Maternally Yours to Air Exclusive Interview with CNN Hero of the Year Robin Lim

Last night, international midwife Robin Lim was named the 2011 CNN Hero of the Year, accepting an award of $250,000 for her non-profit birth clinic Yayasan Bumi Sehat in Bali, Indonesia. Maternally Yours, Sarasota’s Conversation about Pregnancy, Childbirth and Early Motherhood, recorded an exclusive interview with Robin just days before her win, and will air the interview on Tuesday, December 13th, on Sarasota’s community radio station, WSLR 96.5 LPFM.

“To say I am thrilled for her is the understatement of the century,” says Maternally Yours co-hostess Ryan Stanley. “This win will make real change for mothers and babies in Indonesia and worldwide—mothers and babies will live and thrive because of this award.”

Since 2005, Robin Lim’s clinic Bumi Sehat (translated as Healthy Earth) has treated nearly 113,000 patients and delivered nearly 4,000 babies for free in Bali, where rates of postpartum hemorrhage and maternal and infant mortality are among the highest in the world. “Ibu” (Mother) Robin is a midwife, well-known author and talented poet who has dedicated the last 13 years of her life to this clinic, despite constant financial, cultural and geographic challenges.

“The earthquake that we just had last month…was big enough that we have cracks in the building. The floor started to rise up in one of the birth rooms because of the movement underneath the ground. About twenty minutes after one of our moms gave birth, the floor actually exploded,” Robin told Maternally Yours last Wednesday. “When that happened, I committed in my heart to winning. Should we be gifted that money…from CNN on Sunday night, it will go toward building that clinic.”

Speaking from the Texas home of her daughter Deja Bernhardt (who directed the film Guerrilla Midwife about Robin’s work), Robin told Maternally Yours how she was feeling en route to Los Angeles to find out if she would be named CNN Hero of the Year. “I would say that nervous is one good word; I think it’s because it’s so much bigger than me,” said Robin. “I feel like this is the time for people to come out and vote for the concerns of mothers and babies and children, and that woman-to-woman, midwife-to-mother model of care.”

And, for eleven weeks straight, people voted.

During her acceptance speech last night, Robin Lim made a tearful plea for the world’s help in reducing maternal and infant mortality.

"Today on our Earth, 981 mothers in the prime of their life will die—and tomorrow again, and yesterday," said Robin. "We don't even know how many babies are lost, but all of us can help change that. The very best way that I know is to support your midwifery to mother care, so that the midwives can help lower the risks of motherhood, and we can save lives together—mothers and babies.”

Robin Lim is a friend and listener of Maternally Yours, which seeks to educate and inform women and families about the options, support, and evidence-based best practices available to them in maternal-child healthcare. “What you’re doing…is an exciting thing,” said Robin. “In this day and age, we’ve lost that radio medicine. You’re bringing it back in a beautiful way.”

To hear the exclusive Maternally Yours interview with 2011 CNN Hero of the Year Robin Lim, please tune into WSLR 96.5 LPFM Tuesday evening, December 13, at 6:00pm. The program is also available via live streaming on wslr.org, and podcast at podomatic.com/profile/maternallyyoursradio. For more information, please contact the hostesses of Maternally Yours at MaternallyYoursRadio@gmail.com.

About Maternally Yours: Maternally Yours is Sarasota's Conversation about Pregnancy, Childbirth and Early Motherhood. The Conversation airs on Tuesday nights at 6:00pm on YOUR Community Radio Station, WSLR 96.5 LPFM. The hostesses of Maternally Yours are Cheryl Kindred, Carmela Pedicini, Ryan Stanley and Laura Gilkey. The mission of Maternally Yours is to educate and inform our community about the options, support, and evidence-based best practices available to them in maternal-child healthcare.

About Bumi Sehat: Founded in 1995, Bumi Sehat is a non-profit, village-based organization that runs two by-donation community health centers in Bali and Aceh, Indonesia. We provide over 17,000 health consultations for both children and adults per year. Midwifery services to ensure gentle births is at the heart of Bumi Sehat and our clinics welcome approximately 600 new babies into the world each year. For more information, please visit www.balibumisehat.org.

About WSLR 96.5 LPFM: WSLR is an innovative, listener-supported, non-profit, non-commercial FM radio station dedicated to serving the Sarasota community. WSLR features locally produced programming and presents cultural, artistic, and political perspectives currently underrepresented in the media. Our goal is to inform and empower listeners to play an active role in WSLR and in their community. WSLR’s programming promotes equality, peace, sustainability, democracy, and social and economic justice. For more information, please visit www.wslr.org.

Ina May Gaskin's Acceptance Speech: The Right Livelihood Awards, 2011

It is a great honor to have been chosen as the first midwife to receive the Right Livelihood Award. In accepting this award, I feel a deep sense of responsibility to my fellow midwives throughout the world. Most of us necessarily share an awareness of powerful forces that now threaten the continued existence of the profession of midwifery in many parts of the world.

Rates of cesarean section are rising rapidly in most countries, far beyond the upper limits recommended by the World Health Organization. As cesarean rates increase, rates of maternal death and serious injury rise as well, and women’s fears of birth increase. At the same time, time-honored knowledge and skills begin to vanish. I have visited private hospitals in Brazil where the cesarean rate was 95%, because women (and their doctors) had become so afraid of the normal process of birth that the cesarean became the default.

When surgical and technological interventions in birth become the norm rather than the exception, the profession of midwifery loses its basis for existence, and obstetrics itself no longer encompasses the skills and knowledge that were once considered essential competencies of the profession. I’m speaking of the skills and knowledge necessary for assisting vaginal breech birth, the birth of a second twin, the ability to manually assess fetal weight, to distinguish between normal labor pain and pain that warns of complication, to determine the position of the baby in the womb, to change it when it is unfavorable, and even to accurately diagnose pregnancy. To explain what I mean by this last-mentioned skill, we in the U.S. have already come to the point of discovering several cases of false pregnancies diagnosed only after a woman’s abdomen was opened for a cesarean, an order of mistake that could hardly have been imagined two or three decades ago, when physicians’ education in manual skills was still considered important. The shrugging off of traditional knowledge in the U.S. had progressed to the point that by the 1990s, the two major obstetrics textbooks no longer included any reference to the phenomenon of false pregnancy (pseudocyesis), even though it has always been known to exist in humans, as well as other mammals. Only a country which has become superstitious in its use of technology could imagine that the use of imaging technologies could eliminate the need for teaching traditional manual diagnostic skills and all of the phenomena that occur in women’s reproductive lives.

The history of birth in the U.S. during the 20th century illustrates well how essential a strong midwifery profession is if women are not to be held within a web of fear concerning their bodies’ supposed defects when it comes to giving birth. The elimination of the profession of midwifery in the U.S. in the early 20th century paved the way for a factory model of hospital-based maternity care that by the mid-century had two-thirds of all babies pulled from their mothers’ bodies with forceps. Such a radical overuse of forceps did not happen in countries in which the value of a strong midwifery profession was recognized. With no midwives present in hospitals to instruct medical students in the wise ways of nature, men with the least understanding of the conditions necessary for women to give birth in a humane way soon came to believe that birth was necessarily a brutal and bloody affair and that human females actually represented a serious failure on the part of nature – one that could only be remedied by routine use of technology and medication. Now the profit motive really began to emerge vis-à-vis birth, and fear, greed, and ignorance have combined to make a nasty brew, as well as a witch-hunt against midwives who work according to the rhythms of nature.

The belief soon grew that babies would be most safely born when the mother’s body was intentionally injured in order to free the baby, with the further rationale that such an injury would prevent worse injuries that would otherwise occur. Such myths, unfortunately, are perpetuated through Hollywood films, which usually focus on birth complications for dramatic value, while physiological birth is not depicted because of taboos against showing the relevant portions of the female body.

As one of the mothers who knew there was nothing wrong with my body and that the birth of my first child by forceps had been unnecessary – risky for me and my baby, with no discernible benefit, and psychologically harmful as well – I was left to find an escape route for myself for my next pregnancies. This dilemma prompted me to arrange for my own midwifery education (as I was unaware of that any other way was available), an arrangement that I was able to accomplish with the timely help of four physicians who also saw the need for midwives in our country. Free to learn from any sources I considered relevant, I learned from non-literate traditional midwives, from old books, and animals, as well as from kind physicians.

From the beginning of the Farm Midwifery Center, my colleagues and I placed women’s needs at the center of our policy-making and found that this way of organizing care yielded huge benefits for our babies as well as their mothers. We learned how to prevent complications by providing good antenatal care and we developed practical methods for preventing unnecessary cesareans and inductions of labor.

Looking around, I found some other midwifery services backed by supportive physicians in other parts of the world with outcomes that were nearly identical to ours. The midwives who worked with the late Dr. John Stevenson in south Australia, those who worked with Dr. Alfred Rockenschaub in Vienna between the mid-60s and the mid-80s, and those still working with Dr. Tadashi Yoshimura in Okazaki City, Japan, all reported cesarean rates well under 5% with good newborn outcomes – just like ours. This was especially interesting, since we hadn’t previously been aware of each other’s existence. Unfortunately, in each case, these physicians – instead of being saluted by their peers – were treated as if they were hopelessly out of tune with the times and therefore irrelevant. We need to honor these men, who are still writing and teaching anyone willing to listen.

