what we believe about breastfeeding (and whether or not we can easily nourish our babies) affects milk supply.  Applying that notion to birth, I did an exercise from Birthing From Within.  I drew pictures of what I thought would happen, and what I wanted to happen.  Before thinking, I drew the picture of what I thought would happen: the baby was head-up.  A breech baby.

* * *

To each prenatal visit, I brought a list of (obsessive) questions.  “What if the baby is breech?”  I asked Dr. Guy, during my second trimester.

“Don’t worry about that now,” he said.  But because I hadn’t “proven” I could give birth, I probably wouldn’t be “allowed” to do it naturally.  I had learned to trust Dr. Guy.  I knew he supported natural birth if he thought it was safe.

When I was 33 weeks pregnant, our daughter hadn’t turned head down yet.  Only about three to four percent of babies are breech after week 37.  By week 37, she still hadn’t turned.

Breech babies’ heads comes out last–trouble if the head is too large.  There is also the risk of cord prolapse–the umbilical cord is squeezed, limiting the flow of oxygen and blood to the baby.

Dr. Guy tried to turn the baby from outside my belly.

I breathed deeply.

“You’re a good relaxer,” he said.  But she wouldn’t turn.  He smiled and said, “She’s stubborn!”

We scheduled an external version–in the hospital “just in case” I went into labor, or needed an emergency C-section.  Then Dr. Guy hurt his back.  Could I trust another doctor, relax with a stranger?  And if it worked, I would have to wear a girdle so the baby would not turn back to breech.  This sounded medieval.  If I waited to go into labor, the baby might turn at the last moment, allowing a vaginal birth.  This happens.  Or I could schedule a C-section.  In my desire to avoid surgery, I left the question to time and nature.  Caesarian sections are chillingly common nationwide, comprising about 23% of all live births in Ohio.  When necessary, medical interventions can be essential and lifesaving.  But I wanted a natural birth.

Why hadn’t the baby turned?  Perhaps there’s a good reason she’s breech, I thought.  “Trust your instincts,” I told her, “If you need to be born breech, it’s okay.”  In the meantime: inversions, moxibustion, visualization, and chiropractic.  Fetal speakers placed low on my pelvis, my husband Robert and I played the Ramones, and Elvis Costello, trying to snake-charm her to turn.

Because the baby was in the frank rather than another breech position, Dr. Guy didn’t consider a vaginal birth prohibitively risky.  He learned we had great support from our doula.  He respected our commitment to natural birth.  I was lucky.  Dr. Guy was one of the only two “old school” doctors around who still supported vaginal breech birth.  Medical students don’t learn this stuff anymore.

I’d have to go to labor and delivery, not the birth center.  This was disappointing.  Labor and delivery was just a few turns down the hall, but miles away in enlightenment.

“And,” Dr. Guy said, “The best thing you can do is come to the hospital at eight centimeters dilated, and have labor progress smoothly.”

No problem.

* * *

A week after my due date, midmorning, mild cramps began.  I ate a sandwich.  Robert made final corrections to a collection of short stories and sent them to his publisher.  After lunch, I rested in bed.  The contractions strengthened.  Over the phone, Amy suggested I rest and eat, reminding me that early labor can last a while.  I called Dr. Guy.  Five minutes apart, my contractions were still pretty mild.

Around dinnertime, Dr. Guy called to check my progress.  He said to come to the hospital when my contractions were 2-3 minutes apart and I had trouble walking or talking.  About ten o’clock, Amy arrived, and gave me a massage.  Robert, always a counterbalance to my anxiety, seemed calm.  Home was a cocoon, safe, peaceful.  Though we forgot to take photos, fixed in my mind are the winter night shades of our living room, the heart of our house, dark purple sofa, woodsy trim, and my deep red nightgown.  Time was velvety, as we three steeped in this mystical stew of hushed intensity.  Wrapped in the purple-striped shawl my mother had knit, enveloped with warmth and maternal love, I was aware of this special thing happening, expectation, a quiet gem waiting, waiting.  The night was thick and dark as my pain swelled and subsided.  I moaned, trying not to wake the others as they napped.  In bed, during contractions, Robert pressed his knees into my back to relieve pressure.  Amy reminded me that each contraction, each specific moment of pain, would never return: once a contraction is over, say goodbye, let it go.

