The Midwife's Desk

Maui and the waterbirth of Matson

2012-02-26T13:29:00.001-08:00

Aloha readers!

The midwife is back, after an extended winter of travels. I had just recovered from my travels in India, when it was time to attend Jenny and Chad's beautiful birth. (see video below!) Then we set off on a major family camping expedition to Maui. The Moes Family Band played at a music fesitval, Maui Mystic Island, at the end of January. We stayed for two more weeks, camping and exploring the wonders of the tropics. Here we are playing our set at sunset on the beach.

Some YouTube footage will be coming soon.

Speaking of YouTube, my January clients Jenny and Chad made this lovely birth video!

Enjoy!

Dena

Heart Meltdown at the Taj Mahal

2011-12-14T19:33:00.000-08:00

   It's official - I have been in India long enough that my armpits smell like curry. Really, this has happened! Eat Indian food twice or three times a day for ten days and your body sweat becomes fragrant like tumeric and cumin.. I was sniffing my shirts to determine the need to launder them, and they smelled aromatic and spicy, instead of sweaty, right in the armpits. At first I figured I had spilled food on my shirts - how else could they smell like that? - Then I realzed the odor was truly coming from the armpits. Just imagine how aromatic Indian ladies' amniotic fliud and breastmilk are...

I miss my children. I dreampt last night that I had left Sophia home all alone and gone to a big Chikoko gala event. Suddenly I realized that it was 11pm already and quite dark outside. I hadn't meant to be out so long! How would Sophia be handling that all by herself? So I went out to the lot to get my car, and the lot was like an Indian taxi lot, cars so crammed in tight you couldn't even get one out if you wanted. And I couldn't remember where I left my car anyway. A feeling of urgency to get back to her came on, and I woke up. Whew, I didn't really leave her alone; I am in India, she is home with Adam safe and sound.

   I spent a day in Agra this week. I was told that while I am in India, I must see the Taj Mahal. Simply must; it is a two hour trip from Delhi. Agra itself is known to be a bit of a pit, so I did it as a day trip. There is a train that takes you to Agra in the morning, and brings you back again that evening. They feed you breakfast on the way and dinner on the return. Once at the Agra train station I hired a taxi and driver for the entire day for fifteen bucks. My driver took me to all the Agra sites - the Agra fort which houses the fantastic palaces of three Moghul emperors, the backside view of the Taj from across the river to see it cloaked in morning mist, and the Taj itself for afternoon and sunset. He also took me to his "friends'" jewelry and carpet shops, (meaning he gets a commission for bringing me there) which was an annoying waste of time because I wasn't interested in buying.

Agra was as bad as I had heard. It is filthy, ugly, poor. There used to be factories here but they had to close them because the industrial pollution was turning the Taj Mahal brown. So tourism is the only industry, and the locals are hungry for tourist money. One is intensely hassled wherever one goes As we drove from site to site I peered into the crowded neighborhoods. Filthy children playing in the dirty streets and pooping on the roadside, garbage everywhere, starving dogs and cows eating the garbage, children fetching water from a central pump (no sewage or running water here) , monkeys copulating on the rooftops, men urinating , people washing their clothes on the stones by the water pump, and throngs of colorfully dressed people carrying all manner of things on their heads filling every space. Wow. We are definitely not in Kansas anymore.

    The sites themselves were as amazing as the city was horrifying. The Agra Fort brought to life the book I just finished reading about the area's history called City of Djinns. The Moghul Empire was a brutally violent, but artistically and culturally brilliant Muslim dynasty that lasted in Northern India from the 1500s until the British took over rule in the mid 1800s. Delhi and Agra were the seats of the Empire. The Emperors perpetrated incredible acts of violence upon their enemies, and also on their male relatives, inlcluding their own sons and brothers, in order to keep hold of the reigns of power. They rode around on elelphants, kept palace harems full of hundreds of women, and built palaces, mosques, and mausoleums that are some of the most beautiful buildings on this great earth. These have remained remarkably intact despite India's turbulent history and the area's profound poverty. When you build with solid white marble within a fort of fifty foot sandstone walls with spiked gates unbreachable even by elephants, you really are building to last...

The Taj Mahal itself is the biggest monument to love ever built. It was built for Emperor Sha Jahan's beloved wife when she died in childbirth. I passed through the gate of the Taj complex at three o'clock, looked out across the vast park/pavillion, and up to the Taj glistening white in the bright sun. My breath was nearly taken away. Yes, seeing the Taj is worth the hassle of a day in Agra. It is the most beautiful man-made thing I have ever seen. Pictures cannot show you what you see in person. The giant building floats above the ground. It does not appear to be anchored to this earth. The pure white marble domes soar in the air. It made me weep in awe. I pulled my shades over my eyes, pulled out my hanky, and gazed to my heart's content. For three full hours.

    I found my way to a mosque off to the side of the Taj. The courtyard in front of the mosque was completely empty except for a few muslim men washing their feet in a pond and coming in for afternoon prayers. The tourist crowds were all in the main pavillion area. I sat down against the wall of the mosque in the corner, covered my head with a shawl, gazed up at the Taj, and had a good, good cry. The contrast of the bleak poverty with the stunning beauty, all happening side by side, finally caused my heart to crack open. How can we stop the poverty? How can we help all these children have a clean place to live, school to attend, a way out of their current conditions? How can we clean up all the garbage?   I felt how much I love them all - every single person in India from the hasslers and touts, to the filthy children, to my sister and her sweet baby. I want to help everyone!

After a while my tears turned into song, and I softly sang a tibetan mantra of peace and enlightenment to myself. The sun began to set, and the Taj turned from bright yellow-white to soft pink. I lingered until dark, and slowly made my way back through the pavillion. At the gate I turned one more time to gaze. The Taj was now dusky blue-grey in the darkening evening, mist from the river rising around it like bedcovers. I pulled myself away, back into the taxi, and then to the fly and rat-infested train station to await my ride back to Delhi.

I don't have answers to the poverty and suffering, neither do the Indian people. But now my journey will take a spiritual turn, and perhaps some greater understanding will arise. Tonight I go to Varnasi, City of Light. This town has been the holiest site for Hindu pilgrimage in India continuously since 600 BC. That is 2600 years of pilgrimage! Hindus believe that to come to this city , do puja on the banks (called ghats) of the river Ganges, and then bathe in the river, will remove you from the suffering world and bring you to Paradise. I have a hotel room booked right on the river above one of the main ghats for three days. When Mark Twain visited Varnasi he wrote "Varnasi is older than history, older than tradition, older even than legend. It looks twice as old as all of them put together."

Then I will travel on to Bodh Gaya, the place of awakening, where the Buddha attained enlightenment. You can sit under the Banyan tree that is the grandaughter of the one the Buddha sat under. It is said that just to sit there brings one close to enlightenment. .Buddhist pilgrims come from all over Asia and the world to be there. I am hoping some of that enlightened energy will rub off on me, so I can bring it back to the family and community that I love, and the women and babies I serve.   This will be my last post from India - offered with love. Namaste!

A Palace, a Bollywood shoot, and an Opium Tea Ceremony

2011-12-13T19:56:00.000-08:00

The morning after the wedding was a slow start at Hem Guest House. I was the first up, and did some yoga on the rooftop. Our tired hosts (who had come home at 4am) managed to put together chai and toast, and I went off to sightsee for the day. I spent the day in the fort above the city. The palace in the fort was the home of the local Maharaj for centuries. There is still a Maharaj today but he lives in a newer palace on the edge of town. He and his family have lovingly preserved his ancestral palace and created a fascinating museum within in it . The museum has art and royal artifacts from the 1500's on. An audio tour that comes with the ticket explains everything, and tells anecdotes and stories. The Maharaj himself speaks on the tour, explaining things. Here are some pics pulled off the web of the palace.

What was not part of the regular palace tour was this - a Bollywood movie was being filmed at the palace that day. There was a cavalry of medieval soldiers, some on horseback, some carrying giant spears and swords, bloodied and wearing full medieval Rajasthani armor, being filmed marching into the palace complex. There were medieval princes and princesses watching them from the palace steps. There was Bollywood music blasting during each take. After the tour I sat in the cafe drinking a lassi and watching the actors. It was a lively addition to the palace visit.
I had a mellow evening at the guest house, and had dinner with some folks visitng India from Singapore. It was interesting to learn about Singapore, which is an English-speaking country full of Chinese, Indian, and Malaysian immigrants. The next morning my new friends Ering and Peng joined me on a jeep tour into the rural villages outside of Jodhpur.
This activity known as "Village Safari" brings foreigners into traditional rural villages to see how the craftspeople make their wares using centuries-old technologies. It is brilliant - it costs tourists just a few bucks, is a fascinating experience, and gives us a chance to buy the crafts from the families that make them. This provides them a living so they can continue to live in their traditional ways. It was lovely to get out of town, into the trees and fields, and dirt roads. The simple lifestyle of the villagers was just as I imagined. Whitewashed mud huts with thatched roof, outdoor kitchen cooking over a fire, food grown and then stored in large clay pots in a cool storeroom.

no microwave oven here!

     These are pictures of a Bishnoi house. The Bishnoi are a Hindi sect that are known for being especially respectful of nature. They will not cut down trees, only take dead branches. The area in which they live is full of healthy, beautiful trees, and antelope and happy cows. Three hundred years ago, the Maharaj sent his army into the Bishnoi village area to get wood to make his palace doors. When the army arrived to cut down some trees, a woman ran out and hugged the tree to stop them. India's original Julia Butterfly. Except then they cut off her head. So her three young daughters ran out to hug the trees. Their heads were also cut off. After 62 Bishnoi heads had been cut off , the Maharaj caught wind of the problem. He ordered the army to stop cutting heads, came out and apologized profusely, and promised to protect Bishnoi trees forever. The subsequent Maharajs have maintained this promise.
Opium has been used in this area for centuries. It is not smoked, but taken as tea. The maharaj would give opium tea to the soldiers before marching them into battle. That way, they would be braver, having visions of Paradise, and if they were hurt, they already had pain relief on board. The Bishnoi people drink opium tea as part of their rituals as well. We were privleged to participate in an opium tea ceremony at the Bishnoi home we visited. An ancient vogi prepared it by straining it through cotton filters, and praying and chanting over it. I am a "when in Rome" sort of girl, so while my friends politely declined, I tried some. He poured it into my right hand to drink. It tasted very bitter, but I sure felt relaxed and happy for the remainder of the safari...
   We got back to Jodhpur in time for a big meal and then catching my night train back to Delhi. Now I am here regrouping and taking long shifts of baby-holding for my sister. I have certainly forgotten how busy it is to have a one-month old baby. This baby likes to be held all the time...isn't that a shocker! Tomorrow I am off to Agra for the day to see the crown jewel of the Mughal Empire - the Taj Mahal. Then on Thurday I will take a night train to Varnasi on the Ganges, the holiest city in India. It is Shiva's birthplace, and where Hindus make pigrimage to bathe in the holy river Ganges. From there I make pilgrimage to Bodh Gaya, where the Buddha attained enlightenment. That will about just wrap up this India adventure.

Cheerio!

A Wedding in the Blue City

2011-12-10T23:18:00.000-08:00

I just had a mad-wonderful three days in Jodhpur, in the heart of Rajasthan beside the Great Thar Desert. Jodhpur is called the Blue City because for hundreds of years, the homes have been washed in Indigo to keep them cool and bug-free. The city sits at the foot of a hill on which a giant 17th century fort sits, looking over everything in majestic glory.

A nice feature of Jodphur is that the streets of the Old City are so narrow and winding, that cars cannot get through. Thus, a pedestrian has only the cows, motorcycles, and bikes to contend with

Or, for a real blast, one can ride in a tuk-tuk and be the queen of the road. You see, on India streets, the biggest thing wins, and everyone else must get out of its way. There is no waiting and allowing pedestrians to pass first. It has taken me a while to learn how to walk through the congested bazaars and not feel nearly run down by motorcycles and tuk-tuks racing through. But I am getting the swing of it. And after a day of walking about, hopping in one of these and racing through the streets myself is a blast.

    As I tuk-tuk through the streets, there are so many sights, sounds, and smells all around me, I feel like I am on some exotic Disneyland ride. Mr Toad's Wild India Ride. I cannot describe the sheer volume of it all - there is nothing in America to compare it to. A friend said, as we laughed at the absurd bedlam of our shared tuk-tuk ride, "India sure is lively!" People say that when you leave India and go anywhere else, it seems like you have cotton covering your eyes, ears, and nose. Your sense experiences are that much duller, anywhere else in the world!