Now that many industrialized countries are reporting cesarean rates of 30% or more, despite the fact that midwives have always been accepted members of maternity care staff, it’s important to recognize other factors that drive up rates of intervention in birth. Popular culture, the profit motive, fear, prudery, and ignorance all play a role and should be addressed.

What is often missed is that excessive cesarean rates have other negative consequences than the loss of midwifery and obstetrical knowledge and skills. Simply put, as rates rise beyond 15-20%, more women die from complications such as pulmonary embolism, infection, hemorrhage, and a sharp increase in placental complications in subsequent pregnancies. None of the countries with

the highest cesarean rates can report on low maternal death rates. This is especially true of the U.S., where women now face at least twice the chance of dying from pregnancy-related causes as their mothers did. In California, between 1996 and 2006, the maternal death rate tripled, with much of the increase being attributed to an excess of cesareans. Don’t expect the U.S. to report these telling facts with any accuracy, though, because the current lack of an infrastructure that requires and produces accurate and consistent reporting, and analysis of maternal deaths, means that the official maternal mortality figures represent possibly only a third to a half of the actual numbers.

To avoid facing the problems that we are now experiencing in my country, I have some recommendations to propose:

Countries with increasing cesarean rates should consider taking positive steps to reverse this trend, including stepped up efforts if rates rise about established limits. Midwives should be placed at the gateway to maternity care, instead of being introduced to women late in pregnancy and grudgingly if at all. This model of care recognizes that a woman’s confidence and ability to give birth, care for, and breastfeed her baby and the baby’s ability to feed effectively can be enhanced or diminished by every person who gives them care and by the birth environment. Because of this, all care given during the time surrounding birth should give the needs of the mother-baby pair precedence over the needs of caregivers, institutions, and the medical and insurance industries. Individual hospitals should consider implementing the 10 Steps to Optimal MotherBaby* Maternity Services (www.imbci.org).

Midwives must have an important say in the formation of maternity care policy. Care should be individualized and founded upon consideration and respect for every woman. When not under

threat of a dominant medical profession, which is itself dominated by a powerful insurance industry or a powerful hospital industry, midwives can provide care that is organized around the principle that women’s and children’s rights are human rights and that access to humane and effective health care is a basic human right. Independent midwives must be able to make a living from their work, which means that insurance companies should not be permitted to charge such high premiums that it becomes impossible for them to make a living.

We must wake up to the fact that it is easy to scare women about their bodies, especially in countries in which midwives have little or no power in policy-making, relative to physicians and the influence of large corporate entities. This takes no real talent. Given such imbalance, fear, ignorance, and greed begin to reinforce each other, and rates of unnecessary intervention soar, with women and the babies suffering the consequences. Birth care must not be profit-driven. This makes incentives to cause problems, not prevent them.

For this reason, there should be no more fee-for-service payment – for instance, financial reward for the unnecessary use of a vacuum extractor.

If all countries put the welfare of mothers and babies at the center of maternity care policy, midwifery would have to grow strong again. In some countries, such as my own, it will be necessary to greatly increase the number of midwives as just one of the ways to prevent complications and to reduce rates of medical intervention in birth. We’ll need lots of doulas as we make this transition. Midwives need to have a say in the major issues surrounding birth. In countries where they currently work under the intense domination of obstetricians, the work will be to bring the relationship back to one of balance. Midwives cannot allow obstetricians to bully them, because doing so is almost certain to mean that laboring women will be the next ones to be bullied.

Attempts to make home birth illegal in any country will only distract from the real problems and exacerbate them, since planned home birth for healthy women provides a necessary safety valve for women who want a wider range of choice than their hospital might offer and a learning opportunity for midwives to learn about women in their natural state. Home birth midwives must be able to make a living from their work, and insurance companies should not be permitted to keep home birth midwives from being compensated for their work. Home birth midwives are being persecuted in almost every country, even in The Netherlands, where home birth services have a long and honorable tradition. I believe the development of a country can be measured by the degree to which it respects the right of a birthing mother to receive a woman centered birthing experience, whether the birth occurs in a home or hospital setting. In this regard the current situation in Hungary greatly disturbs me. There, the failure to fully provide and protect this important right is highlighted by the prolonged discrimination and mistreatment of the independent midwife Dr. Agnes Gereb. Agnes has spent more than 20 years trying to defend the fundamental rights of mother and child and in doing this she has been imprisoned, recently received a further 2-year prison sentence and has been held under house arrest for the past year. I now ask the Hungarian government to intervene to stop the abuse and unjust treatment of this internationally respected homebirth expert.

Birth shouldn’t be thought of as money-making commodity or condition in which large institutions or governments control and dictate how women will give birth, ignoring individual mother’s wishes and needs. Inevitably, this too often puts bullies in charge of women’s bodies, something no other mammalian species allows. Some countries have midwives who are totally subordinate to physicians. In these countries, it’s typical for very harsh methods of birth care to be applied, and outcomes show this. It’s time to stop this sort of behavior. Traditional peoples, indigenous people don’t permit such behavior. We need to learn from them.

Sarasota Leads Statewide Prematurity Awareness Month Campaign

Would you please pass the cranberry sauce and the facts?

Just as families are preparing to gather together in celebration of the Thanksgiving holiday, theFlorida Association of Healthy Start Coalitions (FAHSC) and March of Dimes Florida Chapter are launching a campaign as part of Prematurity Awareness Month (November). “Healthy Babies are Worth the Wait” is designed to raise awareness about the myths and risks of premature births, as well as educate the public about the importance of staying pregnant at least 39 weeks if a pregnancy is healthy.

According to studies, a growing number of babies are delivered between 37 and 39 weeks. Many of these births occur as a result of planned or scheduled deliveries that are not medically necessary. Nationally, labor induction rates during these weeks have more than doubled from 9.5 percent in 1990 to nearly 23 percent in 2006. In Florida, preterm birth rates increased from 12.8 percent in 2000 to 13.5 percent in 2009. Sarasota is one of seven priority communities leading the statewide community education campaign being launched by FAHSC and Florida March of Dimes in observance of Prematurity Awareness Month. Hospitals in these communities are participating in a statewide quality initiative to reduce elective deliveries.

Non-medically required preterm deliveries pose increased risks to an infant’s life including neonatal hospitalizations, death, respiratory stresses, developmental delays and learning disabilities.

“We are pleased that our coalition and community have been selected to lead statewide education efforts to reduce the risk of babies who are affected by late preterm deliveries and non-medically necessary inductions and c-sections,” said Jennifer Highland, Executive Director, Healthy Start Coalition of Sarasota County, Inc. “There is an alarming misconception among many that a baby is full term and ready for delivery at 36 weeks…so, unfortunately, we see a lot of mothers seeking to schedule C-sections or induced deliveries when there is no medical reason to do so. This campaign will help Sarasota citizens understand that the last weeks of pregnancy actually do count.”

Sarasota is joined by Miami-Dade County, Broward County, Palm Beach, Fort Myers, Tampa and Santa Rosa County as lead participants in the “Healthy Babies are Worth the Wait” statewide campaign, being implemented by the Florida Association of Healthy Start Coalitions with funding from the March of Dimes.

The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality.

Founded in 1938, the March of Dimes funds programs of research, community services, education and advocacy. For more information, visit marchofdimes.com/florida.

Founded in 1991, the Florida Association of Healthy Start Coalitions is a statewide network of 32 Healthy Start Coalitions that exchange and disseminate resources and information designed to improve maternal and child health. FAHSC was awarded a March of Dimes Florida Chapter Community grant in March to educate Florida women, families, medical professionals and providers about preterm risks.

Vote Robin Lim as 2011 CNN Hero of the Year

Robin Lim, the midwife featured in the film Guerilla Midwife, shown on the International Day of the Midwife in Sarasota in 2010, has been chosen as a Top 10 CNN Hero of the Year Nominee. If she wins this honor, her non-profit organization Yayasan Bumi Sehat will receive $250,000. People can vote for Robin 10 times per day until December 7th. This money would help Robin save so many mothers and babies; her birthing sanctuaries offer free prenatal care, birthing services and medical aid to anyone who needs it, in areas of the world where postpartum hemorrhage, obstetric fistula, and lack of prenatal care claim far too many lives.

"Naturally I hope that being a CNN Hero will bring attention to the global need for better maternal and infant survival care," says Robin Lim. "Bumi Sehat has a huge responsibility keeping the two community health and childbirth clinics open. There is also the Bumi Youth Education Center, our scholarship program, village recycling and environmental stewardship.

"We do capacity building for Indonesian midwives from many islands and countries. Bumi provides free ambulance and emergency medical service, HIV/AIDs counseling and testing, pediatric care, free weekly special clinics to treat chronic illness. We have elderly and prenatal exercise programs. Bumi Sehat is open 24 hours a day, every day of the year. In the first eight months of 2011 Bumi Sehat has helped 20,500 patients and delivered nearly 400 babies for free!"

Quite close to the epicenter of the 2004 Indian Ocean tsunami disaster, Bumi Sehat operates a clinic which also sponsors capacity building for youth education and environmental protection. "Bumi Sehat needs the CNN #1 award, and will put it to use doing culturally appropriate sustainable care. Imagine a world in which each child is born with an intact capacity to love and trust. This is the world midwives work day and night to build."

Click here to VOTE for Robin Lim. A vote for Robin Lim is a vote for gentle birth, for mother and child survival, for culturally sensitive natural community health care and disaster relief, for midwife-to-mother care that effectively saves lives.

