Joy Restored

Childbirth practices had changed since I began my career as a labor and delivery nurse. The use of pitocin to hasten birth had become common. The rate of cesarean section had risen from 15% to 30%. I saw a full term infant die after inappropriate use of pitocin. I didn’t like my role as nurse, and I told my husband that I wasn’t sure that I could continue.

I was aware of a group of doctors and midwives that attended homebirth. I interviewed with them and chose to take a cut in pay to work with them. It was refreshing to attend women in their homes, supporting them as they labored.

Women were more relaxed, and the family was often involved. I saw that God had given women the ability to give birth. I saw the strength of women. Sometimes intervention was necessary. Hospitals are important and are equipped to handle complications. We transferred about 5 to 10% of the women to the hospital.

The four years that I participated in home birth restored my joy as a nurse. When we are burdened and lose our joy, we may need a new perspective. I am thankful that God led me to take the home birth position (something that I never dreamed I would do).

This lesson stays with me. I need to step back from hard situations and ask God to give me a new perspective. He will restore our joy and renew us in the roles he has given us.

How about you? Could you benefit from a new perspective?

I am joining  the Five Minute Friday community of writers. Our one word prompt this week is: RESTORE

Different Environments: New Perspectives

I am joining the writing community, Five Minute Friday, today. We write for five minutes (or sometimes a little more). The prompt today is: ADAPT

Family - Bouquet

 

It was a decision I came to after much thought, choosing to work with physicians and midwives that attended home birth. I had worked in the hospital for many years.

I continued to work in the hospital labor/delivery unit on a  per  diem   basis, while taking weekend call for the home birth group.   Nurse colleagues in the hospital who knew about my second job warned me to keep quiet. Don’t tell any of the doctors.

There is a big divide and limited communication between hospital based birth attendants and home birth attendants. Home birth practitioners are reluctant to transfer patients to the hospital until absolutely necessary. Hospital staff only see the home birth patients that are in crisis. They don’t see the healthy births that take place at home.

I learned so much attending labor patients in their home. I carried supplies that might be needed (IV fluids, oxygen), and arrived at the home when a woman was in early labor. I assessed her and encouraged her to rest in early labor. As labor progressed I helped her with positions changes, suggested a warm shower and offered massage. I made sure she stayed hydrated and nourished.

It was so much easier for a woman to work with labor in her home. (I had taught Lamaze classes, but rarely saw such focus and ability to cope with labor in the hospital setting.)

It was my job to notify the doctor of any problems, and to update him on the progress of labor(so that he/she would arrive in time) . Of course, sometimes a woman needed the interventions available in the hospital. Sometimes I urged the doctor to transfer the patient. A couple of times I rode to the hospital with a labor patient needing intervention.

Hospital staff and home birth practitioners could benefit from switching places. They could learn skills from each other and develop better communication.

As I worked with a foot in both settings, I tried to adapt what I had learned in the home to the hospital setting. The home setting had given me new perspectives on birth.

Call the Midwife: the Spiritual Aspect of Childbirth

It is the 7thseason of Call the Midwife, and I make time to watch it. This weeks episode had me in tears. Death is hard, but I am glad that the current series has reflections on faith. When it first aired I wondered how close it was to the book that it is based on.

In the fall of 2012 I wrote this blog post:

If you liked the new program, Call the Midwife, airing on PBS, you will like the memoir written by Jennifer Worth. A few years ago I came across The Midwife: A Memoir of Birth, Joy and Hard Times. Jennifer was a midwife for the east end of London in the 1950s. The TV program is based on her book.

The PBS program is accurate in presenting episodes described in the book. I did go back to check the validity of the  premature  birth  story.    According to the memoir the baby was born at 28 weeks gestation after the mother had taken a bad fall. Despite being very sick and weak the mother refused to let the medical staff take the baby to the hospital.

She kept the baby on her chest, skin to skin. She expressed colostrum from her breasts, and every half hour she used a little glass tube to drip the colostrum into the tiny baby’s mouth. By instinct she was keeping the baby warm and nourished.

This was a 1950s example of kangaroo care motivated by maternal love and instinct.

Jennifer Worth recorded that the baby survived without impairment.

The program left out spiritual messages in the book. As a young midwife, Ms. Worth was frightened by the situations that she was thrust into. She wrote how the prayers of the nuns gave her calmness. Ms. Worth gave insight into the emotions she had while preparing to attend the premature birth.

She wrote: The knowledge that sister Julienne would be praying for us had an extraordinary effect. All the tension and anxiety left me, and I felt calm and confident. I had learned to respect the power of prayer. What change had come over the headstrong young girl who, only a year earlier, had found the whole idea of prayer to be a joke?