* * *

Around six a.m., everything intensified.  Was it time to go to the hospital?  Amy suggested I take a bath, then see how I felt.  She explained what to expect at the hospital–answering intake questions, being admitted to labor and delivery.  Within reason, the longer I could wait, the less chance my labor would stall.  The more chance of birthing naturally.

Amy said giving birth was the hardest thing I would ever do.

Daylight finally came, and with it, more optimism.  Robert made hash browns and a goat cheese omelet; all I could eat were small bites of toast with almond butter.  I drank a little cocoa.  I went to the bathroom and bled, tangible proof of what was happening.  Progress.

By one p.m. on Sunday, about twenty-four hours after the stronger contractions had begun, we decided to go to the hospital.  After weeks of dress rehearsal, I put on my birth bracelet, each bead given by a friend, colors spangling my wrist with love.

The nurse who couldn’t find my cervix summoned another nurse who could.  She said I was eight or nine centimeters dilated.  (As the doctor ordered!)  Although the nurse offered a wheelchair, I walked to the birthing room.  Because I was Group B Strep positive, which means there was a slight chance of passing it on to the baby, protocol necessitated IV antibiotics.  And, though the nurse knew I wanted a natural birth, she said an intravenous site was necessary just in case I wanted pain medication.

It seemed the nurse was waiting for me to break, and scream out for an epidural, like a clichéd movie scene.  I touched my birth bracelet.  The Mylar hospital wristbands clashed with the multicolored beads, juxtaposing the medical and the beautiful.

Labor was nine additional hours of breathing, working, chanting ohm…I laughed, wondering what the hospital staff thought of our hippie circle of three, almost four.  After I’d been pushing for a while, Dr. Guy broke my water to relieve the pressure.  Hooked up to IV saline and monitors, I tried lying in different positions.  Amy was benevolence embodied, contrasting the bossy coach nurse.  I focused inside, and bid good riddance to each contraction.

The nurse yelled:

“Don’t give up!”

“Push my fingers out!”

“Show us what you got!”

“Just get around that corner!”

Is there a corner somewhere inside my body that I didn’t know about?

With false sincerity, she said, “I know, I know,” but without much credibility.  Yelling, “Push!” at a laboring woman does not to help open the birth sphincter.

I wish I’d told the nurse that words have power and hers were not helping.  I formulated sentences in my head, ways to tell her, but it seemed pointless.  Her hand was inside my body and my daughter needed to be born.

Amy, who had a great working relationship with Dr. Guy, cornered him in the hallway.  She told him I’d probably kill the nurse but that I’d be able to birth this baby naturally because I trusted him.  If he recommended a C-section, I’d believe him.  He returned, which was reassuring, though the nurse was still in the primary spot between my legs.  But having Dr. Guy there, touching my arm, smiling, helped me feel safer.  I’d come to trust his voice, his round, childlike face.  His presence soothed like sunshine.  Later, I learned this was unusual–the OB usually arrives just in time to catch the baby.

I was exhausted.

Robert joked about a contortionist who squeezed himself through the head of a tennis racket.

Robert gave me water when I was thirsty.

Amy helped me find breath.

I thought, “This would be okay if not for the heartburn!”

I only recall feeling fear once: during a very strong contraction, as I was chanting ohm, my voice wavered.  Chanting had become my buoy, bringing focus, and when that faltered, my head dipped underwater.  But somehow I knew I would be okay.  All the women who’d ever birthed helped pull me through.  I never doubted I could do it.

* * *

Somewhere in the cascade of pushing, a new nurse arrived; the first nurse’s shift was over.  Gentler, wiser, the new nurse suggested different positions.  But the first nurse stayed, wanting to see the breech birth.

Even Dr. Guy, a valiant proponent of natural birth, would have recommended a C-section after two hours of pushing, but he had to go catch another baby.

Many women describe the moment of birth as feeling split in two.  The description fits.  I pushed, pushed, pushed…I’d been pushing for four hours; strangely, it didn’t seem that long, yet each breath and each movement of muscle was eternal.  The baby must be partially out–she must be.  But she was still inside my body, and there was more work to do.

When the baby was finally ready, we moved to the operating room…protocol, “just in case.”  By then, I knew I’d push her out naturally.  Someone asked if I wanted to touch her when she was crowning, or in her case, butting.  I didn’t, I couldn’t, it scared me; I needed to focus on my work.  But a few pushes later I put my hand between my legs.  I felt her emerging.  My body had been changed for months by her body, but now here was her form, blossoming.  I felt the force of her, almost here, and I felt gravity, and I felt the world.