   Let me now tell of this wedding!   I arrived in Jodhpur on a night train, which worked out great. I was a little anxious about leaving Delhi at 10 pm by myself, and the train station was a filthy old station in a run down neighborhood, used only for trains to Rajasthan. Even the train looked dirty and rickety. But once on board, things looked up. I was given a small clean bed, complete with sheets. blanket and pillow in an AC cabin, and slept all the way . I slept great. When I arrived, the younger of the two brothers who run Hem Guest House, which I had picked based on Tripadvisor reviews, picked me up on his motorcycle and took me to the House. He told me I am very lucky, I get to come to his cousin's big wedding party tonight. Really...
At the House, I was given chai and toast on the rooftop, looking up at the beautiful fort and down at the lovely blue town as it was waking up. The House had five rooms for guests, and we all ate breakfast together in the fresh morning light. Sure enough, we were all invited to attend the wedding that evening.
   I spent the day wandering around the old city. I found my way into a gorgeous white marble hindu temple, and sat while a group of elderly sari-clad women sang their puja. I marveled at the artwork in the temple. Painted reliefs, marble carvings, and brightly adorned alters from what looked like multiple centuries all mish-moshed together. The profound sense of antiquity in India is amazing!   There is so much history here, and modern life is just happening right on top of ancient things. The temples are like living layer cakes, with crumbling ruins at the bottoms and kitchy modern posters on the top and everything in between.
        At sunset we gathered and were tuk-tukked off to the wedding. The wedding was held in empty lot, where rolls of carpet were laid out covering an area the size of a large soccer field. White curtain "walls" were strung all the way around, and bright lights were erected, lighting the whole thing like a Bollywood set. Tables with tradtional Rajasthani foods lined the perimeter. Hundreds of people filed through a rainbow-lit curtained tunnel to enter. Everyone was dressed in their finest traditional clothes. I took pictures like crazy. After guests feasted on all the dishes, the tandoori-roasted chapatis slathered with ghee a real winner, the bride arrived. She was dressed in traditional wedding garb, a red sari so heavily ornamented with jewels that she could hardly walk in it. She was escorted to a corner to be photographed, and wait for the groom.
Finally the shout "the groom is arrived!" went out, and a small band of turbaned musicians marched in, blowing what looked and sounded like dissonent bagpipes and banging on drums. The groom rode in on a white horse bedecked in flowers. He was stopped at the entrance and made to bargain with the bride's female relatives. Some rupees were procured and in he rode. Bride and groom met in the middle, and climbed up upon a flower covered pedestal above the throng. A fireworks display ensued above the party. The bride and groom placed giant flower garlands around each others' necks, and stood smiling and holding hands. Then, the pedestal on which they stood began to revolve. It was a turntable. Around and around the bride and groom were slowly turned while the crowd cheered and a canon beside them shot endless pink flower petals into the air and everywhere. More fireworks, more flower petals flying, more cheering. Wow, what a spectacle. I was speechless and teary-eyed in amazement. By 11pm us foreign guests were wedding'ed out, so we missed the more traditional Hindu part of the ceremony, which apparently took until 4am. Oh, what a night!

Old Delhi Sights

2011-12-06T17:18:00.000-08:00

Yesterday I spent the entire day sightseeing in Old Delhi - an amazing and brain boggling experience! Old Delhi is a vast maze of bazaars and markets built in narrow passageways on the first floors of crumbling old buildings. These buildings are a mish-mosh of architectural wonders from 600 years of Indian history. The passages are filled with people, bike-rickshaws, sights, and smells. Truly a bizarre bazzar!

Old Delhi also has majestic Moghul mosques, forts, and palaces. Top that off with numerous Hindu and Jain temples filled with giant glittering alters to a vast array of dieties scattered everywhere, and you get an inkling of an idea.

I took the Metro in the morning from my sister's house. It was easy; the Metro is clean and convenient. One brilliant feature is that every train has a "ladies car" where only ladies can be. Since most of the metro riders are male, sittting with all women was lovely. We could all look around and smile at each other without any wierd vibes.

I took a bike-rickshaw from the station to Jama Masjid. Fun, swift, bone-rattling and white-knuckled way to go as the rickshaws just weave in and out of everything, passing pedestrians and cars with an inch or two on each side.

Jama Masjid, a mosque built in 1656, took my breath away. The soaring, swooping architecture lifts my spirits right along with it. I spent an hour here praying and taking in the beautiful, ancient energy of the place. I paid 100 rupees to climb to the top of one of the minarets and take in the dizzying view. The temples built at Burning Man each year borrow heavily from Islamic temple architecture. In fact, I do believe that this year's Temple of Transition was based on this very one!. While the Burning Man temple lasts for one week, this mosque is going on 500 years. Incredible.

I was told to find Karim's for lunch, in a tiny passage down a narrow bazaar. After losing myself completely, kind people pointed me the way. Karim's family has been cooking there since the 1700s, so the story goes. It was a remarkably clean little enclave with white marble floors in the midst of filth and mayhem. I ate the most delicious chicken lunch of my life. Recharged, I hit the bazaar-wandering in earnest.

I found the wedding bling market

the gem market, and the sari market where I was made to try on a sari that kept dropping in price...

I found my way into a crumbling marble Shiva temple, and a beauitufl Jain temple which has a charity bird hospital attached.

I went to the Red Fort, a sprawling comlex from the Mughal Empire. It was very busy with Indian families and groups touring. Actually, I saw very few non-Indians all day. Delhi is not a toursist destination for Westerners. A funny thing happened at the Red Fort though. All these people, especially small groups of nattily dressed young men, wanted to be photographed - with ME! I was a rare, exotic creature to them. I was happy to oblige since all day I had been snapping shots of people in the bazaar. It seemed like a fair exchange.

Another wild ride on a bike-rickshaw through the spice market to the Metro, and I came back to Amy and her precious baby just as the sun was setting. What a day!

Today Amy and I are going to lunch with her friend who works in an NGO that aids traditional midwives in rural areas. Hmmm...that just happens to be right up my alley... Then tonight I am taking an overnight train to Jodphur in Rajasthan. I will stay there for a couple days and then return. Blessings!

A Day in the Bazaar

2011-12-05T08:00:00.000-08:00

     Amy and I spent all morning in baby-love land. Okay, Ananya is the third cutest baby EVER, after Clarabel and Sophia. I know I am saying this with a midwife's objective eye. I helped Amy take a bath with her baby for the first time, instead of bathing her in a little pastic tub thingie. Mother and baby loved it.

   Finally she had nursed enough for the meantime and we decided to go out to a craft bizarre to do a little browsing and shopping. As soon as we were in a taxi, pulling out of Amy's quiet back streets onto the main road way, it was like, oh yeah, we are in India! My eyes were again working at warp speed to take in all the amazing sights flashing by us. People pulling ridiculas loads on bikes, like ten mattresses piled on top of each other, little markets and stalls, crazily careening auto-rickshaws, food being cooked on the street, horns blaring. The women are all so colorful and beautiful in their saris and salwars.

My sister took us to a special bazaar that only the Indians know about. It is not in the Lonely Planet guide. It is a government-regulated market, and it costs 20 rupees to enter (40 cents) so that keeps beggars and touts out. All the stalls are run by the artisans themselves, with crafts and beautiful things from all the different parts of India.   Crowds of beautiful Indian families were there to shop. It was festive and colorful. Ananya happily slept in her Baby Bjorn as we walked around.
     My sister can look at things and say, these shirts are from Lucknow. These things are from South India. They make these in Kashmir. She also has the ability to dicker and discuss in Hindi with the shopkeepers, which came in handy. Everything was already very inexpensive but she bargained everythng down . Every time I was about to make a purchase, no doubt at the 'tourist' price, she walked up and spoke loudly in Hindi and suddenly 300 rupees were knocked off the price. It was impressive, to say the least. I am not much of a shopper, but it seems I will make an exception to that rule during my visit here. And I will definitely do my big purchases with Amy-ma at my side.

    Women do not breastfeed in public here so my sis is naviagating how to manage being out with her baby. We found a quiet corner in the back of the food stalls where she nursed her discreetly and we ate corn roti and almond ice cream. My sister will probably become Delhi's first Lactivist. She can be an example to the middle class professional women who do not breastfeed their babies. Her friend told her that only the beggar women nurse their babies in public.

      There are no big box stores in India. None. No walmart, no Target, no drugstore like Longs or grocery store like Safeway. Everything is picked up at little markets and bizarres. In a city of 9 million people, isn't that amazing? That is one of the reasons that Delhi feels like a village - no strip malls!       What India does not have in 'things', it makes up for it in charm and character.   I wonder how long they will keep the big box stores out....

that's all for now,
Dena

Passsage to India

2011-12-04T11:06:00.000-08:00

I decided to come to India the day my sister's baby was born. The preparations were a whirlwind; expedited tourist visas, vaccinations, gathering baby things for her. I would be coming alone, leaving my dear hubby and children safely having their Chico Christmas season without me. Then all my November mamas supported my travel efforts by ALL three giving birth ahead of schedule, within a crazy four days.   At that point, I got to move my trip up by almost a week!
In the days leading up to my departure I would start crying at random moments, just thinking about how excited I was. Truth is, I have ALWAYS wanted to come visit India, but it had never seemed like the 'right time'. First, we had no money, then we had babies, then we had no money AND babies, then we were buying a house...then.. then...then.

    I hadn't flown overseas in more than a decade, since before Bella was born. I was a bit anxious, but mostly just excited. When you are used to traveling with kids, going on a trip by yourself is just ridiculasly easy! I am tuning in with my old backpacker-adventurer self, who globe trotted in her early twenties, now twenty years ago!

My travels all went smoothly, except for the fact that I did not really 'sleep' on those two overnight flights like I thought I would. More like drifted in and out of half-sleep and watched a lot of good movies courtesy of Virgin Atlantic.

I had an all-day stopover in London, which turned into a magical, wonderful day. My friends, Sonya Sophia, the EFT teacher and practitioner Goddess extraorinaire, and her British hubby Simon, picked me up and gave me a personal tour of the beautiful city. Big Ben, Buckingham Palace, Harrods, and all the rest. God, I love cities filled with five and six-hundred year old buildings. They really knew how to build them back then. We ended up at a swanky place called the OXO tower on the Thames and had the best meal ever with fabulas London views. A three-course lunch that included a delicious bottle of wine and the most amazing bitter chocolate mousse that has ever passed these lips. Lack of sleep, who cares!!

Late that evening I caught my flight to Delhi. I already felt like I was in India just at the Heathrow gate. There were only a handlful of non-Indians on the packed flight. Food was Indian, and instructions were in English and Hindi. I got all weepy for the last time ....no really, am I REALLY going to India? Oh my, I really AM going to India NOW.

   I envsioned a bustling megapolis crazed scene at the airport. Actually there is not a whole lot going on at the Indira Ghandi International Terminal. Just a few flights a day, I think. The vibe was way more like when I landed in the Soviet Union in the late eighties. They have built it, but not many have yet come. Very chill, enormous buildings, mostly empty. I gathered my bags and headed outside. There, I saw a huge crowd of people packed around the exit, waiting for people. It looked a bit...intimidating.. And there was Amy's driver waving at me, holding a sign that said 'Dena, welcome'. YES!

   A few minutes later we were on my first Delhi road. Oh SH*T!!!!!!    There are no lanes, there are bike-rickshaws, auto-rickshaws which are motorcycles with tin-can bodies that can hold riders in it, trucks, cars, buses, people walking, more cars, and even a family riding on an elephant. Yes, I saw an elephant walking along the freeway. Everyone is swerving around the slower movers, and EVERYONE is constantly blowing their horns.   Everyone is driving on the 'wrong' side of the street, which is disorienting. The steering wheels are on the 'wrong ' sides of the vehicles! On the sides of these crazy roads, cows are sittings, packs of women in colorful saris are carrying big trays of things balanced on their heads, children are playing, little stands are selling things, lots of people are just standing around, and the horns are blaring...and on and on.   Did I mention the horns?

