From New Beginnings, Vol. 26 No. 2, 2009, pp. 36-37
Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.
A woman's experience in giving birth affects the beginning of breastfeeding and her attitudes toward new motherhood. In this new column, "Giving Birth," we'll be relating stories and sharing information on how birth and early breastfeeding can be satisfying experiences. We welcome birth stories, spanning the spectrum from cesarean to home birth, and everything in between. We particularly want to know how breastfeeding went afterwards -- for better or for worse!
In this first story, Coby describes how a difficult birth becomes a positive experience. She is supported throughout her labor at home by her partner, Rinze, and a pair of Independent Midwives. In the UK, Independent Midwives are fully qualified and registered midwives who, in order to practice the midwife's role to its fullest extent, have chosen to work in a self-employed capacity. The midwife's role encompasses the care of women during pregnancy, birth, and afterwards so as to provide continuity of care. With their support, Coby is encouraged to trust her own instincts and give birth without intervention. While the birth is a difficult one, Coby's sense of maternal fulfilment and personal self-worth shine through.
Coby's Birth Story
I have heard that if a woman wants to start labor she should eat a good hot curry! That evening we cooked a mild one because we don't like it too hot.
When I woke up the next morning, I felt sure that labor would start. We decided to go shopping to try to get things moving. During the walk I had contractions.
During contractions later that evening I leaned on my partner, Rinze, and started to sing a song. It was about meatballs and red cabbage! Sometimes I could cope with contractions by standing on my own, singing a song with my arms in the air. When I was fully relaxed it was easier to deal with contractions and the contractions could do their work.
When my midwife, Sally, arrived the next day I was still singing my song. The contractions stopped for a while, which can be normal when someone strange enters the birthing room. Later when I got into the birthing pool my contractions disappeared again. I asked Sally if she could feel the baby because I was a bit worried about her position. My baby was moving all the time and had hiccups.
Sally suggested I start walking and be active or alternatively go to sleep. She stayed while I slept and, when I woke up, we talked about why my labor wasn't progressing. I needed to let go of my worries. Sally left and we went back to sleep. Soon my contractions started again and splash, my waters broke. The contractions became stronger and stronger and I had the feeling that I had to defecate. Rinze called Sally. When she arrived, I climbed into the pool thinking: "Second child so a short second stage. We will have my baby before Jelmer (my son) wakes up!"
So Rinze and I went in the pool around 7 o'clock and I started pushing with each contraction. I found it hard to focus on the contractions. I was pushing and pushing. After a while Sally asked me to leave the pool and encouraged me to try different positions on the floor. I managed to do that and tried standing, kneeling, lying, sort of jumping but nothing much happened. I had a terrible backache. Sally, Jo (my second midwife), and Rinze had to push on my back when I was pushing. The midwives told us that the baby's head was in a difficult position. Jo mentioned going to the hospital because nothing was happening. I wanted to go in the pool before we made a decision.
Back in the pool, there was some progression. I reached down and I could feel my baby's head. But it didn't move. Nothing was happening and I asked them to call the ambulance because I thought it wasn't going to happen.
To my mind it was a bit too cozy around my pool. Jo made some coffee and they were drinking it in front of my nose (don't do that!) and were chatting. I ordered them out of the room and to leave me alone.
In the pool I dozed off a couple of times: I couldn't push continuously for that long without a break.
Sally came in to check on me and sat quietly in the room. I think Rinze came as well, but it was labor again and not a cozy tea party any more. Suddenly I felt the head moving. Hurray! Her head is moving. I remembered Jo saying, "when the baby comes out she might be facing you."
The ambulance came and the driver wanted to wait for 15 minutes because labor was progressing now and when the midwives asked him to leave, I felt I really could give birth to my baby.
It was easy in the pool to change position, which I did a lot. I adopted all kinds of different positions. I was sitting on my knees and I yelled "I can feel an eyebrow!" It was her right eyebrow. Sally was in the corner and came quickly. She asked me to lean backwards and finally, finally at 11:31 am there was Lienke, a chubby little baby. Born with her face up and back to back. She was chubby, pink, breathing, and she felt good. She looked for my breast, latched on properly, and drank for a while. The placenta came just when I thought I couldn't bear any more pain and, after a while, I cut the cord while Rinze was holding Lienke.
When Sally weighed Lienke she was 10 lb 5 oz. Wow, a really chubby baby! I felt dreadful and so tired as it had taken everything to deliver her normally. I did it but don't ask me why or how!
Breastfeeding with Lienke went well from the start. I had breastfed Jelmer, so I knew what to do. With Jelmer I was an inexperienced mother with an inexperienced small sleepy baby. This time I had some experience and Lienke was a chubby, healthy baby who knew exactly what to do. I've read that babies who have a difficult birth can have problems breastfeeding because of exhaustion. But despite her difficult birth, Lienke did better than Jelmer had after his straightforward birth. Nursing a baby weighing more than ten pounds needed a different approach to nursing a tiny one. I'd had to use all the sleepy baby techniques with Jelmer and now needed totally different techniques with Lienke. I had a very strong let-down and if I wasn't careful I gave her a full milk shower. Once at a La Leche League meeting I gave the person next to me a milk shower because Lienke suddenly stopped nursing, I was so embarrassed. But better at an LLL meeting than somewhere else!
I thought any engorgement would be minimal because my breasts were used to lactating and I had nursed Jelmer during the pregnancy. But I was wrong, my breasts were overflowing with milk. Lienke did her best but I had to express as well. On day six I was feeling really poorly. My body was still recovering from the tiring birth and the possibility of developing mastitis wasn't welcome. By offering Lienke the breast more often, not wearing a bra, and staying in bed (which I was doing already), I managed to avoid a full blown infection.
With Jelmer we were given a timetable for feedings and told, "let the baby sleep in his own bed." But with Lienke we were in charge and she could nurse whenever she wanted. Our midwife was very supportive of breastfeeding and didn't have any reservations about cosleeping.
All in all, the experience with Lienke was much more natural. We were very happy with our midwives: they did a great job watching and waiting and letting me do my own thing. Without them, Lienke would probably have been born by cesarean section or with other interventions.
In the days after Lienke was born I had difficulty processing the birth. Why was she in that position (persistent occiput posterior), why was she so heavy, and why this combination? What had I done? In Great Britain, where Lienke was born, a home birth is considered brave and not using pain relief almost madness. I'm proud of what I did to bring Lienke into the world and I loved her from the moment she was born. It was a beautiful if difficult labor and I would do it again.
Lienke is amazing. In the Netherlands, my home country, her name means "stargazer" and we chose this name for her because when she was born she was looking for the stars.
Gaskin, I. M. Ina May's Guide to Childbirth, Bantam Books, 2003.
Goer, H. The Thinking Woman's Guide to a Better Birth New York New York 10014: The Penguin Group (USA) Inc.
Read, G. D. Childbirth Without Fear. The Principles and Practice of Natural Childbirth. Pinter & Martin, 2004.
Simkin, P. The Birth Partner. A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor, Companions, third edition, Harvard Common Press, 2008.
Ten Tips for a Normal Birth
Adapted from Lamaze International's Ten Tips in The Womanly Art of Breastfeeding, Schaumburg, IL: LLLI, 2004; 19-20.