And then Merida was born, though we hadn’t named her yet.  Dr. Guy lay her on my belly.  She was sweet and slippery and new, and she was our baby, and writing this, and thinking about that moment makes me cry.  As memories fade or are immortalized into story by retelling, I don’t want to forget the sensation of her slick little body on mine, us, finally together, skin to skin.

They put a striped hat on her head, and a warm blanket over us.  She was fine and I was fine and it was amazing and wonderful and I was so glad to be done!

The placenta came out, and Dr. Guy said I’d torn a little and needed stitches.  I don’t recall feeling pain then: in our weary celebration, I was experiencing a metaphorical orgasm.  She was here.  We were done.

* * *

While they wheeled me back to the labor room, I told Dr. Guy how grateful I was that I’d been allowed to do this.  He’d forgotten my age.  Amy stayed for a little while but needed to go before she was too tired to drive.  The three of us had summoned this power, formed a circle of humor and love and rubber-band-bonded-glue-team: mama, papa, and doula, a family, in a way.  There was a new hole, with Amy gone.

Before we were transferred to postpartum, the new nurse asked me for a hug–she said I’d made them all look good.  I was glad people were impressed with how hard I’d worked.

As I think about enduring a breech birth without medication, with very little fear, two clashing facts seem crucial: 1) It will hurt; 2) Our bodies are made to do this.

Support from Robert and Amy, laboring at home, and the Ina May energy embodied in my birth bracelet gathered to protect me from the harshness of the hospital IV jewelry and what it represented.  Dr. Guy was experienced and comfortable–accepting breech as another normal (if rare) birth position.  A warm, caring, giant-hearted man, he wanted the birth we wanted.  I’ve since learned more about the AMA (American Medical Association, in this case) and their vast lack of support for natural birth.  Envisioning how hard it must be for Dr. Guy to work in this context, my gratitude to him is ever-deepening.  And as one of the midwives had said, they’d had several “good” breech births recently.  Unwittingly, the other woman whose baby Dr. Guy had to go catch gave me more time.

I was lucky to have these people help me birth my daughter.

I had no reason to believe I could do it.  I let go.  I trusted that I would have medical help if truly necessary.  Amy was my fierce angel.  Robert never faltered; he was completely present and real throughout the whole adventure.

As a 41-year-old first time mother, at this point in the history of birth, having my breech baby naturally felt like a victory.  My baby and I worked together: to/get/her into the air, healthy and whole.  Because I’d advocated for myself, and the birth was so powerful, I entered motherhood clearheaded and victorious.  Strong.  Like a warrior goddess.

Women’s bodies are made to birth babies, including breech babies.

My story should not be so unusual.

 

Advertisements

Essay at Tiferet Journal!

IMG_20170805_110509302

(un-edited, sweaty, post-Zumba author photo/selfie.)

I’m thrilled to announce that my essay, “(Perfection) DEFECTION” was published in the summer issue of Tiferet JournalYou can read the essay by clicking on the link below. Please also consider purchasing the full issue for $4.95 through Tiferet’s marketplace.

This essay grew from a rant I wrote and performed at Women’s Voices Out Loud in Yellow Springs, Ohio in 2016. (You can read more about Women’s Voices Out Loud here.)

I’m grateful to Gayle Brandeis and all the good people at Tiferet for the opportunity to share this piece, and for the work they are doing in the world.

Enjoy!

Kuder-TiferetSummer2017

Open letter to my daughter

img_0818

January 20, 2017

Dear Merida,

Today, I’m knitting the last of three black wool pussy hats for friends who will travel to Washington DC to the women’s march. Today, for a few more hours, Barack Obama is president. I’m grateful that he’s been the only president you’ve know in your lifetime thus far. I’m sad to see him go. No one is perfect, but he has been a wise and compassionate leader. This morning when I put on my Obama tee-shirt, you said you’re sad for your friend. When I asked why, you said because her birthday is the day after Trump moves into the White House. I said no, he can’t ruin our parties! I said he’s not that powerful.