Delhi is more like a sprawling collection of jumbly ancient villages connected by insane roadways than a cosmopolitan city, at least from what I have seen so far. Delhi has been a city since 2000 BC and there are bits of the architectural remains of each time period here and there and everywhere. We took a walk in a park with beautiful Moghul tombs from the 1500s. There are lots of trees, and lots of birds with strange screaming bird songs. Parrots. The sky is the smoggy color of LA skies circa 1975. My sister's neighborhood Defense Colony is a quiet little back street zone. It feels peaceful and very old. The cook comes in and prepares homemade Indian food in her kitchen every day. yum!

now I am holding a sleeping baby so Amy can get a bit of sleep.
Cheers!,
Dena

Destination Delhi Doula

2011-12-03T17:50:00.000-08:00

Dear Readers,

Three and a half weeks ago, a miraculas birth took place in New Delhi, India. My sister Amy Kazmin is a foreign correspondant and has lived in Southeast Asia for over a decade working for the Financial Times of London. She is an amazing writer, and passionate about covering events with empathy and compassion for all peoples involved. She has had incredible adventures and an illlustrious career in her 44 years of life. As fufilled as she has been by this exciting life - there had been one thing she longed for - a child.
This summer, Amy informed us she was expecting, already 5 months along. She had waited to tell us because she could hardly believe it herself. She feared that at her age things could go wrong. A few months later, on November 10, she called me from Delhi to Chico complaining of gas pain in the middle of the night. I spoke with her for an hour, feeling a bit suspicious that it was something more than gas. When she called me back an hour later, she had thrown up and was shaking a bit, and moaning that she must have eaten something 'off', I asked her to please call her doula NOW! While on the phone with the doula, her water broke. The doula arrived, realized Amy was in advanced labor, and helped her pack her bags. A wild ride to the hospital ensued, and the baby's head was crowning when she arrived Thus my 44 year old first-time-mom sister had a quick, and nearly painless birth.

Here is the lovely Ananya Rachel, a genuine beauty as only a half-Jewish half-Indian baby can be:

And now I am here with her. I have just traveled to the exact opposite side of the planet so I can show my dear Sistah how to burp her baby, swaddle her tight, and wear her in the sling I wore my babies in. I can hold my dear new niece while Amy showers and takes care of herself. I can reassure her that Yes, it is normal for the baby to nurse a million hours a day. Ananya is a darling little sweetpea and Amy is doing a great job. This is the best postpartum doula gig of my life! (I will get to travel around and see a bit of India while I am here too).

To follow my India adventures over the next couple weeks, stay tuned!

With Love,

Dena

News of an Upcoming Book, the Midwife Way

2011-11-05T08:09:00.000-07:00

I knew I would have a homebirth with a midwife when I was pregnant with my first child in 1999. I had heard my own calling to become a midwife in 1992, and had already been a CNM for three years. I had been longing to have my own baby for years! I still remember my first trip to the bookstore, pouring over the pregnancy books looking for a fun read. Sure, I had studied William's Obstetrics, Oxhorn's Human Labor and Birth and Frye's book on suture of the perineum while in school. Now I was not the student or the midwife, I was the pregnant mama, and I wanted to be inspired by a book written for me, a woman planning a homebirth,

I was stunned to find nothing. As in nada, zip. The one book that had midwives in it was Spiritual Midwifery by Ina May Gaskin, but I had already poured over my dog-eared copy dozens of times. I would heal my bouts of self-doubt during nurse-midwifery school by reading the sweet stories of Ina May's homebirth commune in the sixties The stories of joyous, empowered women birthing on the Farm attended by midwives reminded me why I was suffering through my student nursing rotations, pharmacology, and statistics.

In terms of regular pregnancy-advice books, there was not one for the homebirth-bound woman. In all the numerous pregnancy books on the shelf , either midwives were not mentioned at all, or there was just one small paragraph or section that mentioned midwives. These paragraphs mostly said something like “Some women choose to have midwives attend their births at home, but this is rare and hospitals are the safest place for birth.” I felt blazing mad when I read these things! I felt so clear about the benefits of my birth plans, yet every book on the shelf either completely marginalized me or simply denied my existence.

All the pregnancy advice books I looked through had strong underlying assumptions that 1. pregnant women are under the care of doctors and will give birth in hospitals. And 2. pregnant women are obsessively worried about weird things happening with their babies. The book that most embodies these two assumptions is the pregnancy tome we midwives call What to Freak Out About When You Are Expecting.

Neither of these assumptions were true about me. I was not going to be seeing a doctor. I was young, vital, and filled with a sense of well-being. I just knew my baby was healthy and growing perfectly. I did not need any prenatal testing to tell me so – I just knew. I knew that just as I could grow my baby, so could I birth my baby. I knew I wanted support in labor but that was it – no medical nothing. Fears about the unknown would come up but a walk beside flowing water would ease my mind.

My external situation was not rosy and perfect, either. We were going to be having this homebirth in our tiny one room studio, which was all we could swing in Santa Cruz. My husband was a full-time student. We had no idea how we were going to afford even our one room place when I stopped working to have the baby. Yet I felt so connected to my baby, so delighted to be experiencing the miracle of pregnancy, that these others things did not really matter. Where were the pregnancy books that supported a woman's trust in herself to grow , birth, fall in love with, and nurse her baby with ease and joy?

Fast forward to 2011 and the bookstore bookshelf is pretty much the same. Ina May has written a new updated version of her classic, Ina May's guide to Childbirth. There are several new encyclopedic pregnancy books written by doctors to compete with What to Freak Out About. There is still no pregnancy advice book written by a midwife, for the homebirth mother.

The birth world itself is undergoing a revolution. The cesarean section rate has climbed from 18% in 1999 to 33% in 2008. Vaginal births after cesareans have been banned in hospitals across the nation. Natural childbirth in a hospital is becoming a thing of the past and pregnant women are turning to homebirth in record numbers. Ricki Lake's documentary “The Business Of Being Born” came out in 2006. This film provides an honest look at the medical model of birth and introduces mainstream America to the benefits of homebirth. Most of us midwives saw our birth numbers double the year the film came out. The numbers continue to grow. This October, a watershed Homebirth Consensus Summit was held near Washington D.C. to support the integration of homebirth into the health care system.

A new field of study, peri-natal psychology, has flourished in the last decade. Peri-natal means “around the birth” and peri-natal psychology looks at how events during pregnancy, birth, and the immediate postpartum impact a new baby's psychology. The term birth trauma refers to the experience of a baby being frightened, overwhelmed, hurt, and /or separated from his mother at birth. Peri-natal psychologists attribute the problems in the world today such as violence, the epidemic of depression,and behaviors that contribute to environmental degradation, to the massive scale of birth trauma resulting from three generations of hospital birth. A 33% cesarean section rate is not good for mothers, babies, or the planet. We homebirth midwives believe we can literally save the world by keeping birth gentle and safe for babies, creating a new generation of humans who are secure and healthy in both body and mind.

I have decided to write the book I cannot find. This book will contain the heart advice of a home birth midwife for pregnancy, birth, and beyond . Herein will be the wisdom gained from years of working with birthing families. This book is intended to help women gain trust in themselves and in their abilities to grow, birth and nurture their babies the way nature intended. It will be full of inspiring stories of women's remarkable experiences birthing at home, including women who have previously had cesareans. Welcome to the Midwife Way.

An OB and I work Together: Tracy has the VBAC of her Dreams

2011-10-10T16:31:00.000-07:00

    Tracy had the birth of her dreams on Friday. She did this at our local hospital where such a birth, a VBAC, is banned!   She came up with an amazing plan, and it worked out magnificently. This plan included hiring both myself and an OB. The result was an unprecedented collaboration between myself and someone who has been hostile towards me in the past. Let me fill you in on the details!

     First, a little of Tracy's story... Tracy's first birth was the typical hospital induction that went awry and ended in cesarean section. Baby was posterior. She was induced with pitocin. She needed an epidural. The baby never rotated. She pushed for five or six hours, numb from the waist down and on her back. Not feeling the contractions, her team had to scream "Push!" for her when contractions showed up on the monitor. Rolled into surgery finally. The drugs from surgery gronked her little system so the first hours with her baby were just a blur, she can't even remember them. The first weeks were a misery of surgical pain, drug-induced fog, depression, and breastfeeding problems. She was shocked this had happened to her - her mother, grandma, and aunt all had easy natural births! She felt betrayed by her doctor, and upset with her husband and mother for not protecting her from this. She felt guilty for having such emotional turmoil around her birth experience, even though she got her healthy, beautiful baby. "My first birth was the worst experience of my life." She wanted her second to be the best.

    When Tracy became pregnant again, she was determined to avoid another cesarean. She lives out in the rice fields, almost an hour from the closest hospital. She and her husband decided homebirth was out of the question due to the distance to the hospital.    But VBACs are officially banned at our local hospitals! Despite this fact, OB docs occasionally tell very determined women that they CAN refuse surgery.   To everyone else, they say sorry, their hands are tied! They don't want to get in trouble! Tracy's OB doc Dr L agreed that she had the right to refuse surgery. He told her that if everything was "perfect" and she showed up in advanced labor, he would attend her as a VBAC. Tracy hired me to help her do that. She planned to take a hotel room in downtown Chico to labor in. We would have her labor there, just two minutes from the hospital, We would go to the hospital somewhere between 8cms and complete and Dr L would take it from there.
    Second, some back story on me and Dr. L:   This particular OB has been very communicative about his disapproval of me. He happened to be on call for my two most medically intense transports from home, and let me and my clients "have it" in those cases. My clients and myself have experienced his communication style as intimidating and inappropriate at times. He tells his patients "they are crazy" if they decide to have a homebirth, or if they have had a homebirth. Tracy let him know that she had hired me to monitor and support her first stage of labor out of hospital, and come with her to the hospital as her doula for the delivery. I was shocked that he agreed to the plan!
   Third, the lead-up: . I gave Tracy my best holistic prenatal care. We met several times over the months. She cried at every visit as we gave time and attention to her emotions and fears. We processed the trauma of her first birth with EFT and a supportive, listening ear. We did guided visualizations of what this birth could look like.    She did acupuncture and chiropractic, and poured over the spinning babies website, www.spinningbabies.com   doing the recommended exercises religiously. She prayed and meditated and practiced relaxation. She chatted on Baby Center's VBAC listserve and paid attention to what worked and what didn't work for other mamas. Dr L saw her for routine prenatal care and would ask her if he could talk her out of it. When she said "no", he said " All right then."
   The Last Week: On Tuesday, she came in for what would be her last her prenatal. Her baby was STILL posterior, and she was discouraged. I checked her and found her 2cms, 80% effaced and the head low in the pelvis. Very good sign! I noticed that her pelvis did have a narrow arch at the outlet, and at 5 feet tall, her belly looked huge. Not good sign. She asked me, can I do this? I looked deep within myself, remembering that you JUST NEVER KNOW who can or cannot birth. Everyone deserves a chance! "Absolutely." I said calmly, smiling, and gave her a big hug. "You CAN." She wiped tears from her eyes for the zillionth time . "And your baby will rotate, if not before, then during labor. So stop worrying about it now, relax and soon we will have a baby." I said.
    The Grand Finale: Two nights later the Call woke me up at 2:30 am. It was Jay, Tracy's hubby, telling me her contractions were 2 to 3 minutes apart, lasting a minute long. They were getting into the car and would be in Chico in 45 minutes. 2 to 3 minutes! That sounded like labor was already well underway. I called him 20 min later and he said now they were two minutes apart. Let's just go straight to the hospital, we decided.   We met in the parking lot at the hospital, where I was prepared to examine her in her car to make sure it was time to go in.
     Tracy got out of the car in the dark parking lot, and I took one look at her and thought, "She is completely dilated!" "Don't touch me" she growled at Jay. Then she grabbed him and bent over, putting her hand over her crotch for the contraction. I smiled at Jay. "This is great, really great. Tracy is almost done!" Over about 20 minutes, we crossed the street to the hospital. They brought out a wheelchair but she refused it. Then she climbed onto it so she was kneeling backwards on it, her bum in the air. She was brilliant, letting her body guide her and not letting anyone get in the way of that!
   When we finally arrived in the labor room, she was checked by the nurse - completely dilated just as I thought, and the baby's heart sounded great. "Tracy" I said, "Why don't you get up and go to the bathroom. You probably need to do that." So we got her off the bed after only about 10 minutes and she went into the dark closet-like bathroom with me. We spent the next hour in there so she could find her own way with pushing. "Just let your body guide you" I whispered. "Push if it feels right with the contraction. For some women it feels GOOD to push". Slowly, slowly she began feeling into pushing. And over the hour she pushed with more and more gusto until finally she made those sounds that let us know the baby is moving through the pelvis. The nurses were respectful of our process. So was Dr L! He popped his head in, said "Oh , you're in the bathroom!" and disappeared for another 40 minutes. When her pushes were the roaring, baby-ejecting kind, she went onto the bed and Dr L. came in. He looked at her bulging yoni and said "Oh, the baby is coming out this way."
     A few minutes later she was crowning. Dr L cut a tiny episiotomy and then looked at me and said "I only cut her a small one." "Thank you." I said, "I am sure she appreciates that." Then, the baby was born. Tracy was on the moon! "Wow! That was SO MUCH EASIER THAN I THOUGHT! I can't believe that was it!!!!!!"

