The Why Behind the When to Start Baby on Solid Foods

New mothers for all time have asked “when can I start my baby on solid foods”, and it’s a question that I get asked regularly. A hundred or more years ago it may have been a question of necessity because of struggles with breastfeeding and the literal survival of a child. Now, it’s a question of anticipation, overwhelmed by the newness of parenting, or simple convenience. And like everything else in life, there has been an evolution to my response. Following the WHO recommendations, I used to say, “It’s recommended that you wait until at least six months.” Then I began to answer, “Around six months and when they show all the signs of readiness.”  Now my answer is, ”Not before six months and they show all the signs of readiness,”  What’s changed? Science, new research, and my continued desire to help parents make informed decisions. We simply know more now. 

We get so excited to see our babies do new things and we love watching their responses, especially when it comes to tasting new foods! We often catch it on camera or video to share those moments with family and friends. Who doesn’t love watching those videos?!  But if I told you that you might be putting them at risk with solid foods too early, would you pause and want to know more? Of course, right? Because as parents we want to do the best for our child. And that’s also why I don’t want you to feel guilty if you have made some choices about solid foods for your little one(s), like I did as a young mom. Parenting is a journey and when we know better, we do better. 

The major “why” of waiting to feed solids comes down to new research on microbes! Yup, all those amazing and not so amazing thousands of different strains of bacteria that live in, on, and around us. Those bacteria that make us sick and keep us healthy.  Those same bacteria that we’re introduced to from the moment we are born and every moment thereafter.  The connection is gut health and the optimal opportunity for a baby to establish a healthy microbiome to last a lifetime. Those same bacteria that we’re now learning have significant effects in our gastrointestinal tract also have an effect on our long term physical health and immune system, including the risk of obesity, diabetes, and allergies. 

There is significant research that shows a vaginal birth, immediate skin-to-skin contact, and exclusive breastfeeding should be on everyone’s birth plan. Each of those specific events contributes to the early and healthy establishment of a strong microbiome. Sometimes medical challenges arise and those birth wishes are not in the end realized. The good news is that at about one year of age, most babies have similar bacterial presence in their guts. But what research is also showing is that what happens in between birth and one year contributes to lifelong health. One key factor in the equation is how soon a baby starts eating solid foods. 

A baby’s digestive and immune system grows and evolves over months and years. HMO’s, the third most common component of breastmilk is not digestible by the baby. They are present only to feed bacteria in the baby’s intestines creating a healthy gut microbiome. As a baby feeds on an exclusive milk (or formula) diet for at least six months, their digestive system is maturing to be able to digest solid foods. Continuing to ingest the majority of their calories through breastmilk/ formula until about one year of age allows the baby’s digestive system to optimally mature, in turn supporting a well developed immune system. Rushing the introduction of solid foods and the amount of food can tax your baby’s system and interfere with the ideal evolution of their gut health. 

If you follow up with research, you will get a range of when and how to start solid foods from resources including WHO, ACOG, AHS, and the Canadian Pediatric Society. This reflects the research they used to create their recommendations, but also acknowledges the individuality of babies. We shouldn’t overlook a baby’s muscular development in their readiness for solid foods, but recognize it as a contributing factor to proper digestion. An interest in food alone is not an indicator of readiness for solids. First, your baby should be able to sit unassisted. They should be able to not only grab food and bring it to their mouth, but have fine motor control to pinch food between their thumb and a finger. Additionally, your baby should be willing to chew food, the first step of proper digestion, and be able to move food to the back of their mouth. This is in contrast to the newborn reflex of pushing things out of their mouth with their tongue.  These are the signs of readiness you want to see in your baby before introducing solids. 

This is meant to be a caution to parents about rushing those few weeks or even months to start feeding their babies solids before six months and showing all the signs of readiness. Babies will reach these stages at different rates and that is totally fine! Create a positive environment around food in your home and as they near those readiness steps, include your baby in your daily meals. This can be as important as the when and how of feeding solids. And above all else, trust your mom instinct and your baby! Your child has a lifetime of opportunity to enjoy foods, but a small window of time to set their intestinal gut health and immune system up for a lifetime. 

istock photos

Virtual Doulas

There is an interesting controversy in the birth world these days and it’s all over virtual doulaing. I was a little surprised myself when I recently listened to a few podcasts on the topic. It really intrigued me because last spring, a few months into the global pandemic, I posted the option of virtual birth doula service on my website. I never had any intention of expanding into the virtual world, but my heart hurt so badly for those expectant parents who were being told they couldn’t have in-person support during their birth, regardless of money paid or signed contracts, especially at a time when SO many things were uncertain for them. There was little to no information on how the virus may affect them individually, their baby, their desire to breastfeed, or the labour and birth process itself. My goal was to offer some reassurance and consistency at a time of higher than normal vulnerability. 