Here’s what else I want to say to you today: There are so many ways to make the world better. Some ways are to listen to other people, to be kind, and thoughtful, and maybe most importantly, to be fair. To realize that we all deserve to be free, and to work to make that happen. When we see something that isn’t right or fair, we speak up and make it better. If you keep these things in your mind and heart as you grow, if you keep paying attention to ways you can make the world more kind and fair and just, you will make the world better. No one can ruin the party of the world that you and your generation are creating. You know that song we sing, the one that goes: “A woman who loves herself, though she may be shaken, a woman who loves herself will never fall.” The beautiful world we are creating is the same as that woman. We do create the world, all of us, each of us. If we fill it with fairness and compassion, even when it is shaken, it will never fall.

At the Women’s Park in Yellow Springs, along with many other friends and family, your name is on a stone, along with the words of Patti Smith: “The world is yours, change it, change it!” You and your generation will find, and will be, the leaders. You will continue making the world more fair and loving. All you need to do is keep listening, and trust what you know in your bones: that we all deserve to be loved and free.

I have infinite faith in you and your generation. You are strong and mighty. Your hearts are brimming over with love, and your voices resonate.

Use your strong hearts to keep shining the light of love and compassion outward to all.

I love you,

Mama

The Normal Magic of a Place (on the Antioch School)

tattoo

Peter breaks through (from Peter and Wendy, by J.M. Barrie; illustration by Lucie Mabel Attwell)

In perusing the Antioch School’s website this evening, I noticed that a piece I wrote awhile ago about the importance of story had been posted there. The memory of that time provided uplift for me just now, so thought I’d share it here.

Uplift is nice.

 

A song I am praying for Hillary Clinton.

IMG_0368.jpg

I sing this song often. I sing it in my circle. When I sing it, it is sometimes a balm, sometimes a war cry, sometimes a dirge for some part of myself, or a blessing, or an encouragement for someone who needs to remember what is waiting inside her, and has been, all along.

It goes something like this:

My sister, pick up your power. 

My sister, claim your voice.

Remember those gone before us.

And pray for those yet to come.

Today I am singing it for Hillary Clinton: May she pick up her power, claim her voice, remember those gone before us, and pray for those yet to come.

May she plant her feet firmly in the ground, feeling the connection to Mother Earth.

May she feel the strength of the ancestors in her bones.

May she sing the songs of peace and protection that are in her to sing.

May she access all her selves, and even discover new ones: mother, warrior, peacemaker, human.

The Climber (an old poem)

IMG_0281

 

When my daughter was four months old, I wrote a poem called “The Climber” which was published by Mothering Magazine in 2008. Because the magazine is now defunct and the poem is no longer archived online, I’m posting it here so I can share it with a Facebook friend.  (p.s. I always feel vulnerable when I put a poem out because I’m not a poet. And because this is old, I want to edit and make it a better poem, but I’m not going to tinker right now, and instead just share it. A new mother of my acquaintance describes how her baby and her body intertwine as they nurse, and when I think of that, I zoom back to those raw, free-falling moments of early motherhood, when the tiniest thing seemed also like the biggest thing, and vice versa, and I was so sleep deprived and confused, who could even tell the difference. I remember how hard that time was, and now just want to stand in the swirl of those complexities and say to anyone in the midst of any of it: you are not alone.)

***

The Climber

 

When I was twenty-one,

I went rock climbing in the Clifton Gorge.

 

The leader held up

a bandanna,

said:

we could use it

to climb

blindfolded

if we wanted to.

 

Late in the day, I decided to try.

 

Belayer below me,

blindly I climbed,

finding foot holds

by braille.

 

Later the other women said I’d picked

places to support me

I wouldn’t have chosen

with my eyes.

Crevasses chosen by touch, by feel.

 

Twenty years later, the rocks in the Gorge are off limits

to climbers–

there were accidents,

people got hurt

or worse.

 

So I hike there,

carrying you,

and find columbine in the rocks

I climbed before.

 

And at night, when you nurse beside me,

eyes closed,

your tiny toe finds my navel.

 

Okay, you be the climber,

I’ll be the rock.

Trust your toe holds,

don’t fall,

don’t fall.

And if you fall,

I will catch you,

breech baby climber,

head up.

 

Little rock climber,

four months ago,

you were on the other side of my belly button.

Your hand grips my thumb now

like a walking stick.

 

You came from here.

“How not to buy more babies”

Photograph of three dolls

Left to right under Merida’s arm: Big Baby (note 99 on foot); Sasha, Gregor.