Here is how she looked:

Afterwards, Dr L admitted to Tracy, "I didn't think it was possible for you to do this. I was just humoring you." "I know", Tracy replied,"That is why I hired Dena." He and I had a friendly exchange at the nurse's station, acknowledging that this was a nice collaboration of available resources, and how well it worked out. He expressed again, how with her narrow pelvis,short stature, history of a stuck baby, and the size of this baby, he had been sure she wouldn't be able to birth. I told him that I have seen VBACS like this before, and that you just never know who can do it and who can't. Everyone deserves a chance. The nurses listened, smiling to themselves. On his way out, Dr L stopped in the room one more time. "I am surprised, impressed, and proud." he told us.
I left soon after. Tracy was still flying high, raving about her experience. The baby was nursing away. My heart was full of joy. This birth has changed Tracy's life. She wanted to experience natural birth more than she has ever wanted anything. She got to experience a fierce, primal, undisturbed birth where her body just found its way! This birth also helped to bridge some of the abyss that had grown between myself and the hospital staff. I was treated like a valued member of the team. And that, dear readers, is progress for all birthing women in our community.

100 Births

2011-09-30T06:53:00.001-07:00

    A few weeks ago I attended my 100th birth as Sacred Ways Midwifery. This is the first business I have ever owned, and I still remember how nervous I was six years ago when I took this leap, letting go of receiving a steady paycheck to pursue my true passion.. Fortunately, Chico was ready for more homebirth options, and the beautiful families came to seek my assistance and keep on coming.
One hundred births feels like a milestone in my practice. When we talk about birth, we often talk about risks of things as "x" in a hundred. Now looking back I can see what has happened in 100 births. For example, I've had 1 baby who wouldn't turn to head down and was born at home as planned breech. (We had a whole team of midwives for that amazing birth) . I've had three other babies who were breech at 36 weeks that we turned to head down before labor.
   I've had many women in their forties, and one of them had a baby born with Down's syndrome. I've had one baby born with a cleft lip and palette, whom we syringe fed with breast milk overnight until we could get the special feeder in the morning . The baby arrived before me a couple times, mama in labor less than an hour. I've had one baby that required several minutes of help starting to breathe, and three others who just needed a couple breaths.
I' ve enjoyed many repeat customers. What a joy to see a family through the birth journey more than once! I've had many women come to me after having hospital births, wanting something different. I've had many first time mommas. Not a single set of twins yet but at least a third of all women ask me at the first visit, "Could I be carrying twins?"
My 100th baby belongs to Heather. She is a repeat client, whose strapping toddler Conner I saw into the world two years ago. Her sister- in- law Sarah has also had two lovely births with me. Heather lives an hour away, and I drove swiftly to her home on a hot August afternoon, remembering that she was ready to push by the time I arrived with Conner.
Sure enough, she was ready to push again when I arrived. She pushed and then said that something doesn't feel right. I decided to check her and see what was going on. When I did vaginal exam I found that she was completely dilated but it was not a head I was feeling! " The baby is breech " I said.....then I checked again. Well, maybe it is a head... but not the right part of the head. I felt around and felt a soft mound ....of....maybe it is the baby's privates? No, it really feels like head... Eyeball? Nose? In a hundred births I have NEVER been unable to tell what part was coming down!. In the hundreds of other births I've attended as nurse or hospital midwife I've never been unsure like this!. I didn't want to hurt anything so I withheld from poking too much. Heather rested on her side while we talked about her options. I knew that this not-knowing needed to be taken seriously. We were a good 25 min from a hospital, down winding country roads. After another brief try at pushing, we decided to go in.
    When we arrived at the hospital, the OB checked her and said " the baby is breech!" Then he felt again...."the anus? The nose? Oh! It bit me! It is the mouth!"
   Heather's baby had decided to come out MOUTH first. This is what that looks like:

The odds of this happening is about 1 in 600. Doesn't look very comfortable for the little one, does it? In fact, pushing in this position puts strain on the neck and can damage the head, neck and spine. Peyton was born by cearean section to save her little self and courageous Heather took it all in stride, grateful that we transported when we did and that her baby was safely in her arms. She was back home within two days, baby nursing like a champ.
One hundred births and never a dull moment.

The Midwife Returns and the Revolution Unfolds

2011-09-14T12:49:00.000-07:00

Dear readers,

It has been three months since my last post... I have been offline and out of town for most of the summer. This is by design, as I take time off midwifery during the summer so that the people known as My Family get my full attention. We took a month long camping trip up to Oregon and Washington. Spending time with my husband and kids in beautiful, natural places with no schedules, no interruptions, and no place to be but Here, Now means the world to me. Being self-employed we happily trade income for quality time. And what a time we had!

We got into some hot water (hot springs galore):

some white water:

and then the salty spray of the beautiful Pacific waters:

We also played as the Moes Family Band at some music festivals like Concow Wild Mountain Faire

and the Mystic Garden Gathering

The grand finale of my time away was a trip for me and Adam to Burning Man. The theme this year was Rites of Passage. I do, in fact, feel reborn...

Meanwhile, some amazing midwives have been working throughout the summer to improve the collaboration among health care providers, insurers, and all parties involved with homebirth in the U.S.

I am thrilled to inform you that next month will be the first ever U.S. "Homebirth Consensus Summit: The Future of Homebirth in the United States; Addressing Shared Responsibility" http://www.homebirthsummit.org/ is the website for this project.

The purpose of this summit is as follows :

"The Home Birth Consensus Summit will bring a cross-section of the maternity care system into one room to discuss improved integration of services for all women and families in the US across birth sites. Delegates will be a multidisciplinary group of leaders who have a passion for quality in maternity care and a commitment to work together to improve safety for women and babies across birth sites. All perspectives and viewpoints will be considered in this purposeful dialogue, while delegates explore facets of the existing system and propose solutions for the future."

the description continues,

Rates of planned home birth in the US have remained low for several decades, but women are increasing their interest in this option. Women today want and expect choices for childbirth without compromising quality of care. Choice of birth site - home, hospital, or birth center - is not an option for many expectant mothers in the United States.

Safety of birth in any setting is of utmost priority. Maternity care providers and researchers in the US disagree about appropriate settings for birth. Ultimately, women and families are ill-served by inter-professional conflict. The current debate on home birth in the US indicates the need for constructive discussion and consensus-building. Successful collaboration between health professionals has been found to result in improved experience and outcomes for consumers.

The meeting will be organized in a way that is most likely to foster the dialogue needed to find common ground and spark constructive action that will ultimately benefit all stakeholder groups. This summit will encourage dialogue among health care professionals, consumers, policy makers, and other leaders from disciplines that support maternity care, with the shared goal of identifying a common agenda for the provision of birth services in the United States.

The point is not to debate the “rightness or wrongness” of homebirth. The goal is to establish what the whole system can do to support those who choose homebirth, and provide the care, safety net, consultation, collaboration and referral necessary to make homebirth the safest and most positive experience for all involved—moms, babies, families, communities, health care workers, hospital personnel, administrators, payors, and so on. "

This summit is a revolutionary step for birth in this country. Major stakeholders, i.e., doctors, hospitals, and insurance companies are acknowledging that Homebirth Isn't Going Away Just Because They Want it To. Some doctors in my community have been hostile towards me and my clients when we transport to the hospital . Their attitude has been "I don't like you because I don't understand you and I want you to go away. I will be rude and hostile and thus I will help to make homebirth go away. " When we transport to the hospital, we never know which doctor will be on call; a hostile or friendly one. This issue has been the biggest problem I have faced as a midwife, and I have been contemplating ways to improve doctor/midwife relations. This summit will set some precedence and perhaps guidelines for our communities.

I will keep you posted as the summit unfolds. Some incredible midwives are behind this event, Director of Midwifery at UBC Saras Vedam CNM, and my dear friend, the incredible midwife and professor of nursing Sarah Shealy http://www.artofnursing.net/meet-the-art-of-nursing-staff.html These ladies are my heroes of the summer!

With love and gratitude,

Dena

Letter to a First-Time Mother

2011-06-13T16:56:00.000-07:00

Dear New Mother-to-be,

   Your life is full of excitement right now; joy and expectation. You are feeling new life within you and when you tune inward, you can sense that you are a part of the great mystery of creation. Many parts of your life may need shuffling around, requiring re-arrangement to make way for this new human, who will be joining our world soon thanks to your hard work. Perhaps there is more stress in your life than you would like, in which case I pray for your peace of mind, and for easier times. Taking good care of yourself is the number one job of an expectant mother - getting enough sleep, eating wholesome food, and cultivating joy and relaxation, all help to grow a healthy baby ready for a good and straightforward birth.

   Our culture is so complex and information-saturated right now, that you are facing all sorts of important decisions right from the get-go!   Will you find out the sex of the baby mid-pregnancy or not, will you have genetic testing or not, should you take hypno-birthing or Bradley classes, and on and on... All the choices feel confusing The biggest birth-related choice, the one that will provide the framework for all the other decisions and details of your birth experience, is this:   Should you use a hospital based provider (doctor or midwife) and give birth in a hospital, or hire a homebirth midwife and have your baby at home?

    Maybe you are just now realizing that you even HAVE a choice. It is likely that your own mother went to a hospital when she had you. Her mother may have given birth in a hospital as well but you can bet that your Grandmother's mother gave birth at home. Hospitals were not used for birth until the 1910s in urban areas and the 1940s in rural areas, just so you know. Before that babies were always, everywhere, born at home. For ages, since the dawn of humankind. But when you were growing up, birth in the hospital was the norm, and if you were like me, you never even HEARD of a midwife as a kid.

   But now, you are a grown woman, and a pregnant one. Times have changed again and homebirth is suddenly something to consider. You are healthy and have taken relatively good care of yourself thus far. You may have a vague distrust of doctors and the medical system, which you have heard is driven by the engines of the pharmaceutical and insurance industries You may have relatives who have gotten sicker while taking drugs or treatments prescribed by doctors. And now that you are pregnant you are noticing that SO MANY of your friends have had hospital inductions that ended in c-sections. And if you ask around, you hear that in most U.S. hospitals there are 70-80% induction rates and that 32% of U.S. births end in c-sections. This is probably true of the hospital in your neighborhood. It is true of the three hospitals in our area. Yikes! In 1970 the c-section rate was 5%. And we all turned out fine! But what is homebirth all about? Is it really safe?   It is hard to know where to turn, whom to trust. What is the "right" choice?

   One thing I have learned in my work as a midwife is that there is no one-size-fits-all answer when it comes to pregnancy and birth. You are a unique woman, that baby inside of you will be a unique individual, and this birth will be uniquely your own experience. Your task as a blossoming new mother, is to learn how to take in external information and then turn inwards and listen to your own inner wisdom. That is right -YOUR WISDOM. You may think you don't know anything about this stuff, but your body knows everything it needs to grow your baby and give birth. Say you close your eyes and imagine giving birth easily in a pool of water and then picking up your baby and kissing her; your body tells you something right?   It feels good, your body can almost feel what it would be like to hold your new baby. And say you hear about a scary emergency surgery where the baby was barely saved, you can feel the fear and the anxiety in your body, right? Pregnancy makes everything feel deeper, giving you the opportunity to really feel into your choices. So I ask you to not just THINK about your choices, but FEEL into your choices.

    Make an appointment with a doctor and see how it feels in his office, with his staff, in the exam room. Ask questions about his philosophy of birth, his c-section and induction rates, delayed cord clamping (REALLY important for baby's health) How did it feel when you asked? How do you feel afterward, leaving the office? Does this person and environment support your emotional as well as physical well-being as you prepare to undertake the most profound and challenging rite of passage of your life under his care?   Because birth is not a "medical event". It is a physiologic event that all mammals are capable of.   It is also a profound transition for both mother and baby. How mother and baby experience the birth has implications for both that last a lifetime. (See birthintobeing.com for further information) For many humans, ( too many, these days) it also becomes a medical event. This is largely a result of it being placed under the auspices of doctors and hospitals in the first place. (Watch The Business of Being Born for a thorough explanation of this phenomenon)

Now for some of you, underlying medical conditions necessitate that you stop here. Insulin dependent diabetics, those with heart disease or other chronic or underlying illnesses, you are perfect candidates for hospital births. In the olden times a woman with your condition may not have survived pregnancy or been able to conceive in the first place. Or even lived until adulthood. Doctors are ideally suited to your needs and are experts at taking care of high-risk women such as you.