Eventually, I reconsidered if this option of birth doula support was really viable, and if it was an option potential clients were even interested. I asked some questions of colleagues and got some surprising responses. Their views and experience was something quite different from what I had conceptualized of virtual support. So, what’s the controversy?

Birth doula work is a combination of informational, mental, emotional, and physical support prior to and throughout the birthing process.  We typically employ a variety of methods of communication with our clients including email, text, phone, and face to face meetings. Three of these four areas of support can be done just as easily from a virtual setting as in-person.  I am truly thankful for technology that gives me the ability to connect with my clients in so many ways! But how can a birth doula offer virtual physical support? This is a BIG question because physical support is arguably the most important aspect of birth support. 

Having the consistency of one support person on the birth team is often the key to experiencing the advantages of doula support. Not only do we provide hands on support in the form of pressure, massage, simple touch, and “gophering” needed/wanted items, we often teach partners how to do the same. Typically, we teach comfort measures prior to labour in prenatal meetings, but honestly, much of that is forgotten by the birthing parent and partner in the midst of labour! There’s usually a lot going on.  It’s common for a birth doula to gently remind and show partners what and when to provide comfort measures throughout the labour and birth process. It’s also the main way we support the partner so they can help the labouring person! 

Is the physical support a birth doula gives during labour doable from a virtual context? Yes! It’s especially realistic when it is part of the birth plan, a focus of prenatal meetings, and the expectant parents practice suggested comfort measures. Doulas can absolutely give virtual suggestions and reminders of movement, massage, pressure, and the encouragement to communicate with the medical team. And from my experience, it is particularly helpful to have “eyes” on the room, rather than time-consuming texts and phone calls. Many doulas have a way of reading the room and clients that they think is “magical”. Honestly, it’s part instinct, part experience, and part connection with the client. But you can call it magical.  

Will a virtual experience be the right choice for every birthing couple? No. It will depend on the doula’s, clients’, and medical team’s expectations.  It’s definitely a conversation that needs to be had with your provider, as a couple, and the doula you are interviewing before signing a contract. But while we continue to ride the wave of ever-changing restrictions and medical allowances for how many support people there can be in Labour and Delivery units, I believe it’s definitely an option worth exploring!  

The Pandemic Evolution of a Doula

Well, it’s been a full year since news of a pandemic hit the airwaves and life took a swift turn. Undoubtedly, it has been a catalyst for many changes in your life. The same holds true for me but perhaps more in a “If you give a pig a pancake” sort of way. Ah, yes, I love the Laura Numeroff books! They’re a great read for kids in their repetitive, rhythmic, predictive style. Oops, there’s the language teacher coming out, but these books really do reflect the last year of my life. So, what happens when you give a doula a pandemic? 

The very first thing is, with great frustration and disbelief, she cancels the long awaited and planned family vacation to Hawaii! We were packed and ready to leave the next day when travel from Canada was cancelled. Instead, we had some extra time on our hands to process the events of the world while we processed the stages of grief and sat on hold with various companies to cancel reservations and get some money back from our holiday. 

Then came the months long process of sorting the influx of emails from all the professional organizations a doula is associated with (and EVERY business you thoughtlessly gave your email address to). The limited knowledge of what this virus is, how it could affect an expectant or breastfeeding mom, the unborn baby, and the newborn. Hospitals were closing their doors to doula support; some were isolating mothers from their partners and their babies. Reports were coming in internationally. How do we navigate this? Some early research started coming out mid to late 2020. In-person birth support is currently still a crap shoot, depending on the numbers and other factors. 

How can doulas and birth educators support prenatal, birthing and postpartum families in this environment? That’s our job, after all. But what we do is highly connective, in-person work. That’s not an option with the restrictions. Or is it? Our work is often unrecognized by the larger medical community so the restrictions were, and for the most part continue to be, in the grey zone. And the emails continue to flow for webinar re-training, re-framing,and support for our work - from the latest research, organizational positions and expectations for members, technology training, online teaching methods, and discounted new training.  There has been much research on cameras, microphones, virtual platforms, testing, and several purchases thereof to be able to offer a suitable quality virtual educational and birth support experience! 