BIRTH STORY: We Become Three

(written by Kassandra Lowther, about the birth of Aiden Anthony, born 10.10.11)

I awoke at 6am on the dot on 10/10/11, not feeling "right." Anthony sat up at the exact same time that I did and just looked at me; he says now that he just "knew." I was having a lot of intense period-like cramps that would leave me falling to the ground. I went to the bathroom thinking I had to take a poop, which I did; I thought that after that, the pain would go away and I could go back to sleep. Boy was I wrong!

I tried laying back down but I was in too much pain to sit still. Anthony was on and off sleeping at that time, still making sure I was alright every few minutes. I tried going to the bathroom again--nothing. Only a piece of toilet paper's worth of blood. I texted my mom and she responded that she was surprised I was awake so early and asked me to keep her posted. I finally went out into the living room and logged onto facebook to ask if anyone else had ever experienced the kind of pain I was, during labor or just at the end of pregnancy in general; many of my friends said it sounded like labor!

I went onto contractionmaster.com and started timing my contractions, they would come anywhere from 6-7 minutes apart and would last anywhere from 45 seconds to a minute. These were pains I could not talk through, walk through, etc. I knew either something was wrong or I was in labor. I told Anthony he could go to work, that I wasn't exactly sure if I was in labor or not and I didn't want to have him call off if it was only random pains like usual. I timed the contractions for about an hour and realized that I had been having these pains for about 3 hours--time to call the midwife.

I paged the on-call midwife at 8:48am and waited about 2 minutes until I got a call back. Harmony Miller was on the line, I explained to her everything I was feeling--the blood, the contractions; I had multiple contractions that left me breathless while on the phone with her. She said that it definitely sounded like I was going into labor, that I should keep timing the contractions and said that "I will know" when I need to come in and to call her when I need her. Lucky me that was the day she had come back from her maternity leave, her son Cairo would be attending his first birth--mine!! I then called my mother and asked her to come over, that Anthony was at work and I needed someone there with me; she told me after that she could tell by the way I was talking that I was totally in labor.

My mom showed up and she helped me through many contractions; she tried rubbing my back a few times but I just didn't want to be touched. We called Anthony (he had been at work for about a half an hour) and told him that he NEEDED to come home, that I was in labor and we had to get to the birthing home soon. He came through the door about 10 minutes later and asked me if I was sure I was in labor, ohhh yes I was!

He and my mom helped me through more contractions. I was grabbing onto the edge of the couch and on the floor begging for a trash can because I swore I was going to throw up. All I could smell was garlic bread from dinner the night before; it made me gag but I just couldn't throw up. Anthony called Harmony at 10:34 and told her that we were on our way to the birthing home. She said for us to call when we were out the door. I know now why she said that. It took me about 20 minutes just to get off the floor and out of the house.

On the way to the birthing home I wasn't even in the seat of my mom's convertible, I was on the floor in between the front passenger seat and the back seat in sooo much pain; the contractions were definitely a lot more intense. Some a-holes decided to honk at us from behind so I flicked them off, they then pulled in front of us and went about 10mph ON FRUITVILLE just to get me back for giving them the finger. Anthony was so irritated at that and almost jumped out of the car.

We arrived at Rosemary Birthing Home and it took me about 5 minutes just to get out of the car because I was finally and constantly throwing up into a big black trash bag. Anthony helped me waddle my way up the steps and into the birthing home. I looked and saw the sign on the door that said something like "There is a baby being born today!" I couldn't help but smile because I knew that it was put up specifically for me!!

We walked inside and hurried me up the stairs before the contractions came again. The moment we got into the purple birthing room I was already on the floor in pain. My mom got me some water and I was drinking "Frost" Gatorade like there was no tomorrow, although no liquids could quench my thirst. Harmony arrived soon after and I was on the bed on all fours, holding onto Anthony's hand for dear life as yet another intense contraction overcame my body. She asked if she could check me and of course I wanted that more than anything, because if I was only 1-4cm dilated and in that much pain I would've been so mad. I laid on my back and I started having another contraction, she waited patiently and quickly after it subsided stuck her fingers in for a check. The look in her face was pure shock, I don't remember exactly what she said but it was something along the lines of "Oh! You are 6-7cm dilated and STILL stretching as I keep my fingers in!" I was dilating rather fast!

I asked for the birthing tub to be filled because I knew the warm water would put my body and mind at some ease. I kept laboring on the bed with Anthony by my side for what seemed like forever. I kept staring at the birth tub praying in my head for the water to fill up faster; it was taking so long! Anthony's mother and grandma showed up at some point then, I was fully focused on the contractions at this point. I remember saying hello to them and telling Michelle how I loved what she did with her hair! I was given a green bowl to throw up into, it was in front of me on the bed; I had nothing in my system besides Gatorade and water so mostly I was vomitting bile (ew).

Finally the birth tub was "full enough" that I could at least get in and relax. We got into the tub and the heat of the water felt AMAZING, I never thought that water could ever feel so orgasmic. With each contraction came all new sensations: the feeling of wanting to poop, the most intense back pains I've ever felt in my life, the want to get out and give up. I remember looking over and my mom a million times shaking my head, she would just smile and nod; letting me know without saying a word that I can do this. Those looks really got me through it. She kept trying to take my green bowl away from me though, which I kept in the water with me the whole time because I kept feeling like I was going to throw up, which I actually never did; I guess I was just territorial over it!

Grandma Pat kept going downstairs to get ice chips and my mom would feed them to me, and although they didn't seem to help with anything, they still felt amazing to chew on. Anthony was behind me in the birth tub putting pressure on my back with each contraction that passed, most of the time his hands felt to almost make the pain feel worse and I remember smacking his hands away a few dozen times. I then felt inside of me and could feel my bag of water still intact, and behind that I could feel Aiden's skull...it was only about a fingertip away but never seemed to want to budge. I looked around the room many times during labor and kept telling Harmony and the rest of the birth team that I couldn't do it, that it hurt so bad. They kept telling me that I was doing an amazing job and it would be over soon, so I kept trying. Every contraction now sent me into wanting to PUSH, I'd push so hard and feel Aiden coming out but then I would have the feeling to poop so I'd stop pushing. Even though I was in so much pain I really didn't want to poop on my husband who was sitting behind me, it would just feel so awkward to me. The only time I had cussed during labor was about this time, when I yelled "God damnit!" after which I apologized to everyone in the room.

Finally after a few hours of trying not to let my bowels out I turned around and faced Anthony; holding onto his knees, legs, arms, hands, hugging him so tight with every contraction. I finally couldn't hold it anymore and pooped, just little particles came out but at least they came out behind me and not right in front of Anthony. Every contraction after that I kept pooping out little peices; Harmony told me that that meant Aiden was very close, that he was pushing on my anus. It honestly did feel like he was trying to come out of my butt and not my vagina, it was awful! One of the birth assistants (I don't remember her name, sorry!) helped put pressure on my back as I squeezed Anthony's leg through yet another painful contraction. I felt "down there" and I could feel my bag BULGING, I knew he was close. I gave out a really hard push and could feel Aiden's head giving way, coming out into the tub. I leaned back a bit and just let the pain over-take me, this was definitely the most painful part of my labor. All of a sudden everyone was around the tub watching as Aiden's head, then shoulders, then whole rest of his body came out of me. Anthony told me later on that he asked Harmony if he could still breath while inside the sac, she assured him that he was still breathing oxygen and not to worry. Anthony then had him in his hands and pulled him out from the water. There he was, our beautiful baby boy. The moment I saw him all the pain had disappeared, like the labor never happened and my perfect little boy had just come out of the water out of nowhere.

Aiden Anthony Lowther was born on 10/10/11 at exactly 4pm; caught by his daddy Anthony R. Lowther, after a 10 hour all natural labor in the water at Rosemary Birthing Home. He was born still in his sac, which I was told later is very rare, there are several old wives tales about it. Aiden weighed 7lbs 7oz and measured 21in long.

I have never experienced something so amazing in my life, and I definitely plan on having more natural water births in the future. Thank you to everyone who was there, for your support and love; I couldn't have done it without you guys!!!

Introducing Maternally Yours Radio

I am proud to introduce to you a new radio program I am co-hosting, and am honored and very excited by the opportunity before us. I invite you to tune in and welcome your feedback!

Earlier this month, four Sarasota mothers launched a weekly radio program dedicated to maternal health. “Maternally Yours: Sarasota’s Conversation about Pregnancy, Childbirth and Early Motherhood” airs every Tuesday night at 6:30pm on Sarasota’s community radio station, WSLR 96.5 LPFM. It is the first ever local broadcast dedicated to the subject, and WSLR’s first program hosted by a collective of women.

Maternally Yours is an opportunity for Sarasota to learn about issues affecting pregnant families, infants, and young children from a consumer perspective. The program will be hosted on a rotating basis by four women well-known in the community for their expertise in the areas of pregnancy, childbirth, and the postpartum period. The hostesses will invite local experts in the fields of midwifery, obstetrics, nursing, pediatrics, healthcare administration, breastfeeding, doula work, public health, and consumer advocacy, as well as (and often) parents who might share their experience on a given topic. The show will offer listeners a broad range of perspectives and opinions incorporating all models of maternity care available.