In my computer files, today I found something I had written in June 2011 for one of my daughter’s caretakers. The title of the file is “how not to buy more babies.” Good timing. Last night my husband and I were reminiscing about one of our daughter’s babies which we called “Big Baby.”  Big Baby was purchased from a thrift store in Dayton when my very young daughter fell in love with the hunk of plastic and wouldn’t leave the store without her. Big Baby had “99” sharpied on her foot, because she cost 99 cents. A while later, my daughter agreed to pass Big Baby along to another family. I found a photo of Big Baby with the Sasha dolls from my childhood, and my daughter having a drumming circle with them. Here are my instructions about how not to buy more babies:

We’re working on some population control strategies for the baby dolls in our house. I know it’s hard to say no to her, but this has worked for me:

If she asks to go to the toy store, offer another option, another place to go, like the playground. If she is insistent, say you will take her to the toy store and get her a balloon, she can choose whatever color she wants, but not a baby. This works best if you talk about it before you are there. When you get there, if she grabs and wants a baby, tell her what a nice baby that is, but that baby is for someone else, and that she can come back and VISIT the baby at the store again sometime. (And by the way, what color of balloon would she like?)

There are several reasons we want to control the number of babies in the house:

  1. She has plenty already. There’s too much stuff on the planet and in our house.       We want to teach her that she doesn’t need more and more stuff to be happy. She already has so many other babies that she loves, etc.
  2. For her 4th birthday, we will get her a very special baby, and we want her to understand the idea of quality over quantity.
  3. Also, we want to start teaching her about the value of money. We’re trying to find her a good piggy bank so she can start saving money toward things she wants, so she understands the value of saving and choosing carefully.

With your blessing, we are going to negotiate that some of her babies might come stay at your house, so she will have some other little souls to take care of over there. :)

 

Anyone can fly

 

Betty Bronson_Peter Pan

Betty Bronson as Peter Pan (with shadow)

M, age 8: Will you make a Peter Pan costume for my Finn doll?

(She had me at Peter Pan. She had me at herself, actually.)

I made the thing; tiny green sock-scrap leaves sewn on tiny beige sock-scrap shirt, a messy torrent, surpassingly cute. And then I reminded her that Peter Pan is often played by a woman. That anyone could wear the costume. It was silent for a moment, as it often is when she’s thinking, and then she said, actually, her girl doll A. will probably wear the shirt every day, because of her dolls, she’s the most adventurous and flexible…

And this is how we raise them, how they lift off despite gravity, and perhaps even fly…

 

(Unfinished post about) Hello Kitty

IMG_6471Cleaning up my computer desktop, I found this fragment, written in autumn 2012. I am leaving it unfinished because time has passed, and I no longer have that authentic fire to finish it (=my daughter has moved on), but it still seems relevant.

Why I hate Hello Kitty

  1. She has no mouth. (A friend pointed this out to me. My friend was disturbed because her daughter was interested in Hello Kitty, but Hello Kitty was physically incapable to speak, eat, laugh, or sing. The idea came up to draw a mouth on Hello Kitty, but the challenge becomes how to reach every Hello Kitty in the world? It turns out that someone has written a poem about Hello Kitty’s lack of mouth. http://www.queeg.com/hellokitty/)
  2. Hello Kitty causes an otherwise pleasant four and three-quarters-year-old daughter of mine to whine, yell, and sob when I don’t cave in and buy an emblazoned purse at Target because she had already chosen her “impulse buy” (a pink scraper with a pig head on the handle!) at Bed Bath & Beyond. (And this from a child who can usually be re-directed away from whining for plastic crap.)
  3. It’s impossible to avoid the Hello Kitty aisle at Target: THAT CAT IS EVERYWHERE!

Long live the book (and long live the conversation)

from Peter and Wendy, by J.M. Barrie (illustration by Lucie May Atwell)

from Peter and Wendy, by J.M. Barrie (illustration by Lucie May Atwell)

Here’s a NY Times article that brings up some more questions about where and how we should read to children, and whether any reading (on an e-reader, for instance) is better than nothing.  (The brief answer:

“What we’re really after in reading to our children is behavior that sparks a conversation,” said Kathy Hirsh-Pasek, a professor of psychology at Temple and co-author of the 2013 study. “But if that book has things that disrupt the conversation, like a game plopped right in the middle of the story, then it’s not offering you the same advantages as an old-fashioned book.”)

Again and again, what seems central to so much about how we live: being active (rather than passive) is almost always best.