Local families still need support. I received requests for three postpartum support packages. I wasn’t trained as a postpartum doula but there was a connection with each of them, so I pulled my personal experiences, doula, childbirth and breastfeeding education pieces together to support these families. Then one of those many emails hit the target with online postpartum training. Postpartum training was NEVER on my radar. Neither was a pandemic. I took the opportunity to learn and grow and it underscored the phrase  “you never know how much you don’t know”.  This was the impetus for the now weekly Mother’s Circle virtual postpartum support group I facilitate. These ladies and their babes are a weekly highlight for me now, even when there are tears.

And then there’s babywearing! Thank you postpartum training for opening my eyes to the amazing developmental benefits to baby, not to mention parent/baby bonding. I did not adopt this practice with our own children, but had I known then what I know now there’s no question I would have done things differently. This training opportunity did not come through my email. It was one I purposely sought out because it’s such a natural fit to what I’m already doing in supporting families. This was a steep learning curve for me and one that literally stretched this aging body with carry positions my shoulders struggled to or can’t execute. 

Then there’s the reality that I’m trying to run a business. Marketing is a huge struggle normally but more so in a pandemic lockdown and many people have given up on social media. Babywearing gives opportunity for more visuals to share on IG, but the past months have brought changes to the social media platforms as well. Yikes, more learning.  Wait. My website is now totally out of date! Thankfully, I have a kid who has some pretty solid computer and communication experience who worked many hours to give my site an overhaul. Although there were several comments that “you do too many things, I don’t know how to summarize it.”  Right! True. BUT the focal point is always helping families thrive with education and personal support.

So, when you give a doula a pandemic, she learns - a lot! She pushes her comfort zones, trains in new areas, expands her business, and continues to support families. Regardless of what this world brings us, families will always need support and I will continue to do just that. I’ve also learned to be more conscious of my own self-care. It’s been a long year. Getting out for walks and sitting by a fire have been crucial for me. I hope the “give a pig a pancake” pandemic journey is nearly over. Don’t forget to take care of yourself!

What Have We Learned This Year?

Well, considering it’s August of 2020, that is a bit of a loaded question, isn’t it? Your experience is probably much the same as mine in that you confronted a gamut of emotions, and maybe you still are dealing with many emotions as ongoing mask policies in cities and fall school re-opening announcements are made. This year has not been easy in many respects. With emotions ranging from fear and anxiety about the potential acquisition of the virus and ensuing illness, to disappointment, discouragement, and maybe even worry or despair over missed travel, work life, finances, and next school year. 

For me the disappointment and discouragement has come with news of new parents not being allowed the support they had planned for their birth due to hospital restrictions, especially as policies changed and not honoured at admission, and the stories of separation of mom & baby for days or weeks due to positive testing. Additionally, there’s frustration of how this has affected not only my business but essentially all global businesses offering birth services, not to mention too many local and provincial small businesses. However, the one thing that I’ve learned for the good is that my basic convictions surrounding birth, prenatal, and postpartum care have NOT changed. In fact, my passion has grown stronger and more focused! 

Here is a list of things that have been encouraging to me over the last several months. 

1. More consistent basic hygiene: washing hands before handling, and refraining from kissing and unnecessarily touching babies up to 3 months old is SO important to prevent Group B Strep infections, along other viral and bacterial infections, which can be fatal.  

2. Rates of premature births are down globally: perhaps due to lower stresses in life with changes in work and family routines, allowing for more focus on better self-care.

3. Rates of breastfeeding initiation have increased globally: Is there a correlation between having less visitors in home and hospital thus allowing more uninterrupted bonding time between mom and baby?  

4. Rate of homebirths with midwives have increased: Parents looking for options to hospital births so they can have the support they desire at their birth has brought a bit of revival to the social mindset of birth. This has been an empowering and uplifting effect of current health and hospital restrictions.  The truth is that 85+% of all pregnancies are low risk and typically don’t require medical interventions for healthy birth outcomes.

5. Increased awareness of the importance of community & support: We know humans are social beings, and for optimal individual mental health we NEED other people in our life. Extend that to the very vulnerable postpartum stage when new mothers need even more mental, emotional & physical support to ensure optimal health and recovery. My heart breaks for so many new moms who have had their baby since February of this year..  They truly need a village even at a time when we are being socially responsible to refrain from such contact. 