“This is such a balanced, judgment-free, thoughtful, refreshing show,” says Sarasota mother Abby Weingarten. “What a gift to our community!”

The hostesses of Maternally Yours are Cheryl Kindred, Carmela Pedicini, Ryan Stanley and Laura Gilkey. Cheryl is a certified birth doula, birth assistant, childbirth educator, MotherBaby advocate and leads local groups for Babywearing education and postpartum support. Carmela is an Independent Childbirth Educator, Certified Lactation Counselor, Licensed Practical Nurse, and local musician. Ryan is a long-time Sarasotan and young mother whose daughter’s birth shifted her career path toward Postpartum Doula certification. Laura is an advocate for evidence-based maternity care, a board member for Florida Friends of Midwives and the Healthy Start Coalition, author of the blog Born in Sarasota, and marketing director for The Safe Motherhood Quilt Project.

The unifying voice of the programmers is a genuine desire to empower women to take control of their bodies, their pregnancies, their births, and the raising of their children. “We all believe deeply in informed consent and allowing families to make their own choices,” says Laura. “The best way for them to do so is with evidence, information, and support.”

To listen to Maternally Yours, please tune into WSLR 96.5 LPFM every Tuesday evening at 6:30pm. The program is also available via live streaming on wslr.org, and podcast at podomatic.com/profile/maternallyyoursradio. For more information, please contact the hostesses of Maternally Yours at MaternallyYoursRadio@gmail.com, or call (941) 915-8115.

About Maternally Yours: Maternally Yours is Sarasota's Conversation about Pregnancy, Childbirth and Early Motherhood. The Conversation airs on Tuesday nights at 6:30pm on YOUR Community Radio Station, WSLR 96.5 LPFM. The mission of Maternally Yours is to educate and inform our community about the options, support, and evidence-based best practices available to them in maternal-child healthcare.

Guest Column: Safe Childbirth Advocate Honored

My gratitude to the Sarasota Herald Tribune for printing the following editorial on Monday, October 3rd.

In 2009, American midwife Ina May Gaskin visited Sarasota. She spoke to the physicians at Sarasota Memorial Hospital, displayed her Safe Motherhood Quilt Project at the Selby Public Library, and sat on a panel of experts at the conference on Maternal Healthcare in the 21st Century. She shed some light in our community on the evolution of American maternity care, our current maternal mortality crisis, and the model of care and accountability we must embrace to change it.

These are the kinds of visits Ina May makes on an almost weekly basis, in between delivering babies at The Farm, the "intentional community" in Tennessee she and husband Stephen Gaskin developed in 1970. One book, one airplane flight, one community at a time, she uses her 40-plus years of midwifery experience and research to educate and call to action those of us who are compelled by the fact that, while the United States spends more money on maternity care than any other nation, we remain ranked 50th in maternal mortality and 41st in infant mortality, according to the World Health Organization.

Recently, Ina May received the highest honor of her career thus far: The Right Livelihood Award (rightlivelihood.org), commonly referred to as the "Alternative Nobel." The award, established in 1980, honors "those offering practical and exemplary answers to the most urgent challenges facing us today." Among 2011's four Laureates, Ina May was chosen "for her whole-life's work teaching and advocating safe, woman-centered childbirth methods that best promote the physical and mental health of mother and child."

The Gaskins will travel to Stockholm in December to accept the honor, which will be presented by Sweden's Parliament.

This will be the second time they have done this as husband and wife; in 1980, Stephen became the first Right Livelihood Award Laureate for his establishment of PLENTY International. This is the first time a husband and wife have each been laureates of the award, causing the Right Livelihood Foundation to liken the couple to Marie and Pierre Curie.

Today, Ina May focuses her efforts heavily on The Safe Motherhood Quilt Project (rememberthemothers.org), in which each quilt square honors a woman who has died in childbirth in the United States since 1982. The Project aims at summoning the national will necessary to lower the rising maternal death rate by creating a consistent, mandatory system for reporting, classifying and counting maternal deaths, and reviewing and analyzing their causes.

She is also engaged in a national information campaign, aimed at women and medical professionals, about the potential side effects of using Cytotec, or misoprostol, to induce labor. She continues to teach and speak to physicians and midwives worldwide, and has traveled to Argentina, Canada, Mexico, Brazil, Costa Rica, Sweden, Norway, Denmark, Iceland, Germany, Switzerland, Israel, Italy, Austria, France, the Netherlands, Slovenia, Russia, Hungary, the Czech Republic, Spain, Australia, New Zealand and Japan to do so.

When I was newly pregnant for the first time in 2004, the first book I read was Ina May's "Spiritual Midwifery." Like so many other new mothers, I relied on the birth stories and wisdom so frequently that its pages were dog-eared and tattered by my due date. Since that bestseller, she has penned: "Ina May's Guide to Childbirth," "Ina May's Guide to Breastfeeding" and "Birth Matters: A Midwife's Manifesta," published just this summer. I encourage people to read this most recent work, describing the evolution of our maternity care system, and the path we must take to improve it, not only for the highest good of our mothers and babies, but for nations worldwide that strive to replicate our model of care.

"A society that places a low value on its mothers and the process of birth will suffer an array of negative repercussions for doing so," says Ina May Gaskin. "Good beginnings make a positive difference in the world, so it is worth our while to provide the best possible care for mothers and babies throughout this extraordinarily influential part of life."

We as a nation should celebrate Ina May Gaskin, the U.S. 2011 Right Livelihood Award Laureate, with collective pride and gratitude. Her tireless dedication to her calling has rippled throughout the world, and it is up to us to carry her message. It is a privilege to work with Ina May, and the highest honor to call her my friend.

BIRTH STORIES: Kalina and Jasper

(written by Erin Ernst, about the births of Kalina Jade, 11.25.07 and Jasper Jolee, 07.05.11)

Labor & Birth of Kalina Jade Ernst

November 25, 2007, 11:31am

8lb 14oz ~ 22” long

Pregnant with our first child, my husband & I were so excited. Early on in my pregnancy, I knew I wanted the intimate & personal care of midwives for my pregnancy and birth. I had taken a Human Sexuality (or something along those lines) class in college and we had a lot of speakers come through. One was a group of midwives from a local birthing center. So much of what they said resonated with me, though I was nowhere near wanting kids yet, that I saved the brochure they’d given us comparing the midwives model of care to the typical hospital care of a birthing woman. Over four years after taking that class, it was time to share my wishes with Joe. I had already done some research and found the sweet little Rosemary Birthing Home. He wasn’t too keen on the idea, but agreed to at least do the tour with me. I also signed us up for a tour of the local hospital.

I was just shy of two months pregnant when we toured the birthing home and met the staff. They were all wonderful. There was another couple there who were back for their 2nd pregnancy. They labored there for their first child but ended up transferring to the hospital where she was given some Pitocin and birthed her baby shortly after. I found it reassuring that she was back again and planning on having her second baby with the midwife there. After we met the very knowledgeable and reassuring midwife Harmony, and asked many questions, Joe & I were both pretty sure we wanted to spend our pregnancy and birth with her. We still did our tour of the hospital the following week. After the loving, homey feel of the birthing home, the hospital felt so cold, impersonal and sterile. I’ve always felt nervous & tense just walking into hospitals, associating them with sickness & death, and this time wasn’t much different. I knew that a normal, easy birth was possible in a hospital as I had watched my mother give birth to my brother in that same one when I was just twelve years old, but I still couldn’t picture myself there after knowing there were other options.

So, we decided we would be giving birth at the birthing home. I had contemplated doing a home birth since it’s basically the same thing, but I figured the birthing home was a good “compromise” between home & hospital, and it seemed it would be easier for our families to understand – since they were already surprised we weren’t planning a hospital birth for our first.

From the beginning of my pregnancy, I was sure we were having a girl, though I wanted to wait until the birth to “officially” know. Joe really wanted to find out though, and since our 20 wk ultrasound was right after Father’s Day, I put in his card that we could find out the sex. He was thrilled. So, when the time came, we peeked up her skirt and let everyone know that we were indeed having a little girl! We were excited to meet our daughter one day soon. In the meantime, I read every pregnancy book I could get a hold of, from mainstream books like the What to Expect ones, to Ina May’s amazing books on pregnancy & birth, and I even read a book on the Bradley Method, and a Hypnobirthing book too.

I enjoyed a symptom-less, wonderfully easy pregnancy. I never felt a bit of nausea and was rarely tired. I was looking forward to my “birth day” and was sure it would be short and easy. Harmony even told us she saw us having a wonderful birth. I continued working and we went out with friends every weekend we could. My due date was Mon., November 19th, and I continued feeling great as it approached. I enjoyed my big belly, doing weekly photos, a belly cast, and then had my sister do henna on my belly when I hit 40 wks. Joe & I were both born 2+ wks past our “due” dates, so I figured I’d probably go late as well. As the date came and went though, all those who we shared that magical date with began asking about the baby, wondering if she was here yet… Even out shopping, people would ask when I was “due” and it went from answering “tomorrow” to “two days ago”, and people would look at me like the baby may fall out right there! Even though I knew that was completely normal, I got tired of telling people I was “late”.

I had Harmony “strip my membranes” when she checked me at my 40wk appointment, since it sometimes helps women go into labor if they are ready. I also found out that I was already 2cm dilated that day. That afternoon I began having period-like cramps for a couple hours. I lay on the couch, wondering if the baby may be coming that day, but they eventually stopped, and I realized labor would begin another time.