For those without medical conditions, and 90% of childbearing women fall into this category, now go and find a midwife. Look in your yellow pages or online. Make an appointment and interview her. Ask about safety, about going to the hospital if a problem occurs, and what is her philosophy about labor, birth and bonding. How do you feel in her office, talking with her, and how do you feel afterward? Go and meet a second midwife. Remember, your feelings are clues into what is right for you and your baby. Your body is what will be giving birth and how your body feels gives you clues to what you truly need.

I talk to many women who feel vaguely disappointed or disempowered after their first doctor appointments. Somehow, they were expecting something different. Just not sure what, exactly. They were pushed into a vaginal ultrasound or genetic testing without understanding why, or they waited an hour for a hasty ten minute check-up. They felt they were "bothering" the doctor with questions, although he was "nice". Then they meet with me, and a light goes off and they say "Wow! I didn't know it could be this way ". 'This way' meaning warm, slow, enjoyable, with sharing of information through story and research, and a genuine connection. Why not? This is your sacred birth, your baby, we are preparing for. Let's be real with each other because birth is as real as life gets. You need much more than "nice". Midwives offer individualized care with long prenatal appointments to prepare you for what is ahead on multiple levels - emotional, physical, psychological. We are experts in normal birth and trust that you are designed perfectly to birth your baby. We like to instill in you a sense of confidence in the process, and in yourself. We like you to leave every appointment feeling GREAT about yourself.

   Look deep within your heart. Do you need an IV, a team of nurses, and the availability of drugs to feel safe and empowered to birth your baby? Or do you need to be in your own private nest, with your partner by your side, and a trusted, experienced midwife to watch over you?

Giving birth will be the hardest thing you ever do, no matter where you do it. I have looked into the eyes of over two hundred women in their moment of despair, around 8cms dilated when labor is super-intense, and they feel like they really can't do it. And I have looked right back, offering nothing but calm reassurance with my eyes and smile, and they have known that they ARE doing it. And they own it, and give birth. When you feel like it is too much, you can't do it, we midwives know you are almost done. The baby is coming! Nature has designed birth perfectly that way; to call the midwives to you for the grand finale.   At home, you carry on and give birth and it is a powerful overcoming of obstacles that you will never forget. It changes you forever to overcome that fear, that pain. You get your precious baby from the experience, and you get more; you are reborn yourself as a powerful Mother. You are not rescued by drugs or vacuum extractors or surgery. You are the Hero. Look within your heart and ask what you really want for your birth. Do you really believe in yourself?    Do you think you can do it? What is best for your baby? Your body will tell you the answer.

Blessings on your journey,

Dena

Homebirth Photo Essay

2011-04-20T08:32:00.000-07:00

Greetings! Today's post is short on words and long on lovely images. Here are some photos of Toni Rae being welcomed into the world by parents Kristin and Chad, and big sister Charlie. These are not labor photos but shots taken immediately after the birth, and then two hours later, during the newborn exam done on the bed with the family. These pictures capture one of the benefits of homebirth - after the hard work of birth, the family is in its own comfy bed to relax and take in the joyous miracle of their new baby. No strangers coming in and out, no machines beeping or nurses taking the baby to assess, wash, or "warm". Just uninterrupted bonding time. Enjoy!


Welcome Baby Toni! She is placed right into her mother's arms, where she gives a good cry to open up her lungs.


Happy father embraces them both. Note the bliss on Kristin's face as she admires her new daughter. That look of utter delight often accompanies the completion of natural childbirth, a combination of "yes, I did it!" and "Oh! What a love!"


Excited sister Charlie loved seeing her baby born! She sat right beside me as the baby emerged.


Now a weepy Grandma takes a look... "did that really just happen? Right here?"

Kristin responds to her baby's cues that she is ready to nurse. This image shows how cozy the family is as the baby enjoys her peaceful first hours of life earthside.

After the initial cry, home-born babies are usually alert but relaxed, taking in their new environment from the warmth and safety of mother's chest


"Oooh...that is what those are for!"

"My turn!"

Giving the baby a thorough exam

includes weighing

and measuring

and footprints...

and finally a first diaper

Definitely a keeper!

The Little School that Could

2011-04-07T08:33:00.000-07:00

   Many of us in the homebirthing community embrace alternative education for our young ones.   If we folks are conscious about choosing how and where we give birth, it makes sense that we will also consider how to school our young. Waldorf education, homeschooling, and unschooling are some examples of these kinds of choices. My first daughter was born in Santa Cruz, California, and when she was a wee nursling tucked in my sling, I saw Rahima Baldwin speak about Waldorf education and the young child.   It was music to my ears - an approach to education that seemed like homebirth midwifery for the child's mind and heart!   Rahima Baldwin, by the way, had been a foremother of American homebirth midwifery and wrote Special Delivery, a classic homebirth book . Then she became a Waldorf educator, and her book You Are Your Child's First Teacher is one I recommend to new parents. I knew what I wanted for my children.
    Waldorf education weaves art, music, handwork such as knitting and crochet, reverence for nature, and movement into reading and math. Waldorf classrooms are softly colorful, lessons are poetic, all materials are natural such as wood or wool with NO plastic, and all the children sing and learn music, including string instruments starting in third grade. "Accept the children with reverence, educate them with love, send them forth in freedom" says Rudolf Steiner, Waldorf founder. All subjects are introduced when developmentally appropriate, and the wonder and magic of childhood is nourished and left intact.
   We moved to Chico in 2002 when Clarabel was two. Lo, and behold, Chico had a fledging Waldorf Charter School! Charter means public and tuition free, not private. Open to everyone, by lottery. The school was tiny, just one kindergarten class, but it would grow by one class each year until it was K-8. Clarabel started kindergarten there when it was K-2. There were about 50 students. Over the next several years the school slowy grew and blossomed into a beautiful community of families and teachers. We moved three times as we grew. The final move was last year into a closed-down Blue Shield Call Center that was built to look like an Ivy League campus on the outside, and was an ugly cavern on the inside.    We transformed it into a beautiful school, tore up the asphalt parking lot, and built a playground with our own hands. Then we had to double our school size in one year to fill and pay for this giant new space. Now we had 350 kids, and a year of growing pains as we adjusted to so much change.
Then, this year, we almost lost our charter. I won't get into the details of the politics that led to this, but our charter was denied renewel by our original authorizing agency. So we wrote a new charter and took it to the Chico Unified school board for approval. Over the last several months we have worked hard to raise community awareness about our school, align our curriculum more closely to the standardized tests that are considered the "bottom line" to determine a school's success, and waited to see if our school would stay open. Last night, the board voted. After two hours of tense discussion, it was looking pretty bleak.   The first motion of the vote was to CLOSE the school! It was quickly seconded. Then, by a miracle, one board member stood up and talked to her peers about looking beyond test scores, to other aspects of what an education is. She moved to give us our charter, and the motion was carried, three to two. It was incredibly emotional. Teachers, parents, children, all crying together with joy and relief that our blessed school would stay open. It felt like that moment of relief when we finally meet a baby, after a long, complicated labor. Bravo Blue Oak School, a beautiful, joy-filled school for our children, now for many years to come!

The Midwife in Hot Water

2011-04-04T12:06:00.000-07:00

   In the midst of a busy birthing season, I have been harboring a secret fantasy; zipping off to a hot springs resort for some solo relaxation time. These days my practice is so full that someone is due as soon as someone else gives birth - no time off for me until July, when I don't deliver babies. Except last week, when a tiny miracle unfolded for me. Instead of the one expected birth, I attend two in two days - someone went a couple weeks early! As I rolled out of bed in the dark of night to attend this birth, I realized - hey! I'm going to be off-call this weekend!   I was fried, but I would be free.
    Friday afternoon, I popped my little bag of snacks and my little bag of clothes into my car, and I was off on a weekend retreat to Harbin Hot Springs . Its funny how in the midst of raising a family, even the act of tossing ONE bag in the car for a trip seems so light and carefree. My hubby and the girls would have a great weekend here in town, and everyone would appreciate a happier, de-stressed Mom! I had known for a while I was in need of a break because everything was starting to feel heavy - the responsibilities of work, keeping house, the cooking, and the kids' activities, and on and on. I believe in BALANCE as a guiding principle in my life - when things are big and heavy in one direction, we need to swing a little in the other direction. Some carefree bliss was in order.
   So what did I do during this weekend away? Relaxed profoundly. Soaked and soaked and soaked in the hot pools. Sunbathed. Received a knockout massage and a Watsu treatment. Got away from cell phones, computers, and cameras which are all NOT allowed at Harbin. Ahhhh....a midwife not checking her cell phone every half hour, how bizarre. I ate meals in the restaurant - organic and delicious, and had spiritual, uplifting conversations with fellow weekend Harbin-ites. For a mother to take 48 hours off cooking and tending to others - it is amazing! I read an inspiring book called A Woman's Worth by Marianne Williamson

   The hot springs are considered sacred at Harbin and silence is honored in the pools. There are beautiful alters everywhere with flowers and Goddess statues. As a soaked I visualized all my worries and cares just dissolving out of my body. I prayed that the cleansing makes me clearer, a pure channel of light, love, and holy, wholesome work. I jumped from a very hot pool into a very cold pool over and over, with rounds of prayer in between. I prayed for my husband, and for friends and family who are in need of healing or transformation. I prayed most of all for our Mother Earth, and for healing and help in Japan. I prayed to all the Goddesses and fathers and guardian angels to help us clear the radiation damage from our lands and seas and air. It felt so good to lay down my worries and just pray.

     Ahhhh. When I set down everything I do, I can go inward and re-connect with who I really am. I surrendered my tense posture of "I must DO everything!" and came to a place of "What I do, will come from my divine Heart of Love".

Mothers, wives, sisters, midwives, helpers - in the fullness of work and/or raising our children, let us not forget to also raise up ourselves! This weekend was a gift for me but everyone I love and care for will benefit from a clearer, more tuned-in me. Is it time for you?

You Are All My Babies

2011-03-17T10:30:00.000-07:00

    When I was pregnant with my first baby, I had been a midwife for years already and was in absolute bliss to be finally having my OWN baby. I loved my baby so much that my pregnancy was marked by fits of joyous laughter for no "reason", and a deep joy that came with me everywhere I went. (once the nausea had passed, of course) I glowed.   In my ninth month, my husband took me to San Fransisco to see a very holy Tibetan Buddhist teacher, who was staying with a friend of his. This teacher, the Venerable Khenpo Palden Sherab, was performing sacred ceremonies for generating peace and awakening for hundreds of people. Because he was staying with our friend, I was given a private audience with him. Here is information on this holy man:   http://www.dharmafellowship.org/biographies/contemporarymasters/khenchen-palden-sherab.htm

Khenpo Palden blessed me and my ripe belly, and then he gave me an instruction, which I have held in my heart as my path ever since.   He told me I must love ALL BEINGS as if they were my precious baby.   This is a nearly impossible task, but I am trying. When I remember, my heart is filled with compassion, and anger, hatred, and judgement melt away.   It is the perfect instruction for a midwife, isn't it? And he didn't even "know" that is what I am!

     When disaster strikes, I pray for all the people and creatures who are experiencing harm and tragedy.   I do my best to meditate and send them all my motherly love. I remember Khenpo's words and remember that we are all brothers and sisters. I feel the saddness deeply, even if I don't "know anyone" directly who was harmed.   This week, it has been hard for me to focus on anything but Japan. I experienced the same with the Gulf of Mexico Oil Spill, the earthquake in Haiti, when "we" invaded Iraq, and on and on.   I will someday, when my kids are grown, be a midwife for international disaster relief. But for now, I pray, feel the sorrow, and also cherish all the sweetness of our precious fleeting lives.

   The photo at the top shows a four month old baby reunited with her father after the tsunami. This baby was found in water, under mud and debris, after three days! A soldier heard a baby cry, and then thought "no, I am hearing things'" and kept walking. He heard it again, went back, lifted up some boards, and debris, and there she was. She was wet, but otherwise unharmed! She is so round and radiant, isn't she? Hard to believe she has been through that. She is a testament to humanity's amazing resilience. She is my baby, and all the children who did not make it, are my babies.

