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A Rally

June 25, 2012 by ladysmith

What to do for your friend who is in the hospital because her water broke two months before her baby is due.

Do call, write, text… often.  If she doesn’t want to talk, she won’t answer.  It helps so much to know that folks are thinking of you. By the time you think of it again, it’s time to send another nice text, really. Sending mama and daddy and whoever else is there love and support is one of many important things you’ll pay attention to today.  This is their whole reality.  You can not send too much love.

Do arrange to visit, even if you’re busy, even if it’s kind of hard.  This kind of hospital stay is usually hours of sheer boredom punctuated by moments of intense worry.  Visitors help.  Is she in a tertiary care hospital an hour away, making it difficult to visit her?  She needs you.  Call, find out the visiting hours, and visit with permission. It’s tempting to carpool to visit, but consider splitting it up to really maximize the benefit to her.

Don’t worry if you don’t know what to say, or how to act in the hospital.  Most of us hate hospitals and don’t have good advice about what to do when your water’s broken.  The good news is that at this point she’s an expert on being in the hospital and receiving visitors and she’s really happy to see you, end of story.

Do bring food, good food.  Something delicious.  Something you made.  Something fresh.  Her favorite fruit, Dad’s favorite chips, whatever. There have been drastic improvements in hospital food in the last few years and it still sucks.  If you can bring some nice peaches for mama and partner and the immediate support, you are a good person.

Do bring or send flowers.  Flowers are not just a token gift.  They are beauty and life in a bleak place.  If she has so many flowers that she runs out of counter space, she can share them with the other inmates.  Make sure she knows this won’t hurt your feelings.

Don’t be afraid to ask questions.  Most people are happy to talk it all over and give details but no one wants to bore friends with problems.  Also, they talk to so many people that they probably can’t remember if they told you about the last ultrasound.  If you want to know, ask.

Don’t, please, don’t tell stories of your birth unless they ask.  This isn’t like when you had to stay in the hospital an extra day because your eight pound baby lost six ounces. Really, it’s not.  Maybe they want to hear, they’ll ask.

Do offer to run errands, clean, bring stuff along and generally be useful to everyone.  Try to think about what might be really helpful.  Do you know that they have an indoor cat?  It is your one job today to convince this couple that you absolutely live to change a litter box back home.

Don’t feel like you’re not close enough to the mama or couple to help.  This is the biggest mistake we make- assuming that we’re overstepping our boundaries.  Mostly we all need love and support.  Do you smile at each other in the coffee shop on Tuesdays? Send flowers signed “The friendly lady in the coffee shop”. Did she once admire your potato salad at a potluck? Bring potato salad.  Have you never met her but you have a mutual friend and oh by the way your water broke at 30 weeks?  Please visit and bring pictures of that baby now in little league.

Do support the support people.  If her partner is bleary eyed and wearing the same shirt he was wearing yesterday and last week, see what you can do to help.  (Warning: it may be his lucky shirt.  Don’t try to take it from him by force.) If her mom has been by her side for five days, see if mom has houseplants that need watering.

Do totally disregard any of this advice that is contradicted by the couple.

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Barn Birth

January 19, 2012 by ladysmith

Many of my clients are farmers.  Most of them have lifelong experience with livestock.  All of them laughed at me during my first spring as a goat midwife.  I had attended hundreds of clients’ births and had found my stride as my community’s midwife, but I had no experience with animal birthing and had two pregnant goats due any minute.  To make matters worse, I owned a stack of books that made kidding sound horrifying and fraught with potential complications, requiring a bin of supplies that would eclipse the average birth kit.  My clients’ husbands would chuckle at my questions, answer them simply and kindly, and then look at me askance.  I’d struggle to maintain credibility: “It’s the hooves, I don’t know what to do about hooves!”  Ultimately, I decided to put away the books, put down the anxiety, and wait.