Thanksgiving fell on November 22nd that year, 3 days past my due date. We visited both sides of our family that day, and got to share what our baby’s name would be – we scrambled up the letters of the first, middle, & last name and wouldn’t tell them what it was until they got the whole thing right, which they eventually did. Surely, eating two huge meals would push that baby out of my belly! Joe took the next day off of work. We were hopeful that it would be our baby’s birth day. We went out Friday morning and did a little shopping, and stopped at a deli for lunch. I felt a little funny and didn’t have much appetite, so I just ate a little soup and some salad. We continued walking around and ran some errands. I started feeling rhythmic cramping, so I called Harmony to let her know. She told us to continue whatever we were doing and keep her posted. We were excited that things were finally beginning! When we got home early in the afternoon, we made sure all of our things were together that we’d be bringing to the birthing home with us. Then, I laid in bed and began keeping track of my contractions to see how far apart they were. I was too excited & nervous to rest. I called Joe to bed and we tried playing UNO, but the contractions started getting too distracting to pay attention to the game. They continued getting stronger all evening and we finally told Harmony around 11pm that we wanted to come down to the birthing home. We were thinking the baby may be born before the day was done!

We arrived at Rosemary Birthing Home close to midnight. The 30 minute drive down there while having contractions was awful, so I was so glad to get into that cozy house and fall onto the bed. Harmony checked me and found that I was 4 cm dilated. What!?? But I was already 2 cm before I ever had a contraction… She suggested that we could go back and labor some more in the comfort of our own home, but there was no way I was going to make that drive two more times – besides, I was sure the baby would still come soon. I wanted to get in the tub for some pain relief, so we filled it and I got in. It helped a bit, but I was getting tired, so we went back to the bed after a while. I used the heating pad on my back since the heat seemed to help. I was able to doze a bit between contractions, but it certainly didn’t feel like long enough! Harmony slept on the couch in the next room, but came in often to check on me and listen to the baby’s heart rate. “Active” labor seemed to kick in sometime before the sun came up. You mean, it gets even more intense?! Yep. No more sleeping. I labored more… lying/sitting/leaning on the bed, on the birth ball, and in the tub some more. I had Harmony check my dilation, but I wasn’t progressing very quickly and it bummed me out. I was getting tired. Sometime that day, our family’s came down to the birthing home. I had wanted everyone there when the baby arrived, but it was taking a long time, so they waited in the next room. Someone heated up one of the quiches I had made. Funny, being allowed to eat in labor was one of the reasons I wanted to give birth outside the hospital, but when I was offered food, I wanted nothing to do with it! I was feeling nauseous. I took a couple little sips of smoothie, and was able to drink small amounts of water, juice, & Emergen C, but that was about it. I vomited a few times. I’m not one to puke very often (I think I had a stomach bug in middle school the last time I remembered doing so, and I avoid doing it at all costs), but in this case it actually felt kind of nice – a bit of a distraction I suppose.

I had no sense of time throughout all of this, but I know it got dark again. I was checked and was still only 6-7 cm and had been that way for a while, despite regular contractions and all the positions I’d been in. Baby’s heart rate was great though. Joe and Harmony had been doing their best to help me be comfortable as possible. Joe pushed on my back and Harmony massaged my legs and feet. Harmony had also been giving me homeopathic medicines and herbs, to ease my back labor and to help make the contractions more effective. I remember her asking me if I wanted something that would help me rest/sleep or something to help the contractions get stronger. “Neither” and then “Both” was my response. I was a bit delirious and didn’t know what I wanted, except that I wanted to be done and have the baby out already. Around 8pm, I told Harmony she could break my water. We had hopes that it would get things going, as I was becoming quite exhausted. The last real food I had eaten was that soup & salad over 24 hours earlier.

When my water broke, there was a big gush of fluid that came out. It was all clear and the baby’s heart rate was great. My contractions felt much stronger at this point and sometimes felt like they were coming on top of each other. I felt cheated at those times because I didn’t get my “break” I was promised in between! I spent a lot of time in the tub, trying to relax, and moaning through the contractions. I think we thought I may be in transition, as our birth assistant, Jodi showed up. She sat calmly in the corner taking notes and smiling, taking pictures here & there.

When checked again, we found I had gotten to about 8cm, but was still dilating slowly which made me quite discouraged. I got out of the tub and bounced and rocked my hips on the birth ball hoping I could shake the baby down. I also tried squatting while hanging on the end of the bed.

Joe was with me most of the time, but left the room a few times to pee, eat, visit family, and/or nap. I was grateful that he was being so wonderful and supportive when he was with me, but when I knew he wasn’t with me, I was angry that he didn’t have to go through everything I was going through. I was jealous that he was getting a break and I wasn’t. At one point when it was just Harmony and I in the room, she said that maybe I just needed to spend some time alone with my body and figure out what I needed and she left the room. I was alone. I thought she was crazy for telling me that and I was still mad that I had to do this all by myself. I felt that I needed someone there to tell me exactly what I needed to do to make this work.

Sometime in the wee hours of the morning Harmony offered some IV fluids to try and get my energy up. Someone suggested I try walking for a bit, so I donned a hospital type gown (since I had family in the waiting room and until then hadn’t had any clothing on since I arrived). My mom and sister helped me (and my IV pole) walk down the hallway and back a couple of times. I wanted to lie down on the floor every time a contraction came, but they kept me upright. I also tried sitting on the toilet a couple times, but that felt awful! When the IV bag was empty, I was able to get rid of the pole. But then, they wanted me to climb the stairs! Ugh. I was willing to do anything though, knowing that it may help get the baby out. The stairs were as bad as I had imagined. I wanted to quit, but they helped me along. I made it to the top though, and stopped for a couple contractions, and then back down. I remember feeling a bit self-conscious through all this because of everyone who was waiting there for baby and hearing me moaning and whining, and I knew I was probably waking those who were trying to sleep. I was wishing I had stayed home, but I was really too tired at this point to care. (I did finally make peace with those stairs that I once cursed, painting a mural on that wall when my daughter was just a few months old – hoping to make the trip up & down a little nicer for any mamas who would be following in my footsteps!)

Back downstairs, I was able to fall onto the bed again. Harmony checked me and I was hopeful, but I was still just at 8cm. I started feeling like I’d be too tired to push even if I was fully dilated. My water had been broken almost 10 hours now. We started to talk about the possibility of going to the hospital. The plan would be to get some Pitocin to help with the contractions and an epidural to help me relax and finish dilating, and to help me rest before it came time to push. We thought we would be treated a little better and get what we wanted if we didn’t push it by waiting too long after my water broke, so the sooner we could go, the better. Harmony called ahead to find out who the on-call doctor was supposed to be that day, and it was someone she was comfortable with, so we decided to head over to the hospital. I honestly don’t remember much of the conversation or decision-making that lead us there, but I trusted that everyone was looking out for what was best for me. Luckily, it was a short drive, because riding in the car during contractions was no fun at all.

We arrived at Sarasota Memorial Hospital around 6am on Sunday, November 25th. I rode in a wheelchair up to labor & delivery. I felt like everyone was looking at me, pitying me, and talking about me. Honestly though, I’m sure I looked a mess! I had been in & out of the tub a dozen times and I hadn’t seen a mirror in days. Soon, I was placed in a little room. I could only have a few people with me, and Harmony had a call that another mom was in labor, so I told her to go – I would have Joe and some family members be with me when I gave birth.

Being in the hospital was SO much different than where I had just come from. Everyone was in a hurry. Sweet Harmony was able to painlessly slide an IV needle in me on her first try when she needed to. It took the hospital nurses (3 of them) numerous tries at jabbing me before they got it right. Then they finished strapping me up, with a blood pressure cuff and two monitors across my belly – one for me and one for baby. Every time I had a contraction, I needed to sit up to deal with the feeling, but every time I did that, the straps on my belly would move and they would come running and telling me to lay still. It was crazy. I had piles of papers I was supposed to be reading and signing… I got the signing down. They wheeled in a TV so I could watch a video about epidurals. I felt like an inconvenience to them. I can’t imagine going through an entire labor like that. Luckily, baby and I were both doing great. Even though, they started intravenous antibiotics because my water had been broken for a while. Now we just had to wait to see the on call OB.

Pretty soon, a nurse comes in and tells us that the Dr. (who we have not even seen yet) recommends a C-section, so they will begin to prep me for it. WHAT?! It seemed like a joke, and I’m pretty sure I laughed at the preposterousness of it all! When we realized she was serious, we told her we wanted to see the doctor himself, so she left. (By the way, the doctor who was supposed to be on call wasn’t there that day, so this other doctor happened to filling in for him.) Joe talks to Harmony on the phone, who is as shocked as us, and she tells us we can request a second opinion.

Finally, he came in. He told us, “All we ever get is problems” from the birthing home, or something along those lines. That should have been a warning. He seemed to be out for revenge against anyone wishing to give birth outside the hospital. He looked at me like I was someone who had come in off the street having no prenatal care. Though, I’m positive that the care I had received from my midwife was far superior to anything his clients had ever gotten. Anyway, we discuss his decision to do a cesarean. He says that because I hadn’t fully dilated yet, that I would not dilate, period. I disagreed. Then, he asks me why I haven’t followed the “1cm per hour” nonsense. I had read enough to know that most births don’t follow that logic, but since I was still strapped down to a bed laboring without any pain meds, I just responded with “Some people are just slower than others”. To which he replied, “Physically or mentally?” Wow. Honestly, that wasn’t the worst of his condescending remarks, but I’m going to try not to go into just how obnoxious he was. He makes it clear that we either go with a section, or we are "refusing care" and we can leave the hospital. We tell him we'd like a 2nd opinion. He tells us he is the only opinion available. After more arguing, he leaves.