Prayer was part of my home birth experiences. At times the husband prayed. Occasionally I prayed.  Although I am not a poet I wrote some lines to remember the  scene  at a birth I attended, assisting a physician.

Labor pains came gently
through the night.
Morning light streamed
on her rocking chair.

Her labor intensified.
She walked, clutched my arm,
And listened for
encouraging words.

Her movements
were intuitive. She labored
with position changes
and firm massage.

She knelt down
and asked me to pray.
No pain medication.
She asked me to pray.

I prayed as she moaned
And released her body
To surging waves of pain
Her body pushed.

A circle of crown,
head and shoulders,
a baby girl was born
in the afternoon glow.

Childbirth is a time to lean into God.

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Talking About Sex

On Thursday evenings I look forward to seeing the prompt  that  Kate   Motaung has chosen for Five Minute Friday. I enjoy linking up with this community of writers and seeing where the word takes us. Today’s prompt is: INTENTIONAL

I was born in the 1950s, before the b.c. pill became widely available

My mother had five of us. The women in my church had anywhere from three to five, maybe six children. My aunt had six children.

I was just out of nursing school when Roe v. Wade legalized abortion. I still remember the young woman that was brought in to the  labor and delivery unit where I was working. She was there for a saline induction and as I understood what was happening, I was horrified. The baby would die before being delivered.

The next day I went to the nurse manager and told her that I could never be assigned an abortion case. I wrote a letter about my conviction, and it was placed in my file at work.

I grew up in a different age. The sexual revolution has made things seem common, things that are harmful to women.

I want my granddaughters to know that they should protect their bodies. I want them to know that sex is a deep bond reserved for marriage. It is just one part of a life-long commitment to one man.

I want them to know that sometimes pregnancy is a surprise,  but  it  is  always a gift. Motherhood is hard; it is a self-sacrificing role, but it has many joys. It is a time to get close to God. A time to lean in to Him for strength and guidance.

I will tell them.

All Life is Precious

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A Thanksgiving Birthday

This year I cooked the turkey on Wednesday, a day before Thanksgiving. I scooped out the stuffing and put it in a casserole dish. I deboned the meat and placed it in a  large  baking  dish.   I  put  the  bones in  the  freezer, planning to make broth sometime in the next week.

Turkey

When my daughter and her family came for Thanksgiving my meal was ready. I said to her, “This worked well. I think I might want to do this again.”

She gave me a peculiar look and said, “You cooked the turkey on Wednesday last year too.”

“I did?”

“Mom, the baby was due and we didn’t know when I was going to go into labor. You made the turkey ahead and brought it over on Thanksgiving.”

And then I remembered. She did go into labor late in the day on Thanksgiving. Sometime during the early morning hours of the next day she went to the hospital with her husband—and I went along as extra support.

The birth of my youngest grandson was beautiful. The doctor commented that he wasn’t really needed. Everything proceeded smoothly.

I remember the birth of this little boy,  now  turning  one  year  old.  Memory of the Thanksgiving dinner has faded into the background.

But I think I will keep the tradition of cooking the bird on Wednesday.

This post is linked to Five Minute Friday. Every Friday Kate Motaung gives a word prompt. And then we write for five minutes. Today’s prompt is FAMILIAR.  Visit this community and join the fun by clicking here.

The Midwife’s Story

A number of years ago I read an article about a Finnish midwife. In 1909 she had been at the center of a court case, determining the legality of midwifery in Massachusetts. She had been arrested a number of times (despite the fact that her statistics for live births were better than most doctors practicing in the area).

I was struck by her determination, her sisu, in serving childbearing women in Gardner, Massachusetts. Why did she persist after multiple court appearances and a three-month sentence in the House of Corrections?

Her persistence fascinated me. So I began researching her life. I visited Gardner, Massachusetts and found her burial place in the Crystal Lake Cemetery. During the trip that my husband and I made to Finland, I visited the parish where she lived. The church records listed the significant dates in her life.

The court cases that were brought against Hanna influenced the decline of midwifery in the first half of the twentieth century. I am in the process of writing her story.

This post is linked to Five Minute Friday. Every Friday Kate Motaung gives a word prompt. And then we write for five minutes. Today’s prompt is STORY.  Visit this writing community by clicking here.

When Postpartum Packs a Punch: Book Review

As a former labor/delivery nurse and Lamaze instructor, I am an advocate for prepared childbirth. Women need information and guidance as they make choices about childbirth care. They need to know what to expect.