       And this one is my baby. And I am that mother, nervously watching the numbers as my precious one is scanned for radiation. And now you will hear my maternal roar   "RRRROOOAAAAARRRRRRHHHH!"
I have always been, and always will be, opposed to nuclear power. I hold us all responsible for this evolving nuclear tragedy. How have we been so complacent, and let so many old, crusty reactors continue to operate, and new ones be built? How have we allowed our lifestyle to become so dependent on toxic, dangerous energy sources?    What can we, as the community of caring humans, do to stop nuclear energy?   What can we do with all the spent fuel rods already kicking around our fragile planet? Actually, we are the fragile ones, the planet is not. I don't have answers to these questions, but I am thinking about it deeply.

A few days ago, I posted this on Facebook:

"Dear Everyone, in Every Government, Everywhere,

     Please do not call nuclear energy "clean energy". Please. Are you insane?

Sincerely,

A fragile specimen of life who loves and cherishes all fragile specimens of life.

ps. I WILL sit in the dark each night stargazing with my family and cook over a fire of dry shit. Try me.

NOW....   the general scientific consensus is that we on the West Coast will be "safe" from radioactive contamination. HOWEVER, since the jet stream is carrying everything toward us from Japan, it might be wise to feed your family superfoods that are radiation-protective. Especially if you are pregnant, or have young children, please check out the following links, and add miso, kelp, nettle tea, and the other mentioned plants and superfoods to your diets for the next several weeks, as things "fall out". Here is Susan Weed http://www.wisewomantradition.com/wisewomanweb/2010/11/surviving-radiation-the-wise-woman-way.html
and here is another excellent one from Christian Bates http://christianbates.com/?p=748

In closing I would like to leave you all with a quote from Thich Nhat Hanh, Buddhist Monk and peace activist.

Dear friends in Japan, As we contemplate the great number of people who have died in this tragedy, we may feel very strongly that we ourselves, in some part or manner, also have died. The pain of one part of humankind is the pain of the whole of human...kind. And the human species and the planet Earth are one body. What happens to one part of the body happens to the whole body. An event such as this reminds us of the impermanent nature of our lives. It helps us remember that what's most important is to love each other, to be there for each other, and to treasure each moment we have that we are alive. This is the best that we can do for those who have died: we can live in such a way that they continue, beautifully, in us. Here in France and at our practice centers all over the world, our brothers and sisters will continue to chant for you, sending you the energy of peace, healing and protection. Our prayers are with you. Thich Nhat Hanh

Sayonara,

Dena

The First Breaths of Life

2011-03-05T20:57:00.000-08:00

     It seems my clients like being written about on their midwife's blog. I had no idea when I started this a couple months ago that folks would be so open to my writing about them. Talia and Mishu are my most recent new parents and they have graciously agreed to let me tell about their story. So here it goes...

Talia and Mishu came to me a little less than 2 years ago, nine months pregnant. With tears in her eyes, lovely red-headed Talia requested that I take her on in the eleventh hour. She explained how over the nine months of pregnancy, she slowly realized she should be having a homebirth. She had been seeing the hospital midwives and but now REALLY wanted a homebirth after all.   Mishu was a recently graduated nurse, and they were prepared to do whatever was needed for birth at home . We went for it.   Talia rocked her first birth with twenty-four hours of early labor and then a straightforward active labor the following night. She did great and little Livia happily came into this world.

For her second pregnancy, Talia came to me from the get-go. Mishu has become a very well-respected RN at our local hospital. (I love it when local RNs choose to birth at home!)   Right around her due date, the 1st of March, she had some bouts of contractions during the night that went away at dawn. This happened a few nights in a row. Then, on Wednesday, they didn't go away at dawn. Talia had irregular mild contractions throughout the day, and in the evening they got a bit stronger, although still not strong.    I had checked her in the afternoon and she was barely 1 cm open with the baby's head high. That evening, my assistant Amber went over to check in on her, and she texted me updates such as "No need to rush over here, not that much going on. Contractions, but irregular. Baby's heart tones sound great."   Well, around 9 pm a little voice deep inside me said "Go over there now".   I went.   When I was approaching her street, Amber texted me "Water broke, gush of clear fluid." Oh yeah, it was time.
   Talia was sitting in her bathroom on the pot, cranky about how the contractions felt but still chatty and not really looking like she was deep into labor. About fifteen minutes later she stood up to wash her hands, turned a deep red color and p*u*s*h*e*d.   "Talia, hold on there a second" I said, running to peel off my street clothes and throw on my baby-catching clothes. With my shirt half on, I heard Amber say "Dena, I see the head!"   Sure enough the head was crowning.   Talia was on her hands and knees in her small bathroom. I climbed behind her, half in the shower, and Mishu and I together put our hands on the head as it was slowly born.   The little face was pink and she was making little movements. Hello dear!   Then we waited for the next contraction. And waited. And waited. It was a few minutes but it felt long. These dang irregular contractions! I had Mishu reach down and rub her belly. I had Talia crawl a few feet into the bedroom to give me more space to work.

    A contraction came, Talia pushed, and the baby was born. She was floppy like a rag doll and a mottled purple and white color. She was not grimacing or sneezing or trying to breathe. I quickly dried her with a warm flannel blanket and rubbed her up to stimulate her. While doing so I placed my fingers on the skin where her umbilical cord inserts and felt a normal heart beat. "Good heart beat" I said. But still no effort to breathe at all. And limp. Amber had the oxygen tank and ambu bag ready. I had recently taken the neonatal resuscitation training of Karen Strange CPM, who is the pre-eminent authority on resuscitation in the home birth setting. She talks about mouth-to-mouth breathing as an initial alternative to ambu-bag and oxygen tank. For more info, see her website www.newbornbreath.com
       I lifted the baby to my face, placed my mouth firmly over her nose and open mouth, and carefully, slowly gave the baby an "inflation breath." With mouth-to-mouth, I can literally feel her lungs' alveoli inflate, and her lungs expand to take in oxygen. I am so connected to the baby's life force. A newborn baby's alveoli must inflate so she can take in oxygen through her lungs. In the womb, the alveoli are collapsed and the lungs are filled with water. That is why the baby's first, big breaths are so important. I pulled her away a bit to look at her. She opened her eyes and looked at me. But didn't breathe. "Okay baby, lets breathe" I said, and gave her four more mouth-to-mouth breaths. By the fourth, I felt her suck in on her own, she mewed, and then gave a good cry. She turned a rosy pink from head to toe, and her arms and legs bent into normal position. She was breathing fine. Her heart rate was fine. Her tone was strong. She was a little more than a minute old. I had been working on the baby right beside Talia, with the cord intact and pulsing away, providing oxygen to the baby even while she wasn't breathing. In the hospital, if the baby is not breathing, they cut the cord right away and take the baby across the room to work on her. At home we leave the cord, which is still bringing oxygen to the baby via the placenta for several minutes, and work on the baby beside the mother. I would like to see hospitals learn to do things that way - it is definitely to the baby's advantage.

The baby was now warm, pink, and perfect in Talia's arms. She was letting us know all about it. Talia stood to get into bed and the placenta plopped into a bowl I had at the ready. She hardly bled a drop. Within two hours, and baby had eaten, been cuddled skin to skin with both her Mom and Dad, Talia had been up and showered, and we were all eating blueberry birthday cake. The baby was strong and alert and weighed in at 9 lbs!

Here she is after being checked out thoroughly by her midwives. That is yours truly holding her lovely footprints, her first mark on the world.

Today when I called to check in on the family, Mishu told me they have decided to name their baby Adina, partially in honor of their midwife, who provided her with her first breath of life. I am the one deeply honored, and so grateful to all my teachers and mentors, and supportive, wonderful assistants. Most of all, I am grateful to all the moms and babies I have served over the years, who have truly been my real teachers.

Full Moon Baby

2011-02-18T20:43:00.000-08:00

I am just back from a welcoming a 9 lb baby boy into the world this afterrnoon, and some post-birth weariness is setting in. My client lives out in the almond orchards south of Chico. She and her husband own 500 acres of almond trees, which surround their home. They are all in bloom right now - trees covered in pale white-pink flowers as far as the eye can see.

    Last night I went to check on her because her water had broken, and I needed to take her temperature and listen to the baby's heartbeat. I drove out by the light of a bright full moon, as the dark rainclouds parted like curtains around her.   Mother and baby were fine, so we all got a good nights sleep and labor began this morning. When I arrived this morning, my client was running a mild fever. This was concerning because with waters broken, it could indicate an infection brewing, which could affect the baby. It was mild enough to not necessitate transferring to the hospital - yet.

My plan was to hydrate her really well, and have the baby soon before the condition worsened.   A phone call to my OB consultant, Dr Fischbein down in LA (bless his heart, dedicated supporter of midwives) gave me the confidence I needed to hold to my plan. I started an IV and gave her a large bag of IV fluids, which worked like a charm. When the bag was almost all run in, this Momma turned to me out of her laborland far away place and said. "Take my temp again NOW. I feel BETTER!" Sure enough the fever was gone.

An hour later she squatted on a big pile of towels on the floor and in two or three roaring pushes, out came a 9 lb baby boy. The baby breathed right away, but took several minutes to really "transition" into his outside-the-womb life. He just seemed a bit pale and his heart rate was a little lower than usual, Hmmm. We watched him carefully, gently massaged and stimulated him, and gave him a little oxygen "blow-by" (holding the oxygen tubing close to his face so he is breathing more oxygen-rich air). I considered bringing him in to the hospital to be checked out . But after a thorough assessment and exam, he just pulled his little self together, and was pink as a piggy, with strong tone and normal vital signs.   By then, he was about a half-hour old. Whew, little guy!

By one hour of life, the little one was nursing away like a champ, and remained pink and in excellent shape. We were brought Mexican food from my favorite taqueria and while he nursed, the happy parents and midwives sat around feasting on chile rellenos and tacos, and reviewing the incredible events of the day. A final exam of the baby revealed a fully present, pink, alert healthy babe, and the proud mama didn't even need stitches!

We packed up our bags, reviewed the detailed baby-care instructions, and were home by dinner time. I will go back in the morning to check on mother and babe. Good night!

Special Delivery 2; Homebirth after a Cesarean

2011-02-08T07:13:00.000-08:00

     This post has been written with permission from the family involved. Names have been changed to protect their privacy.  My intent is to inspire others to think through their choices and question the current limits on a woman's freedoms after she has had a cesarean.

     Before I share Hannah's journey from a cesarean to a homebirth VBAC (vaginal birth after cesarean), let me discuss the current climate regarding VBACs. When I moved to Chico in 2002 and joined a hospital nurse-midwifery practice, VBACs were being done in all three hospitals in our county. It was understood that VBACs were safe, as long as the surgical incision was the low, horizontal kind (which most in the US are). These scars are less likely to rupture than the up-and-down kind. I went out on maternity leave, had my baby, left that job, and then started attending homebirths two years later. I began hearing that VBACs were suddenly banned from all three hospitals.   As in, NO MORE VBACs were allowed, period. Even if you had had a previous VBAC, making you a very likely candidate for another successful VBAC, you were told by your care provider "No, I wish you could have a VBAC, but my hands are tied. I am not allowed to attend VBACs anymore. We must schedule your cesarean." If you said "But wait! I just had a VBAC right here two years ago with no problems. Are you kidding? ", you were told " There is nothing I can do. It is up to the hospital, not me. ." OUCH. What happened?
What happened has to do with ACOG, the American College of OB/Gyns , a powerful trade group for OB doctors. They are so powerful that their recommendations, which put the interests of the doctors FIRST, become national health policy. American obstetricians have developed this habit of inducing most of their patients. Because using the induction drugs on VBAC women was found to increase the risk of a uterine rupture by a significant amount, they recommended that all sites where VBACs take place have an anesthesiologist in-house and ready, in the event of uterine rupture. Well, smaller hospitals like the ones in my county can't afford to pay for an anesthesiologist to sit around while a woman is in labor. VBACs were banned in hospitals all across America instead. The result of all these inductions, and all these VBAC bans, is that one in three women in America today goes in to have her baby, and comes out having had major abdominal surgery.
     Women in Chico who want a VBAC must either have a scheduled cesarean instead, or drive at least 100 miles to a larger urban hospital to have a VBAC. Or, they could find a homebirth midwife. Homebirth midwives put mothers and babies FIRST; not hospital rules, not malpractice insurers' rules, and not convenience for the midwife. (Cesareans are very convenient for the doctor - they last an hour, no one is groaning, grunting, or pooping, and the doctor even gets paid more than for a natural birth)