We were shocked. We looked at our nurse, who seemed embarrassed, and only said, “I can’t say anything.” Nice. We contemplated leaving the hospital and going to another, but decided against it, figuring at that point that we’d probably get similar treatment elsewhere. Finally, he comes back in. He says he'd talked to the head of obstetrics as a second opinion and that he’d like to compromise. He says we can do an ultrasound, and if it looks like the baby it "too big" for me to deliver vaginally, we'd do a C-section. If not, we'd get to try the Pitocin. This sounded fair, so we agreed. After all, my petite mother birthed me at 9lb 10oz & Joe was over 9lbs as well. I was prepared for a decent size baby. The ultrasound tech came in and looked at the baby, did some measurements, and left again. Then, the Dr. came back in. He said the baby was 8lbs 14oz. I felt like celebrating! The baby wasn’t BIG after all – she’s even under 9lbs. Unfortunately, the Dr. has a different opinion. He tells us that the baby is definitely too big (something about it being in the 90th percentile for her weight at 41wks. gestation...blah blah blah). He says she is "macrosomic" (which I later find out describes a baby over 8lbs 13oz). I ask again to please just try the Pitocin and see what happens. He says even if I fully dilate and we "blow the baby's head out", there is always the risk of the shoulders getting stuck, and in that case we'd only have 4 mins. to do an emergency C-section, and why would I want to risk my baby's life to make me feel better?!! I wanted to ask him if he hasn’t ever heard of the Gaskin Maneuver for shoulder dystocia, but I was too overwhelmed by what was happening, and figured it wouldn’t help anyway. He was such a bully. I asked him to check me one more time, though I was feeling so stressed at this point that I think my contractions had spaced out a little bit. He checked and said that I was only 6-7cm now, and that my cervix was swollen and the baby would never come out that way. I’m pretty sure he said “Told ya so” to my husband at this point. Deep down I feel he is wrong, but we give in and proceed with the C-section. It was good to know at least, that I’d finally be meeting my baby girl within the hour.

There was no waste of time now. Around 10:30am, they wheeled me in and prepped me for surgery. I couldn’t believe this was really happening. It was so surreal. They gave me a spinal block which felt amazing at that point in labor. I got cold and tingly & then numb all over. It made me want to sleep. Then they put in a catheter. They lay me down and moved me onto the surgery table and put a big sheet in front of my face. I heard the nurses all running around getting things ready, talking to each other, but not to me. One of the nurses asked another what kind of “dressing” this doctor uses. I thought, “Well that’s lovely. They’re ordering the doctor a nice salad. It’s almost lunch time, after all.”, though I felt so unimportant at that point, that I wasn’t in the least surprised. Only later, while reading an online ICAN (International Cesarean Awareness Network) message board, did I realize the “dressing” the nurse was talking about had to with the bandages that the Dr. uses after surgery. Ha! I suppose that knowledge made me feel a little better.

Joe came in and sat by my head. I still hadn't really slept in over 40hrs, so I nodded off a couple times, and Joe would shake me to wake up. I was supposed to be numb from the waist down, but I had a hard time even feeling my arms, and my face was tingly. It seemed like there were a million people in the room walking around doing things. I felt so distanced from the “birth” of my child that was happening that I may as well have been in another room. I could feel my body being jerked back and forth until they said the baby was here. They held her above my head quickly before taking her to weigh, clean & wrap her up like a burrito. Then, they brought her over one more time for me to catch a glimpse before they took her and my husband off to the nursery. I don’t really remember seeing her, but I remember hearing her cry.

Next, they took me to "recovery" for an hour where they monitored me and I waited to feel my legs again. I was in and out of sleep. A nurse sat quietly in there with me, taking my temperature, and asking me to wiggle my fingers and toes. I had a hard time believing that I had just had a baby. My belly was quite bloated from gases and felt bubbly like a baby was still moving in there. It was a strange state to be in.

Eventually, they take me to my room where I'm reunited with Joe and my new daughter! I remember unwrapping her from that silliness and holding her skin-to-skin on my chest. Finally.

They had a lot of drugs in me, so the next couple days were pretty blurry. As soon as I could, I tried nursing that darling girl, and she tried latching on, but I had been pumped so full of IV fluids that I was all puffy and my nipples were flat. She couldn’t get them in her mouth. The nurses, and lactation consultant too (when she finally came to my room hours later) tried mashing the baby’s mouth and my breast together, thinking that would help. It just made me more nervous and made her cry. And cry. And cry. They told me she was hungry and they wanted to give her formula. I refused. Then they wanted to put a drop of formula on my nipple so she would know that was where the food came from. Seriously?! That seemed ridiculous. Again, I refused. So, they told me I needed to pump and bottle-feed her. So, they wheeled in the pumps and I hobbled to the chair squeezing out every drop of colostrum I could to give her. She would drink it up, and then I would try and give her the breast afterward. It was quite an ordeal. Harmony came to see me and it was so nice to see a friendly face. She assured me the nursing was going to get easier at home and I didn’t really need to rent all the pumps to take home like they wanted me to.

The OB came to see us the next day. He was all smiles and cocky, and I think he expected me to thank him for saving me. He told me it was a good thing he did the cesarean because she was so big. It took a lot to not burst into tears. I only replied, “She is long & skinny”.

It seemed like nurses were in the room every 15 minutes needing to do something to me or her. It was impossible to get any rest. If I did fall asleep, I’d have to wake as soon as I’d hear them coming or I’d get yelled at again for falling asleep with the baby on my chest. They’d offer to take her off to the nursery, but there was no way I was letting her go again. Luckily, Joe was able to sleep on the chair next to me the first two nights, but on the third night, L&D was busy and I had a roommate. This meant my husband had to leave, and baby & I were on our own that night. The nurses tried to make cheerful conversation with me while checking my incisions, like, “Now you can schedule your next baby just like a hair appointment!” What?! “I’m not doing this ever again” I tell her, and for the first time, I think about what having a cesarean means to my future baby plans. “Well, I think there is one doctor who does VBACs… “ she replies.

I was so happy when we finally went home the next day. It was a big adjustment for baby though. She cried the entire first night, and it was a rough start. Once we had the peace and quiet of our own bed though, nursing started to become easier, and I felt like I could finally begin bonding with my daughter. I felt guilty for not being with her at the very beginning of her life like I should have. I still couldn’t look at the pictures or the videos of her crying right after birth, or of her in the nursery getting her first bath and first diaper. Now, I could at least spend all day in bed with her, just staring at her and nursing her. Moving (and laughing and coughing) was still pretty painful after surgery, but slowly I was able to get around again.

Unfortunately, we would go to the hospital one more time. A couple days after we were home, my incision began leaking clear fluid and blood. I called the birthing home and was told that I could just tape it up again. I tried that and went to bed, but it opened up again the next day and I bled all over the couch. It was a weekend and we were scared, so we went to the emergency room (at a different, closer hospital). The doctor there didn’t comment much on it, as if it was a fairly normal thing to happen. He just took all the existing tape off and redid it. He said we could go back to our doctor on Monday and have it checked out. So, we did.

I never wanted to see that doctor again, but we went to his office to have the incision checked out. I felt bad for the pregnant women in his waiting room. I wanted to warn them or tell them to run. He saw us pretty quickly and we kept the small talk to a minimum. He basically told me that there was a lot of fluid behind the incision and it needed to drain out. He said it could continue to drain where it had opened up or he could open it up more to drain it. That all sounded awful. I asked him if my body wouldn’t just absorb the excess fluid. He said no, it wouldn’t. We left without having him do anything, and my body did just that.

We continued our post-partum care with our midwife, Harmony. I admit, I was a bit embarrassed going back to the birthing home for our 2 week appointment after I had “failed” at giving birth to my daughter. She was wonderful and supportive though, and never made me feel at all inadequate. She truly cared, and asked how we were doing after our plans didn’t go as we’d hoped. I told her what I though was expected of me, that we were so happy that our daughter was beautiful, happy, and healthy, and that was all that mattered. I remember her looking at me, serious and loving, and telling me that it was fabulous that our daughter was wonderful, but that was not ALL that mattered. My experience mattered too. It was good to hear that. Before that, I felt selfish and wrong for thinking of myself, for feeling sad and cheated, while holding such a perfect child. “A healthy baby is all that matters” was what everyone always says, and that is what people had told me to “comfort” me. And it really was true that our daughter’s health was our utmost concern, and I would totally have done it all over again if I had to.

Harmony referred me to the International Cesarean Awareness Network, where I was able to read online about others with similar experiences. It was comforting to know I wasn’t the only one. When we hear about some celebrities scheduling all their births by cesarean, it’s hard to imagine that someone else may be grieving the loss of their own birth experience due to a cesarean. I explained it to someone to imagine they spent 9 months fantasizing about what it would be like when they lost their virginity, and then when the time came, they were raped by someone else. That’s how I was feeling. I guess it’s all about your expectations.