When Rose began showing signs of labor on a Sunday morning early in April, I was already cleaning out the barn.  Knowing that she’d probably prefer privacy and certainly not want the dreaded wheelbarrow attending, I packed up my tools and scooted out the gate.  For the next five minutes she stood at the gate yelling toward the house, I could only assume for me.  Towels and iodine in tow, I returned to witness a lovely barn birth.

Rose paced.  She circled. She moaned.  I sang to her every song I could remember and when I’d run out of song, she would come over and nudge me with her nose, as if prodding me to continue.  After an hour or so I started again at the first song and began to wonder, I admit, what was next.  In a lady’s labor, there are often distinct signs of… shift, and my Rosie’s labor was no different.  She made a little grunting noise once, twice, and lay down on a soft pile of hay.  There was no question when she started pushing and in just one or two pushes I saw the glistening smoothness of a water bag peeking out, with a little nose and two white hooves behind it. I grabbed a towel and watched as a tiny black and brown creature slid, still in the bag, onto the hay.  If you’ve never seen an animal birth, you can watch one or just imagine an alien pod hatching.

One thing I’d read that resonated was that it’s important not to interfere, but to let the mother break the sac, lick the baby, and bond.  Of course.  With that deep sense of knowing that all midwives bring to the miracle that is a new motherbaby bonding, I sat on my hands.  And watched Rose start in confused horror and immediately try to kill her squirming new baby with her horns.  Really.  I tell this story and people say “Maybe you didn’t give her enough time.”  These are the same people who say to let dogs “Fight it out.”  They’ve never seen it.

Now Rose is *special*.  My friend Wendy, her first human, nursed her through a fever as a kid that we agreed might have had some lasting effects.  Also, she was bottle fed, not mother raised.  This, it seems, makes a goat less likely to take to motherhood.  Or she thought it looked like an alien pod, too.  I don’t know.  Whatever the reason it was clear that I needed to intervene.  I gathered the adorable little slimeball in my lap and toweled it off.  When I tried to show Rose the towel, she let out a bleat and began pushing again.  I set the now really adorable baby girl out of harm’s way as a second set of hooves and nose was born, followed by a second kid.  Again, the confused attempted homicide.  Again the rescue.  Both girl kids were up and wobbling, making bleating noises that would melt a mother’s heart, if she wasn’t *special*.

Molasses water, though, will soften any goat, special or no.  I gave Rosie a long drink to reward her for her efforts and distract her as I got the little babies latched on.  Just like people babies.  Those wee things knew exactly what to do right away and I took a breath for the first time in twenty minutes watching their bellies fill with colostrum.

I named the girls Iris and Flora.  For three days, Rose would allow me to tether her and would allow the babies to nurse, but pulled no punches if one of her two firstborn got far enough away from her udder to give her a good look at it.  For three days, I tethered and fed her, getting the babies latched on and then separating them from Rose when they were full.  Finally, something clicked.  Four days after their birth, Rose decided to keep her babies and keep them alive, and never looked back.  The babies weighed just over four pounds at birth and seemed to almost double in size each day.  There is no joy like watching new baby goats scamper and play, and in the end their rocky start didn’t seem to affect them.

Okay, Flora is a little bad

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New Year Birth

January 11, 2012 by ladysmith

The beginning of Lydia’s third pregnancy had been comfortable, too comfortable to notice.  She called for her first prenatal visit sure she was a few months along with no idea when she was due.  At the initial visit I guessed she was already about halfway to her birth date, sometime in late January.  She visited my backup doc and a midpregnancy ultrasound gave us a range of December 29 to January 26th.  Since her first two children came right on time, we settled in for a surprise.

That surprise came New Year’s Eve at 10:30pm.  When the phone rang, I was in neighborhood party mode, chatting and trying to decide if I’d be allowed a second beer or if someone might call.  The usual winks and teases followed me out to the quieter porch. “Lydia’s water broke, or something happened.”  To be honest, I didn’t really expect to hear from Lydia until Next Year, but I was happy to check on her.  When I arrived at the couple’s home, they had the propane light on and were starting to pack their bags to leave.  Their son and daughter were born at my birth cottage since their house is very public- close to neighbors, a highway, and an intersection- and Amish folks are so very private about their birthing.