        Hannah came to me about a year ago. She wanted a VBAC, and was considering her options carefully. Her son had been born in NYC by cesarean after 30 hours of labor, but she felt that with more preparation and better support during labor, she could DO IT this time. Her husband Jason and the rest of her family were not particularly supportive of a homebirth. Hannah wanted me to do her prenatal care, and then she planned drive down to Berkeley, 3.5 hours away, to birth at a hospital where nurse-midwives attend VBACs. As her pregnancy progressed, Hannah became more clear that she actually wanted a homebirth. She educated herself and her family about homebirth, and finally her husband agreed. The Berkeley scenario was dropped, and we began to prepare in earnest.
   We delved into the details of Hannah's previous birth. A big difference between hospital-based and home-based prenatal care is the attention homebirth midwives give to the position of the fetus. During the last two months of pregnancy, I pay careful attention to which way the fetus' back is lying, so we can be proactive about helping the baby into the best position for birth. This way, we are not surprised with a longer, more difficult labor due to posterior positioning of the baby. Hannah had started her first labor with her baby in the posterior position, and did not know it. Her doctor had never checked for that. Hannah and Jason had driven across the Brooklyn bridge at rush hour to get to the hospital, a major ordeal. When they got there and were checked, they were told to just go on back home, it was too early to be admitted to the labor floor. Well, Hannah was having the strong, painful contractions of back labor, and was not about to face another two hours of traffic. So she and Jason wandered the hospital, found an empty conference room, and spent the night there laboring away.
    When they returned to the labor and delivery floor in the morning, more troubles arose. The "wrong" doctor was on that day, not the doctor Hannah had connected with and wanted. The nurse was kind and helpful, but then the doctor and the nurse "got into it with each other" and the doctor banished the nurse from Hannah's room!   Eventually Hannah pushed for three hours, all alone except for her exhausted husband and mother, with not even her nurse in the room to guide and support her. The doctor came in and out to watch for progress, and then took her in for the cesarean. Afterwards, the doctor told her that surprise! the baby was posterior!   Oh, well.
      During her pregnancy I focused on four main areas of preparation. 1. Giving her undivided attention, love, and support so she could build trust in me and my assistants, and know that we will really, truly BE THERE for her. I imagined she would have another 30 hour labor, and mentally prepared myself to hang with that. If she needed to push for four, five,six hours, so be it. 2. Fetal position! We used chiropractic care, specific exercises, and homeopathic pulsatilla to encourage that baby to rotate forward, not posterior. And she did   3. Healing the trauma from her previous birth. She wrote about her first birth and her deepest fears and we used Emotional Freedom Technique to address them. This technique uses the meridians and acupressure points of the Chinese Medicine system, to clear emotional trauma from the nervous system and tissues. Her biggest hidden fear was having to face her family and friends if her home VBAC "failed" and she ended up with another cesarean. She felt they would think "See? You should have just had the repeat cesarean. It would have been easier on everybody." She was so brave to stand up for what she wanted, outside the comfort zone of her intimate circle, while not knowing what the outcome would be. 4. Filling her with positive images, stories, and vibes to promote a sense of well-being and optimism about this birth.

     Ten days after her "due date", I got the call at 4:30 am. "Hannah is having very strong, close contractions" Jason told me. I heard her moan in the background. I was on my way. I arrived a little after 5 am. Hannah was on her hands and knees in the kitchen, working with contractions every two minutes. This all had started just an hour ago. She had literally just woken up a hour ago. I could tell things were cooking along and readied my supplies. 45 minutes later, her water broke, and she had a strong urge to push. I checked her and she was completely dilated. We moved her to the rug in the living room where she pushed on her hands and knees for twenty minutes and gave birth to her eight and a half pound girl. She had been awake three hours, and I had been there for little more than an hour!
     Well, talk about thrilled, shocked, and delighted! Jason and Hannah snuggled up with their baby and giggled and smooched while she nursed. "That was it? " they kept saying. "Really, that was it????" Her whole labor had lasted three hours and she had barely needed to push. Their eyes were shining with joy. They were both transformed by the experience. Jason was in absolute awe of his wife, so strong and powerful and looking gorgeous lying with their baby in the dawn light. They wouldn't have even made it, driving to Berkeley! It would have been a travesty for her to have had abdominal surgery instead of this experience! As we all ate bagels and eggs, I thought about her two births. Why are one woman's two births so different? Can love, support, and the comfort of one's own home REALLY make such a difference? What do you think?

Special Delivery: A Homebirth after a Previous Stillbirth

2011-01-26T11:59:00.000-08:00

This post is written with permission from the family involved. My intent is to inspire others to think through their choices and have courage. Deep thanks are given to Rachel and her family.

   Eight years ago, Rachel was twenty-two years old, in a troubled marriage, and pregnant. Young, poor, and in a challenging life situation, Rachel did her best to take care of herself and eagerly awaited her baby. She used hospital-based midwives for her care, and had a normal pregnancy. Two weeks before her due date, her water broke. She called her midwives who advised her to come over to the hospital to be checked. She showered, got dressed, and came to the hospital. When she arrived, the heart beat of the baby could not be found. The baby had died. Rachel labored heroically and gave birth naturally after many hours to her stillborn son David. The cause of his death was never found, and the diagnosis of "unexplained stillbirth" was given to him.

    The birth of David changed Rachel's life. She describes the changes as positive, because she used her grief as a catalyst for transformation. She began a profound spiritual journey, left her unhealthy marriage, and basically started a new life, listening deeply into her heart to find what was good and true for her. Rachel says "I believe that David and I had an agreement, made many lifetimes ago, that in this lifetime our time together would only last as long as it did. For whatever reason, that was what was meant for us. If it weren't for him, I would not be the person I am now."

   Several years later, Rachel met Henry, a gentle, compassionate man who shared her spiritual approach to life and love of the wilderness.   They married and bought property in the mountains together, to homestead and live "back to the land" . Rachel says "the urn of David's ashes stayed with me for years. I didn't know what to do with them. I often dreamed of a mountain, where I was to place his ashes, but I couldn't find that mountain. When we walked onto our property for the first time, I looked out and could see the mountain from my dream. I knew we were home." That summer Rachel climbed the mountain and scattered his ashes.   A few months later, she was pregnant.

   Rachel went back to the same hospital-based midwives for her care. She had felt well cared for with David, despite the outcome. The midwife explained that this pregnancy would be considered high-risk, due to her history. She outlined a plan that included multiple ultrasounds, non-stress tests for the last six weeks, and an early induction of labor. Rachel was surprised, and went home to think about all she had been told. She was now a wise, strong, healthy mother. She ate all organic, whole foods, and lived an active mountain life. Her life was full of love and joy. She listened deeply to her heart and discovered how strongly she knew that this pregnancy was entirely different from the last, that this baby was a healthy and strong girl, and that she would be born alive.

At the next prenatal visit, Rachel attempted to explain this all to her midwife. She says "With the last pregnancy I did everything I was told. I had every lab test, I had the ultra-sounds. I did all the medical stuff, and still ended up with a dead baby. Whether the baby lives or not has nothing to do with your lab tests and ultra-sounds. I intend to decline them all. The baby will live because the baby is meant to live."   The midwife became tense at this response, and Rachel feared that a hostile disagreement was about to take place. But then the midwife took a deep breath, centered herself, and gave Rachel a gift. The gift was in the form of these words "I think you would be happier with a homebirth midwife. Let me give you a couple names."

Rachel came to me at the beginning of her third trimester. She shared her story, and we connected right away. She wanted me to help her have this baby, and I felt honored to assist. I was awed by her strength and clarity. We carefully selected some lab tests for her - blood type, iron, HIV, blood sugar. We did not do an ultrasound. We talked a lot about feeling fetal movement, and tuning in with the baby. We talked about her previous birth, and shed tears together.   Henry came to most of the appointments, nervous but open to learning. They read Ina May's birth stories to each other at night. Again and again, Rachel clearly communicated her feelings; with a different father, her own self so evolved and changed , and everything about her life so different, she did not fear another stillbirth.

   Rachel gestated away happily, and her due date came and went. She was taking evening primrose oil and a birth preparation tincture to encourage a timely labor. Her last prenatal visit was three days after her due date. This visit was different.   She was starting to feel anxious, and with so much time "waiting", thoughts about the stillbirth were creeping in. I acknowledged her feelings and gave her reassurance that her feelings were normal. It is hard to wait and wait! We listened to the baby for a long time and heard the heart-rate accelerate with fetal movement, which is a sign of well-being. We decided I would come and listen to the baby every couple days until labor begins. I told her I thought she would have her baby soon.

That same night, Rachel went into labor. My assistant Amber and I arrived at her home around midnight. Rachel was sitting in a comfy chair, eyes full of tears. We sat down beside her, listened to the baby's heart beat, and then listened to her. Between contractions, she wept and told us how excited she was, overwhelmed with gladness. She told us she had been holding her excitement back all this time, just keeping that little piece of her heart safe by not getting too excited. But now that she was in labor, and was still feeling the baby move, she was suddenly feeling all the anticipation of having her real, live baby. The tears rolled down her face, and I told her how good it was to cry, and share her feelings.

Rachel labored beautifully through he night. She cuddled with Henry on a mattress on the living room floor for a long time. She was quiet and tuned inward , and we just listened to the baby every half hour and let her be. Each time we went to listen to the baby's heart, I felt a little extra charge, and then relief at the sound it beating away perfectly.   I focused on taking slow calming breaths in those moments, in order to maintain a calm, peaceful atmosphere for Rachel. We gently reassured her how well it was going, how good the heart beat was. When her labor got intense, I asked her how she was doing and she said, "excited". She never complained, and seemed to enjoy the whole labor. I checked her once, and at three a.m. she was 8 cms. At four a.m. her water broke with nice clear fluid, and a half hour later she felt like pushing. She lay on her side for a while just lightly pushing as her body told her until I could tell the baby had moved way down into her pelvis. I invited her to sit on my Amish birthing stool and ten minutes later her nine pound baby girl was born.   Zoe Elizabeth was born pink and healthy, and was contentedly nursing by the time she was thirty minutes old.

   Rachel had been right- her baby was strong and healthy, and meant for this world. As her midwife, I trusted both her inner wisdom and her body's ability to birth. During her birth I was careful to respect who she is and what her personal process entailed. She was not just "another patient".   This very personal, individualized approach is a hallmark of homebirth midwifery.   I am very grateful to her for inviting me to be her midwife, and now for her generosity in allowing me to share this story with others. May it be healing to those that need healing, and inspirational to those that need inspiration!

"zee hormones of love are zee hormones of birth"

2011-01-09T21:09:00.000-08:00

    When I was a nursing student back in the early nineties, I had the great fortune to spend a couple days with Michel Odent, . He is the French obstetrician who revolutionized birth in his country and helped spread the ideas of undisturbed birth, waterbirth, and peri-natal psychology worldwide.   In the 1970s, he was tired of seeing so many births in his hospital ending in forceps deliveries or cesareans. Clearly, the standard procedure of the time, the take-a laboring woman -and -strap her to a table on her back-and -drug her heavily- and pull the baby out with forceps- method was not optimizing the birth for mother or baby! He redesigned the labor rooms to be like private, dark warm caves, with a tub of warm water and a bed on the floor in the corner. He instructed the midwives to just sit, rocking and knitting. When a woman came in, in labor, she was given complete freedom to do whatever she wanted. Most women gave birth in upright positions in the corner of the room or in the tubs. He coined the term "fetus ejection reflex" to describe the spontaneous, powerful reflex that occurs when a women feels her own urge and pushes her baby out without a cheering squad to yell "push" and count, and tell her how to do it. No one told these laboring women ANYTHING. Just nods and smiles of reassurance. The result of this experiment?
      Fast, uncomplicated births. Forceps and cesareans rarely needed. Mothers who were very satisfied with, instead of traumatized by, their birth experiences. Alert, healthy, drug-free babies. These babies were followed, and grew into young adults with significantly less incidence of addictions, mental illnesses, and suicides than the control population. Did I mention that group singing sessions were added as a part of the prenatal care? Just to promote joy in pregnancy? In a small public hospital in Pithiviers, France, the natural childbirth revolution had begun. The field of perinatal psychology was born.