Luckily, I was surrounded by many loving and supportive people who gave me the time & space to heal, physically and mentally. It took me some time, but I’m glad I had this experience. It left me wanting to help others, and so thankful for the midwives who are there to hold your hand through the ups and downs of it all. It also had me looking forward to my next birth, and having a new experience.

Labor & Birth of Jasper Jolee Ernst

July 5, 2011, 8:48pm

8lb 6oz ~ 21” long

I know that every labor & birth is different from the next, and everyone would remind me of this as I prepared for the birth of my second born. Since I was planning a VBAC (Vaginal Birth After Cesarean) this time, part of me figured people were just being nice & encouraging. I knew that this birth would be different – I was hoping for a shorter labor and a vaginal birth, or course, but my two pregnancies had been so similar so far that I figured my labor would have a lot of similarities too. I imagined I’d go into labor about a week after my due date and thought that I’d probably labor for quite some time before my water broke, if it did break before the baby came. That said, the way this labor began really threw me off.

I prepared for this birth differently than I had my last. I worked hard to let go of the negativity surrounding my last birth experience so that I wouldn’t bring it with me into this pregnancy. The past was just that. I surrounded myself with only positive, supportive people. I didn’t openly tell people of my VBAC/homebirth plans unless directly asked. I wanted to avoid any confrontation & I wanted privacy. My baby did too, so no peeking at the gender prior to birth. And my body needed to be left alone to do what only it knew how to do. I trusted my body this time. This would be my “selfish” birth, and I was looking forward it.

The end of this pregnancy did feel slightly different than my last one. I was more tired, and felt a lot more pressure on my cervix. I assumed it was just a 2nd pregnancy (and having a 3 year old already) thing. I was hopeful though that the pressure on my cervix was working to dilate it in advance, but I didn’t want it to be checked – I knew that would either get my hopes or disappoint me… and knowing that cervical dilation doesn’t mean a whole lot (you can be at 3cm for weeks or go straight to 10cm in an hour!), so I just opted out.

I decided that Mon, July 4th would be my last day working out of the house. I figured the rest of the week I’d spend at home nesting, shopping, and baking. I’d do a belly cast, and maybe I’d even start napping! My husband, daughter, & I went to see the fireworks together that evening. As we sat there waiting for the explosions in the sky and lighting sparklers, I wondered how many more times we’d be out, just the three of us. We talked about our plans to go out for our 11 year anniversary the following Friday – our last time out, we imagined. Little did we know that in 24 hours, we’d be holding our baby!

It had been a long day and a late night for us, and we all went right to bed when we got home. Kalina (our 3 ½ year old daughter) woke up twice that night which was unusual for her… at 2:30 & again at 3:30. She called my name and then went right back to sleep when I went in her room and put my hand on her back. Then, I woke up again at 4am when I felt like I had peed a little. I thought it was strange, but considering I was already getting up to pee like 5 times a night, anything was possible! I realized I was leaking a little more after I peed. I tried to ignore the thoughts that maybe my membranes had ruptured, and tried to go to sleep again. But, the leaking didn’t stop. I grabbed my phone and went to the bathroom to grab a towel and sat on the toilet again. A million thoughts were rushing through my head – mainly that this was the “wrong” way to start labor, since I wasn’t having contractions yet. I was nervous, excited, & scared. I was shaking when I texted my midwife, Harmony, and then I waited. She called me in a few minutes. Her voice was very calming. She congratulated me on my “birth” day, told me to get some rest, and we’d be in touch.

I texted my doula, my friend who would be watching Kalina, and my birth photographer to give them a heads up, even though I had no idea what was happening. I lay back down, but couldn’t relax. I wondered why my membranes had ruptured, but labor hadn’t started – did I not drink enough pregnancy tea? Or maybe I used too much evening primrose oil? I put my Hypnobabies cd on my headphones – it always seemed to put me to sleep in the past! Not this time… I was still worrying. I knew that I was now on “the clock” – which could mean a hospital transfer eventually if contractions didn’t kick in. I felt confused. My 40 wk appointment was supposed to be the following morning. At my last visit, the baby had turned posterior. I had been working to turn baby back, but wasn’t positive that it had happened yet. And now that my water was broken, I was concerned that the baby may not be able to get in the optimal position… I believe head position was one factor that kept our daughter Kalina from descending into the birth canal. I occasionally felt a contraction, but nothing strong or regular, and I wasn’t sure if it was a “real” one or not. I finally woke my husband since I wasn’t sleeping to let him know what was going on. He’d be getting up for work soon anyway, and I wasn’t sure I wanted him an hour away just in case things kicked in fast & hard. He decided to call into work and stay near. Around 6:30am, our daughter woke and climbed into our bed. She snuggled up close to me and I was finally able to go back to sleep! I woke up again around 8:30am (and she slept til 10am! Must have known it was going to be a long day…).

I spoke to Harmony again. Since I was having occasional contractions, she suggested that I could just wait and see if they pick up, or I could go get some acupuncture which generally helps to get things going. I called Deanine and she said she could get me in for acupuncture at 1pm. I had Joe bring me a big breakfast and decided to get some important things taken care of – I washed my hair, shaved my legs, trimmed my nails & painted my toes! Ha! I knew these things wouldn’t be priorities again for a while.

Then, I did some rocking on my hands and knees to get baby in the perfect position, and I sat on my birth ball for a bit, reading my birth affirmations & looking at all the beautiful beads I was given on my birth table that I’d set up in the bathroom. The birth art I did of a labyrinth reminded me of an Indian birth ritual I’d read about in The Labyrinth of Birth, where the women in early labor would draw a labyrinth in saffron on a metal plate, and then rinse it off and drink the water. The idea was that drinking the labyrinth helped the body to know the path and they also believed it would ease labor pains. I figured it couldn’t hurt, so I drew my labyrinth on a plate covered in Emergen-C, rinsed it off & drank it down. The image of a labyrinth is very symbolic to birth and used in many cultures. When you first enter a labyrinth (labor), you seem to be heading straight to the center (the goal, the baby), but the labyrinth twists and turns and takes you away from the center and back a few times before you actually get there. There are no wrong turns or dead ends. You just have to keep going, and know that you are headed in the right direction, one step at a time, even though it sometimes seems you’re going backwards. This was something I wanted to keep in mind for my labor this time, as I thought it would have helped me mentally get through my first labor.

I went downstairs and made a strong batch of red raspberry leaf tea, brought it back to bed with me and decided to rest for a bit. I talked to the baby, prayed, tried to release any fears I had that were holding me back and then dozed for a little bit.

Joe woke me and it was time to head down to Deanine’s. As I was moving around getting ready and going up & down the stairs I realized the contractions I was having were getting a bit stronger. I wondered if maybe I should just stay home and keep moving, but didn’t want to miss my appointment if I ended up needing it later. I grabbed a banana, piece of cheese & a hard-boiled egg as we ran out the door – glad I did as it would be the last thing I ate before meeting my baby! The ride down there wasn’t comfortable. Every time we hit a bump, I’d have a contraction (and yell at Joe!), though I could still talk through them. I spoke to Harmony again and she said she’d meet us down there and check on me when finished with my acupuncture session.

When I finally lay down on Deanine’s table, we realized the contractions were coming about 5 minutes apart. They still weren’t really strong, but I wanted to sit up with each one to feel more comfortable. She decided not to pin me down with needles since I was needing to move, and instead she massaged all my pressure points to make the contractions work more efficiently. It was really great because Joe was there and she was able to show him where on my hand to rub, and how to press on my back to relieve some pressure, along with mixing up some smell-good, relaxing massage oil for us to take home. Her magic was working and contractions were getting intense. I was getting scared of having to drive the 30 mins back home, so we told Harmony to hurry over which she did. She listened to me and to the baby and everything seemed perfect. She told us to head back home and to call her when we needed her. I ran out the back door in a borrowed robe, and a pillow & blanket for the back seat – trying to make it to the truck before another contraction knocked me over.

The ride home was a long one. I stretched out in the back, trying to be as comfortable as possible, moaning through each contraction. With every turn and bump, I tried to picture where we were – hoping we were close! When we got home, I bolted for the door. I ran like a wild woman past Kalina and my friend who were trying to greet me inside the door. I only made it a couple steps up the stairs before I was brought to my knees. As soon as that contraction passed, I hurried upstairs and dove into bed where I cozied up to some big pillows with my hypnobirthing cd again.

Soon, I noticed my doula had arrived. She and Joe rolled in a couple of birth balls and suggested some positions I could try. I made a trip to the bathroom and then tried sitting on a ball. First was too soft, next was too hard…not easy getting comfortable in labor. I finally found a combination of bed/pillows/ball that worked for me. The two of them were great support during labor, rubbing my back and verbally helping me get through.

I decided water would feel nice, so Joe began filling the birth pool. It did feel good. I have no concept of time at this point, but I labored in there for a while. Contractions were strong, but I was able to completely relax, and occasionally drift off to sleep, between them. I thought maybe I had to poop at one point, so got out to sit on the toilet, but couldn’t sit there long enough to do anything – a contraction came on and I was on the floor! Then back into the tub where I got a little relief. At some point I started feeling more pressure, and it felt good to bear down a bit at the end of a contraction.