But in the preparation for childbirth, the postpartum time period may be given brief attention. Women benefit from knowing what to expect in the weeks following childbirth. According to research cited in the book, When Postpartum Packs a Punch, the range of women experiencing post partum depression is 12% to 25%.

When Postpartum Packs a Punch

 

As I read through the book I found the author’s observations consistent with my own as a nurse. Ms. Cowan tells her experience of postpartum depression, along with the stories of women that she has interviewed. She provides a discussion of treatment options. She explains the way her faith in God guided her.

Like the author I have experienced help and healing by trusting God when experiencing suffering. I believe that God helps us grow when we turn to him.

Inspirational quotes appear throughout the book. The tone of the book is hopeful, pointing to healing. Women experiencing depression and the people that support them can find help in this book. The book can also provide a greater awareness of the needs of women in the weeks following childbirth.

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The Health Benefits of Dates and a Muffin Recipe

Dates have some surprising health benefits for expectant mothers.

Women often receive a prescription for iron during pregnancy.  During pregnancy a woman’s blood volume increases by 50% and the red blood cells increase by 30%. Red blood cells contain hemoglobin that carries oxygen; iron is a component of hemoglobin.

Iron is a vital mineral during pregnancy. A low hemoglobin level is associated with fatigue and is a risk factor during childbirth.

I looked up iron-rich foods in my nutrition almanac and found this list:

Organ meats and meats, eggs, fish and poultry

Blackstrap molasses

Cherry juice

Green leafy vegetables

Dried fruits [including dates]

 

A research study, published in March of this year, looked to see if eating dates in the last trimester of pregnancy had an impact on a woman’s     labor, childbirth experience. The study demonstrated that women who consumed dates had less of a need for medication to augment their labor.

Here is a muffin recipe that has iron-rich ingredients, including dates. Brown rice flour or a gluten-free blend works fine.

Date Muffins

Ingredients:

1 + ½ cup flour
½ cup almond meal
2 + ½ tsp. baking powder
½ tsp. salt
½ cup pitted and chopped dates
¼ cup melted butter
¼ cup honey
3 Tblsp. unsulfured dark molasses
2 eggs
½ cup almond milk (or other milk of choice)

Preheat oven to 350°

Combine flour, almond meal, baking powder and salt. Stir the chopped dates into flour mixture until well combined.

Mix together the melted butter, molasses, honey, lightly beaten eggs and milk.

Then mix the liquid ingredients into the dry. The batter will be a little lumpy. Fill the muffin cups—I had enough batter for 14 regular size muffins.

Bake at 350° for 18 to 20 minutes or until a toothpick comes out clean.

Date Muffins

You can find the study about the effect of date consumption on labor here: https://www.ncbi.nlm.nih.gov/pubmed/28286995

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Viewpoint of Alternative Science: Breast-feeding is Unnatural

Cathy Areu was a guest on Tucker Carlson Friday night. She argued that breastfeeding was not natural because it put too much pressure on a woman to feed her baby. She insisted that it was natural for a dad to feed the infant formula. She referenced a recent “study”.

I watched the astonished expression on Tucker’s face as she made her case. Lol.

The argument was so bizarre that I looked for the study on-line. Ms. Areu was referring to an article that was published by Heatstreet on April 26, 2017. The article, “Study: Describing Breastfeeding as ‘Natural’ Is Unethical Because It Reinforces Gender Roles” was written by Jillian Kay Melchior. She writes:

It’s “ethically inappropriate” for government and medical organizations to describe breastfeeding as “natural” because the term enforces rigid notions about gender roles, claims a new study in Pediatrics

I checked the link to Pediatrics and found the opinion piece that was published on April 1, 2016, a little over a year ago. Not a recent study.  The article,  “Unintended Consequences of Invoking the “Natural” in Breastfeeding  Promotion,” * was written by Jessica Martucci and Anne Barnhill.

They wrote: Promoting breastfeeding as “natural” may be ethically problematic, and, even more troublingly, it may bolster this belief that “natural” approaches are presumptively healthier. This may ultimately challenge public health’s aims in other contexts, particularly childhood vaccination.

This perspective really startled me. I looked for other viewpoints. CNN had an article about the study and I was grateful that they included an opposing view. Carina Storrs authored the piece entitled, “Are there unintended consequences to calling breast-feeding ‘natural’?”

In her article she included this quote: “(The authors) are using this article to label the breast-feeding group in a very negative way, and to equate breast-feeding with people who don’t want to take immunizations,” said Eidelman, who was lead author of the 2012 AAP policy statement on breast-feeding.