Here are links to the websites for this amazing man:

His wikipedia page: http://en.wikipedia.org/wiki/Michel_Odent

His latest essays on primal health/perinatal psychology: http://www.birthpsychology.com/primalhealth/

      In 1994 or so I was living in New Haven, Connecticut where I was enrolled in Yale's 3-year-get-your-RN-and-your-CNM-all-at-once program. I was struggling through the one-year-entire-nursing-curriculum portion, learning everything from physiology and statistics, to how to be a med-surg nurse. During this year it was challenging to hold the vision that somehow this was all preparation for becoming a homebirth midwife.

     In the midst of all that, Michel Odent came to town. He came because a group of local homebirth mothers and advocates invited him to give a talk for their birth network/ midwife gathering. (Totally unrelated to school) I think he was also in NYC for something, so he just made a small detour to New Haven. Somehow I caught wind of the event, and went. We ended up talking together afterwards and I think he could see how passionate and excited I was about midwifery and birth. He invited me to tea afterward where he explained to myself and Robbie Davis-Floyd, birth anthropologist, that the hormone that causes labor, oxytocin, is actually the hormone that causes sexual arousal and orgasm as well. He asked if we would make love in a cold hospital room with bright lights on and strangers coming in and out. No way! It's not our thing! Well, he said, then one should not give birth there, either.

    I was dying to bring him to school, and share this information with my large class of nursing students. They were all destined to go on to become midwives, or nurse practitioners, or clinical nurse specialists in various fields. I had read Ina May Gaskin's book, describing couples kissing and cuddling to make labor progress. I had read Michel Odent's book. I wanted all the other students to have the benefit of this knowledge as well!   So I invited him to my physiology class the following morning, which a had a wonderful teacher and all 70-odd students in it. Just come and give a talk on the physiology of birth, I begged him. He agreed!

     My teacher was very obliging, and Michel Odent met me at my school the next morning, and gave my class a lecture on the physiology of birth. Many of the students had never heard anything about this subject, and it had an incredible impact! That lecture was talked about for the rest of the year. As for me, over the years when thinking about the energy of birth, I still hear his words, in his charming French accent, telling me that "Zee hormones of love are zee hormones of birth".

Happy Holidays; Birth in a Barn

2010-12-24T13:44:00.000-08:00

    I have always enjoyed working on Christmas; welcoming a new babe into the world seems the perfect Christmas gift for me. The years I spent working as a labor and delivery nurse or hospital midwife, I gladly took the Christmas shift. Growing up Jewish, and marrying a Buddhist, Christmas is not a big family event for us. Rather, Thanksgiving is the time our family gets together. But the story of Christmas does touch my heart deeply; it reminds me to pay attention to this truth : each baby born is a holy child.

   Every midwife loves the story of Mary having a peaceful birth in a warm barn. No epidural or fetal monitor needed, just the friendly presence of the cow and the horse. Natural childbirth - only the best for the son of God!   The way the stars shone to celebrate the birth, and the arrival of wise men to welcome the special child; and the angels singing overhead; I love these elements of the story. Many a quiet dawn, leaving a peaceful house after an all-night homebirth, I have seen nature display wondrous signs to celebrate a baby's birth: A perfect V-shaped flock of migrating birds against a pink sunrise, Jack Frost's paintings across the rice fields and foothills, rainbows, a mother and baby BEAR crossing the road, an unexpected snowfall, a bright yellow moon in a purple sky.

    Every baby is a baby Jesus to me. A holy being, a child of God, a manifestation of Enlightenment. Call it what you will - I have seen hundreds of them come into this world and I am certain that when we look into the face of a newborn we are looking at the face of God. To have a baby is a tremendous gift- you are holding something so sacred and precious in your arms. Hold your baby, wear your baby, breastfeed your baby, sleep with your baby. Encourage your friends and relatives to do the same with their babies. Every year at Christmas I re-dedicate my life to protecting babies and manifesting as much love and safety for them as I can.   I remember what an honor it is to serve birth and babies. I feel gratitude for having an autonomous, out-of-hospital midwifery practice, through which I stay true to these core values and beliefs. I give homage to our American midwife foremothers, and colleagues around the globe who work under all kinds of difficult conditions and political regimes to help mothers and babies. Happy Holidays!

We are Mammals

2010-12-10T16:45:00.000-08:00

   Today I want to write about something truly obvious, but often forgotten. We, the tech-savy, brilliant, analytical, adapted to extreme-comfort living, humans, are actually MAMMALS. Mammals, yes, same as our dogs, cats, horses, and yes, apes.   In so much of life, the fact that we are mammals does not play a real significant role. Attorneys, computer experts, managers of companies or businesses, salespeople, etc do not need to remember they are mammals in order to do their best work. Midwives, however, do.


   When a woman is pregnant, and preparing to give birth and care for her new baby, there is a lot of information out there about how to "do it". This advice often includes the latest run-down on prenatal testing and lab studies, hospitals in the area for delivery, and many gadgets to soothe and carry newborn babies in. Yet despite all these technological advances, cesarean section rates are at a ridiculous and unneccesary 30% in the US, postpartum depression and breastfeeding problems are epidemic, and children are exhibiting learning disorders and behavioral issues at unheard of, record-breaking rates. What is going on?

   What is going on is that this approach denies some of the most basic things a woman needs to give birth and properly care for her baby. These are things that all mammals need to sucessfully birth and attach to their babies. We need only to look as far as the closet, where kitty-cat has just had her kittens, to see what they are.

   Labor works best when a woman is in a dark, warm, private place like her own bedroom. In this environment, the front part of her brain , the cerebral cortex, quiets down, so the deep, core brain, responsible for the hormones that actually cause labor and birth, can activate and take over. As a midwife, when I come to your home during your labor, I enter quietly and just slip into the room, so as not to disturb your labor process. All mammals find dark, private corners to birth in, this is just nature doing her thing! I never tell women where or how they should labor, and almost always, a woman will end up in a corner of her bedroom or tucked into her bathroom, just like kitty in the closet.

Baby mammals are incredible little creatures! They are all so adorable with their big eyes and wet fresh bodies; puppies, kittens, calves, and humans alike. They are also brilliantly hardwired for life on earth, after being in their watery wombs. Ever watch kittens or puppies or piglets find their scrappy little ways to their mama's nipples and start nursing? It is an amazing sight - no lactation consultant required. They all just do it - it is in their wiring. Well, guess what folks.....human babies will do the same exact thing ! A baby placed naked on her mama's chest will find her way to the breast and feed within about an hour of life. This is called the breastcrawl. They only have problems because 1. they are born drugged (hospital birth only) which suppresses their reflexes, or 2. we, the well-meaning health-care professionals, parents, and friends, FUSS with them. The very worst sort of fussing, is, of course, SEPARATING mother and baby for weights, measurements, cleaning, etc.

A picture is worth a thousand words, so check out these incredible videos...

http://www.youtube.com/watch?v=pjDQN9keKQk&feature=related
http://www.youtube.com/watch?v=auVmnvwNUOE&feature=related

Enjoy, keep your laboring selves comfy and private, your newborns right ON you at all times, and we will continue our discussion of our mammal-hood the next time.

The Midwife's Desk: An introduction

2010-11-30T17:16:00.000-08:00

Welcome to my blog! This will be a space for sharing pregnancy and birth stories, discussion of current research on the health of mothers, babies, and families, and updates on birth politics, both local and global. I am delighted to meet you in this cyber-space and I hope I can share some wisdom and information that may be valuable to you. Please feel free to email me with questions or queries.
But first things first. Let me introduce myself.... I am a certified nurse-midwife providing home birth services in a lovely Northern California town called Chico. We sit in a fertile valley at the base of the Sierra mountains, a progressive college town in a rural area. I serve families in surrounding towns as well, traveling up to one hour in all directions to attend births. I have been a homebirth midwife for over five years now. In fact, my first home-born little clients just started kindergarten this fall. I have been involved with birth since 1993, and have worked in hospitals in several states across the U.S., both as an R.N. and as a midwife. I trained in home birth while living with the Old Order Amish in the rural midwest. These experiences have given me a broad perspective on birth; I have intimate knowledge of all the ways birth can unfold in our country. For healthy women ready to experience the power of their own bodies' perfect ability to give birth, birth at home is the way to go. Over the course of the next few posts, I will explain why.

About the photo: this is an art installation called "Mom" that was displayed at the 2009 Burning Man, the theme of which was "Evolution" This piece spoke deeply to me, as I watched woman after woman take their turn posing in the center of the piece. Each woman was delighted to have this fundamental, creative aspect of their being celebrated in such a grand way! As I stood in the center, I reflected on the miracle of my two daughters' births, and on how amazingly powerful all of us mothers are. We grow you all, we birth you all, we feed you all with milk straight from our hearts. Yeah, mamas rock!

Client Testimonial, October 2010

2010-10-05T22:02:00.000-07:00

It is impossible for me to think back on my two births with Dena without bursting at the seams with pride and a sense of well-being. Above and beyond the leisurely pre-natals and on-call care that are routine with homebirth midwifery, Dena combines professional support with a respect and reverence for the very special rite of passage the mother is on. She would travel with us through the ups and downs of typical pregnancy fears, as well as educate us and empower us to make our own best decisions along the way. It was especially wonderful to have her as our midwife for our second birth, as we already had an established rapport and she knew how my body birthed. It is a joy for our boys to get to see their midwife around town and to have her glowing face in our baby albums. Should we have another child, we would choose to have Dena guide us on the journey again.

T.L., October 2010

Client Testimonial, February 2010

2010-02-15T22:20:00.000-08:00

Thank you so much for guiding us through a wonderful home birth. One thing that really sticks out in my mind is the memory of Dena, Serra, and Jessica sitting around me during labor. Whenever I said that it hurt I would hear all three of them acknowledge my pain in unison with a loud "Unhun."

Now when Collin is crying I sometimes find myself holding him and saying the same "Unhun" to acknowledge that he is sad.

Tim says: You turned childbirth from something that I was afraid of into an event that I anticipated, and this allowed me to play an active and supporting role in Collin's birth. Thank you so much.

Thank you for all your love and support.

-- Stephanie, Tim and Collin

Client Testimonial, March 2009

2009-03-20T22:26:00.000-07:00

When I reflect upon my 9 month transformation, I recall the largest catalyst to my growth, my midwife. Dena knew exactly what I needed. She was gentle when I was emotional yet honest when I needed reality. She helped me discover my inner courage. She guided me through the greatest transformation in my life. For this she will never be forgotten. She is a part of my son's life story forever. His story begins with the miraculous adventure of a 10 lb baby, vbac homebirth."

-- J.M., March 2009

Client Testimonial - December 2006

2006-12-29T22:06:00.000-08:00

My first child was born in a hospital - I didn't have any complications and had a natural 'drug free' labor and delivery - but it felt uncomfortable being surrounded by sick people- why was I in a place with sick people - 'I'm not sick' - 'my baby's not sick' - It doesn't make any sense! Being around sickness is the last thing I want for my newborn daughter. I thought right then that if I had another baby I would do it at home.

Two years later with my second pregnancy-I knew I wanted to have a home birth with a midwife - A good friend of mine had Dena as her Midwife and highly recommended her- Our first meeting I was a little nervous and so was my husband - this was new ground for us, we didn't know what to expect- but after sitting down and talking to Dena and Serra - every thing just felt good and comfortable. Dena was knowledgeable and had all the information I was looking for. I didn't feel like a number or was wasting her time during our prenatal appointments. I really felt like I was being listened to.

Nine months later I felt like I had a relationship with Dena and Serra so that when it came time to make "that call" I was comfortable doing so. Dena and Serra made it to the house calm and relaxed - I was so much more comfortable being in my own home - I had my own bathroom - I could walk and do things around the house - and I wasn't surrounded by sick people. My husband was afraid of the "MESS" that comes with birthing a baby-but Dena had given us a great list of things way in advance and we were prepared, more over, Dena and Serra cleaned up everything - my husband and I didn't have to do a thing. That was great too!

My labor and delivery was very much easier this time, I didn't feel pressure from anyone to do or be a particular way or position - Dena was confident and comforting to me during the times I need someone to look to and at the same time it was fun having someone I felt more like a friend with there during the event - after everything I and my healthy baby could just be in our own bed and sleep soundly- eat food that I want and not have someone waking us up coming into our room every hour or hearing the sick person down the hall coughing all night long.

Home birth with a midwife was such and amazing experience for me and my husband, we both feel so much more bonded to our baby - each other-and to our home. And thankfully Dena and Serra will always be a part of that amazing experience.

I highly recommend Dena Moes; she was everything and more I could have wanted in a midwife to help me with my labor and delivery.

-- Robin, December 2006