My midwife Harmony arrived around 5:30pm (or so I’m told!) along with her birth assistant and our photographer. They all slid in silently, and I’d occasionally open my eyes from my dreamy world of labor and catch glimpses of them. Contractions continued washing over me like waves. I really looked forward to the rest time in between. When they came closer together without giving me a break, I felt angry and cheated - I had whole conversations going on inside my head, though I didn’t manage to get many words out! I felt nauseous off & on and would ask for a bowl, but I never did vomit. Joe joined me in the pool so I could lean against him. The contractions were changing – they’d start out feeling like the contractions I’d been having, but then my body would take over and began pushing down on its own. This went on for long time. My sacrum and hips were so sore. I could tell the baby was moving down.

Joe tried pushing on my back, and I hoped it would help, but it didn’t seem to make it better. I continued this crazy pushing… on one side, and then the next. I kept thinking that I wanted to get into a squatting position to make things happen faster, but couldn’t fathom a way to make that comfortable, so I continued with what I was doing.

My doula would occasionally remind, me with her own sounds, to keep my moans low when I would begin to get high-pitched. It was helpful. I tried to remember to keep my face and hands relaxed too. She held my ice water for me and gave me sips with a straw between the hard work of pushing.

Eventually I reached in and felt a fuzzy little baby head. It was just a few inches in, but seemed so far away still – considering that I was pushing and pushing, and it wasn’t out yet! It was encouraging though, even if I didn’t let on to anyone outside my head, so I continued. I was a bit worried that I was pushing “wrong” though, since I felt like I may push the baby out my butt! That’s what my body was doing though, so I kept at it. My support team was so encouraging. I was feeling tired, sad, & whiney. I would look up at them hoping someone would feel sorry for me (and maybe let me quit?!) and they would just smile and tell me how great I was doing, and how my baby would be here so soon. At one point, I looked at all the women in the room – all of whom had children and two of them who were pregnant again. I questioned their desire to ever do this again. They all said they’d do it again without hesitation. I told them they were crazy…

I decided to check on where the head was during a contraction, and was surprised at how close it was – just a fingertip inside. Of course, after the contraction, it would slide right back. After being at quite a few births as a birth assistant, I knew that this was completely normal, and that it was a good thing – letting your body stretch, blah, blah… but it’s so different being on the other side of it! I felt like I was doing the same thing over and over again. Soon, the baby was beginning to spread me open during a contraction. I had Joe reach down to feel his baby’s head. By his surprised reaction, it seemed like he thought I had been making all this fuss over nothing! He was excited to know we were so close though. And then… it would slide back in. This kept up until we could feel more & more head. I was feeling the burn of my perineum & labia stretching for the baby’s head. “Ring of Fire” is right! My body was still pushing on its own, and I’m lucky it was, because I had no desire to continue! I just couldn’t fathom that it could stretch even more – it felt so tight! I kept my hand down there to make sure I wasn’t splitting in half. This whole time, the Hypnobabies “pushing time” script cd was playing in the room, talking about letting my baby gently “slide” down the birth canal… ha! Part of me was laughing at and cursing the words I was hearing and the other part of me was really wishing that I had actually done the Hypnobabies practice – and not just fallen asleep to the cds at night, hoping it would still be effective! It was good to have something positive to focus on though, so I let it be. I wasn’t sure I could handle a quiet room. I thought about putting Pandora on, and then I thought I’d like the ocean waves sounds cd that was in Kalina’s room, but I couldn’t put enough words together to say any of this. I really just wanted to enjoy the time between contractions and not talk. Pretty soon, a contraction ended and the baby’s head didn’t go back in! I was excited, but it stung so! I complained to Joe that maybe if I had done the perineal massage like I was supposed to, that the baby would be out by now. Who knows if that was true!

Kalina & my friend had been peeking into the bathroom off & on for a while. I had been worried that my noises would scare her, and told them I didn’t want her in until the baby’s head was actually on the way out, so at this point they called them in. She was so calm and excited about meeting the baby. She came over and gave us hugs and kisses and greeted everyone in the room. We told her she could touch the baby’s head and she did. Harmony held a flashlight under the water so she could see. It was so cool that she was able to touch her new sibling before we even knew if it would be a brother or a sister!

I was leaning back against Joe, feeling more & more baby head on the outside. In a couple of contractions, the head was out! I could feel the baby moving between my legs under the water - on the outside for the first time – it was thrilling! I knew the shoulders would be born with the next contraction. I waited, a bit worried that pushing the shoulders out would either hurt the baby or hurt me, and was trying to picture which way the shoulders were supposed to turn to come out. When the next contraction came, my body pushed and she slid right out! I reached down to grab her, while Harmony untangled the cord that was wrapped around her body. I picked her up out of the water, amazed, and feeling SO much better! You could hardly see her blue skin under all the thick white vernix that covered her! She was quite alert with her eyes wide open and her arms & legs flexed. I rubbed her back and talked to her, still in amazement. She began to pink up and make a couple little sounds, but no crying. She just took it all in. Someone finally asked about the sex, so I took a little peek. It’s a GIRL! Just as I thought. Kalina’s sister had arrived! I kissed her forehead and my lips got coated with vernix – best chapstick around, I suppose! I offered her my breast and she latched right on like she’d done this before. She had a cone head from molding in the birth canal (thank God she did!) and her right eye looked a bit swollen and squished, but she was the most beautiful thing. I could feel all those love hormones flooding my body. I asked the time she’d been born, and was told 8:48pm – she waited till sunset to make her grand entrance into the world. I had thought that I would probably labor at night while Kalina slept, as many moms tend to do, and then give birth in the morning. But evening turned out to be such a perfect time to have the baby since we’d all get tucked into bed together and get a full nights rest.

Joe got out of the tub and went to phone our families to let them know that she’d been born. As much as we wanted our family to be a part of this, we knew we wanted a much more intimate experience this time, so we kept everything from our estimated due date to the time I went into labor a bit of a mystery. I wanted to fully relax and not feel any pressure if I went past my “due” date, or feel that people were worrying about me if I ended up laboring for a long time again. So, we decided to just let everyone know when the baby had arrived. And that miraculous time had come!

I was starting to feel uncomfortable sitting in the tub, and nursing was causing painful uterine contractions – as it should, helping to release the placenta. I checked to find that the cord was no longer pulsing, so baby had gotten all that she had needed. I wanted Joe to come cut the cord and take the baby so I could work on delivering the placenta. I thought the baby would be upset when unlatched and taken away, but she was quite content, skin to skin with daddy in the rocking chair. I had someone get Kalina’s new baby doll out of the closet. I was hoping she’d adopt this baby and name it “Lucy” so she would stop insisting that we name our new baby that! She liked the new doll, but she was still pretty disappointed that she couldn’t hold the real baby right then.

I tugged the cord a little to see if it would come, and then Harmony tried, but I ended up needing to change positions – I got on my knees and gave it a push to help it come out. I was really not looking forward to pushing anything else, but the placenta was easy like they said. It came out like a blob – yay for no bones! We put the placenta in a bowl and Kalina came in to see it. We had read some books about new babies & home birth, so she knew about the baby’s umbilical cord and what the placenta’s job was in utero. I gave her a little tour of it and showed her the sack that was her sister’s home for 9 months.

I got out of the birth tub and into some clean water in the bath tub to rinse off before I headed to bed. I then got to join my family of 4 in our very own bed to cuddle and bond. Kalina was pretty excited and had to be reminded not to jump around or climb on me. I propped myself up on pillows to nurse the baby. Everyone went downstairs to give us some alone time and to eat some of the yummy food my friend had been busy cooking all day.

When they came back, they brought me a big plate of food. I was so excited – I couldn’t believe how hungry I was! Harmony & Heidi got the things together to do the newborn exam at the end of our bed. Kalina brought her new baby doll over and got to examine her – listened to her with the stethoscope weighed her, etc. I loved how involved Kalina got to be in this experience. It was the same in all my prenatal appointments. She always had a turn to listen to my baby, take my blood pressure, and to have her belly listened to, whenever she came with me. She’s a real pro now!

The lovely Rosemary Birthing Home ladies did baby girl’s exam while Joe & I ate dinner and watched. From the amount of sticky vernix that covered our little girl, her soft ears, and lack of deep lines on her feet, Harmony estimated that she was possibly a younger baby – she could have been a week early, not just a day early like we had thought. Still though, she weighed in at 8lb 6 oz and was 21” long with a 14 1/4 “ head. They looked her over and she was perfect. After having her on the outside, I couldn’t imagine if I had to wait another week to meet her!

Our birth assistant busied herself emptying the birthing pool and doing laundry. When she was done, our bathroom looked better than it had before she came! Harmony accompanied me to the bathroom so I could pee. My peri bottle full of herbs was ready and waiting for me, along with an ice pack and some pads. My friend was downstairs with Kalina, and my mom was on her way over to take over for her so she could head back to her family after a long day. We were given our post-partum instructions and vitals were taken on both the baby & I. Then we were tucked into bed and told to get some rest since this was the longest stretch the baby would sleep for a long time.

Joe passed out before the birth team even left, close to midnight, but I was so in awe of it all, I just laid there and stared at our precious new being for a long time. I did manage to sleep for quite a bit. Every time I woke, I was so grateful to be in my own home, in my own bed this time around. No one coming in disturbing us every hour, or telling us what we should be doing. There were no roommates, and we had our own bathroom and food. It was bliss. It was just our sweet family and our instincts (and our midwife’s instructions) to guide us. This is what made it all worth it. This is what makes me think I could do it again.