It was troubling to me that, in the Pediatrics article, assumptions were being made about women who breast-feed and women who have questions about vaccines. It is true that some parents are reluctant to vaccinate their child because their child was injured by a vaccine.   Some have studied the issue and are concerned about the risks.    They have   legitimate concerns. The vaccine controversy will not go away by labeling people and denigrating them.

Wow! Over the next few hours I kept thinking about the dismissal of breastfeeding. We know that breast milk has immune factors that formula cannot provide. We know that it is most easily digested and absorbed by an infant. It is recommended that a mother breastfeed her infant for six months to avoid food allergies. The benefits are too many to enumerate.

Breastfeeding

I found that I agreed with one statement that Ms. Areu made. Breastfeeding is hard. The first time a woman breastfeeds she needs support and guidance. But her labor and birth experience have also had an impact .

My observation as a labor/delivery nurse is that the interventions that take place in the hospital can influence the breastfeeding experience. Medications given to induce labor and for pain management can have negative side effects. Women that have cesarean sections have a more difficult time establishing breastfeeding.

How soon the baby is placed in the mother’s arms (hopefully skin to skin in the first hour of life) influences early success in breastfeeding. If the mother has been traumatized by the manner of birth, breastfeeding may be more difficult to establish.

As I tried to understand the upside-down way of thinking that Ms. Areu was demonstrating I wondered what has happened to science.

Are we being asked to consider all medical interventions as natural? When we observe normal physiology and gain practical insights, are these unnatural?

I am sad because the turmoil in science and medicine is only making it hard on parents. My hope is that the medical community will listen to the concerns parents have and treat them with respect.

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*Jessica Martucci and Ann Barnhill, “Unintended Consequences of Invoking the “Natural” in Breastfeeding Promotion”, PEDIATRICS Vol. 137 No. 4 April 01, 2016

 

 

Women’s Rights & Midwifery

Prayer and RestWomen today have more rights than our ancestors. As we have made progress it is odd that the loudest voice in the current women’s movement is for abortion. I would rather support the right of women to give birth in the setting that they choose. Across the world there is unresolved controversy over midwifery and home birth.

At the same time that suffragists were fighting for a woman’s right to vote, the medical system in the United States, was fighting against the practice of midwifery.

For the past few years I have been researching the life of Hanna Pörn and her court case. She was a Finnish midwife that received a certificate of midwifery from the Chicago Institute of Midwifery. She lived and worked in the Finnish/Swedish community of Gardner, Massachusetts. After eight years of practice, having better statistical outcomes than the local doctors, she was arrested for practicing medicine without a license. The case went to the district court, and was appealed several times. In 1909 she was found guilty and sentenced to two months in jail.

Other countries have had lawsuits against midwives. In recent years Agnes Gereb left her position as an obstetrician and trained as a home birth midwife in Hungary. After delivering many babies in the home setting, she was arrested because one baby died. She was placed in house arrest and the case has been moving through the courts. You can read about her case here.

Today my husband handed me the Wall Street Journal pointing out this article, Sweden Blacklists an Antiabortion Midwife. Ellinor Grimmark trained as a midwife in Sweden in response to the current shortage of midwives.

In spring 2013, with one term left in her studies, she asked supervisors at the hospital where she planned to work to accommodate her conscience rights. [She did not want to participate in abortion.]

She received a furious call from one manager. “How could you even think of becoming a midwife with these opinions?” *

It is a strange world if, in order to attend the birth of babies, you must be willing to kill babies. This brings to mind the Biblical account of two midwives.

The king of Egypt said to the Hebrew midwives, whose names were Shiprah and Puah, “ when you help the Hebrew women in childbirth and observe them on the delivery stool, if it is a boy, kill him; but if it is a girl let her live.” The midwives however feared God and did not do what the king of Egypt told them to do; they let the boys live. Exodus 1: 15-17

Ellinor Grimmark was unable to secure a position in Sweden and is now living and working in Norway. Swedish mothers are coming to Norway to give birth.

Many women are seeking a kinder, gentler way of birth.   Birth  has    physical, emotional and spiritual aspects. Midwives understand this.

So  much  emphasis  is  placed  on  the   physical aspect of birth alone—treating pregnancy like an illness. Frequently, aggressive management of labor takes place in the hospital—and there are consequences. We need to swing the pendulum back. Let labor and birth take place at a natural pace. Midwives have an important role in providing healthy birth care.

In Illinois the Home Birth Safety Act is up for debate in the senate.      Thirty-two states allow midwives to provide home birth care. Illinois should join these states and pass SB 1754. If you live in Illinois, call your state senator and ask him to support SB 1754.

*Sweden Blacklists an Antiabortion Midwife, The Wall Street Journal, April 10, 2017, A17.

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