It took no time at all to confirm that Lydia’s water had indeed broken and she was just starting to have contractions.  Baby’s heartbeat was reassuring and when I checked I found that her cervix was softening and thinning but still just one centimeter dilated.  We agreed that I would rest at the birth house and they would call when labor got going.  We’d need to drive the kids down the road to Adam’s parents house so I asked them not to wait too long to call.

Half an hour after I got to the cottage, the phone rang again and Adam sounded rushed: “They’re pretty strong now.”  Now any mother, father, doctor, midwife, nurse, doula, or sleepy grandmother will tell you that half an hour isn’t much time in labor.  Any midwife who works with Amish ladies will tell you that if an Amish mama says it’s time to come, you put your shoes on and go.  This was no exception.  I called Lisa to come and headed out the door.

Lydia was laboring hard.  She had thrown up and was breathing beautifully through a contraction when I arrived.  Adam thrust baby Reuben into my arms and grabbed Hannah and the bags while Lydia started off the couch.  Reuben started to wiggle and I bounced him gently, watching Lydia’s progress to the door.  When Reuben’s eyes fluttered I made a grave error: I absently cooed something reassuring.  In English.  His eyes flew open because, well, the jig was up.  Reuben doesn’t hear much English and never at 11:30 pm.  English at 11:30pm is not reassuring to Reuben, even a coo.  Reuben’s wails trailed behind us as we continued the slow parade to the car.

The stop at Adam’s parents was brief.  Lydia stayed in the car when Adam and I took the kids in, I made Hannah cry by handing her the teddy bear (will I never learn?), and Adam stammered something in Dutch to his sleepy and confused mother.  I could tell that Lydia was done with the whole car thing, and I inconvenienced some less important New Year’s Eve traffic on our way to the house.  It was a little before midnight and I teased Lydia that it’s not often that a woman is in labor and still doesn’t know what year her baby will be born.

Lydia, familiar after two babies with the birth house and all of its amenities, made her way directly upstairs to the giant bath tub.  I was happy to see Lisa had arrived and was ready for action.  I went downstairs to get Lydia water and start some coffee, and right away heard Lisa call.  Now, Lisa and I have been working together for some years, and although the tub was running, the kettle was starting to hiss and I could not hear words, I know when Lisa’s voice says “Pushing”.  Lydia was pushing 75 minutes after I checked her at 1 centimeter and 2 minutes after walking in the door and up the stairs.  I don’t remember my own trip up the stairs then, just that I walked in to the bathroom to see Lydia with (thank you!) enough bathwater to have a baby in, Adam smiling near her head, and Lisa grabbing towels.  I could already see dark hair and in two more pushes the head emerged into the water.  I slipped a loop of cord over baby’s head and the little guy slid into my hands underwater.  As his feet left Lydia’s body I glanced up at Lisa to see if she caught the exact time- I knew we were close to midnight.  She and Adam were both looking at her watch and grinning.  Lydia was exhaltant.  I snuggled Baby up to her chest and we covered them both with towels. “Exactly at midnight,” Lisa said. “Forty seconds after midnight.”

When Mom, Dad and Baby were snuggled into bed nursing and counting fingers and toes, I slipped out to make a phone call.  “Labor and Delivery please,” I told the receptionist.  When the nurse answered I started with my usual Calling-the-hospital-when-we-should-all-be-sleeping line: “Hi Cathy, this is Sarah, the homebirth midwife.  You have helped some of my clients in the past.”  This is an incredibly friendly hospital with doctors, midwives, and nurses that I love and would send birthday card to if I could, but I can always hear the tense hesitation when this phone call starts.  “Hi, Sarah, what can we help you with?”  “Oh, I’m just ringing to call dibs on the first New Year baby.  We had ours at 40 seconds after midnight.”  Cathy called me a name that I didn’t repeat when I told the Amish parents and we laughed together and shared wishes for a Happy New Year.  Indeed.

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