Another thing I’ve learned is that there will be a decent baby boom come December and into 2021! This will bring a new generation of classical named children like Charlotte, Sofia, Ava and Lily, Liam, Elliot, Theo(dore), and Henry. 

In light of this, you can have confidence that your birth community, particularly doulas and educators like myself, have risen to the challenge of finding effective ways to support you prenatally, through labour and birth, and postpartum. We know that your need for support has NOT changed; in fact your need for support has likely increased. The only thing that has changed is how we support you, and those techniques are flexible from day to day, as circumstances dictate. 

Let’s celebrate what we have learned during the last several months and what we still know to be true about pregnancy, labour and postpartum care - you need connection, you need support! It’s not something simply deserved as a new mom, it really is a need for optimal mental, emotional, and physical health outcomes. I guess some things really don’t change.

Good Birth Stories...?!

In honour of my birth month, I thought it was time to share my own birth stories, three in fact. Waaait! You’re wondering if good birth stories actually exist because you typically only hear the horrible ones or what went wrong, right? Well, what actually makes a “good birth” story? I acknowledge there are stories that are not only not good, and even tragic, but I feel like women need to stop feeling guilty about their “good” births! Sometimes they are good even when things don’t go as planned. I’m pretty sure I’m not the only one out there hesitant to tell their “natural”, “non-medicated”, “easy”, “ non-traumatizing”, “fast”, or otherwise “good” birth story.  But, to encourage others, here are my stories.  

      My husband and I had decided about a year into our marriage to try to start the family we knew we wanted.  It actually took us a little longer than expected, but for Christmas 1996 we were able to share the news with our families that we would be growing by one.  My pregnancy was pretty unremarkable except for the normal “firsts” of heartbeat, movement, hiccups, craving jalapenos, and the early arrival.  I stayed active by walking our two large dogs and helping with renovations on our little house, including mixing and hauling wheelbarrows of cement to pour footings on a small addition.

        I had chosen to stay with my family physician for care, as he did maternal care and had privileges at the Lethbridge hospital. Well, that was only after I suggested to my husband that I was interested in a home birth. To which he promptly said, “No.” In hindsight, one of the only regrets I had was to not push that discussion farther! You see, I view pregnancy and birth as completely normal physiological processes, not medical events, so I wasn’t sold on a hospital birth.  But for his peace of mind and marriage harmony I dropped the idea. We enrolled in the six week childbirth education class offered at the hospital, with what we thought was lots of time before baby arrived. 

        A few weeks into our childbirth class and about five weeks before my due date, I went in for a normal appointment before my GP went on holidays.  We discussed the little dribble I had been experiencing for a couple days.  It was concluded that it was probably a slight rupture in the amniotic sac, but without a fever, thus far.  My doctor told me to take it easy (aka no more cement mixing and hauling), that he was transferring my care to an OB while he was away, I’d need to check multiple times a day for any fever, and go for a non-stress test (NST) every couple days.  No problem!  The week passed with great NST results, more minor leakage, and no fever! I was looking forward to Saturday as that was the day of our baby shower.  Spoiler…it got postponed.

        Friday, July 25, 1997 started out perfectly normal. Dave got up and did his shift at work while I stayed at home and got some baby clothes washed and ready.  At about 3pm, I was talking on the phone with a friend when I had to start asking her to “just keep talking” a few times. She finally asked if I was ok and I said, “I think I might be starting labour.  I’m pretty sure I passed my mucous plug before you called.”  We finished our conversation, and I just kind of waited a little longer to see if the contractions got any stronger or more regular. They did get stronger, but never did get any more regular.  Dave quickly showered when he got home about 5pm and we went to the hospital to get assessed.  (I have no recollection whether we ate first.) They confirmed that yes, I was in early labour and the OB that I had been under the care of was now off for holidays.  A completely new doctor would be attending my birth!  I mean, I’d never set eyes on this man, nor heard his name before!  We made a few phone calls to let parents know the scoop and we were moved into a labour and delivery room.  It was a really slow night – we were the only ones on the unit.

        I spent the evening walking halls. I don’t even recall having any regular monitoring done to check baby’s heart rate or cervical exams. My Dad showed up later in the evening with a large yogurt container of freshly picked Saskatoon berries. I was in heaven!  And admittedly, did not share.  I do not remember any staff member telling me I couldn’t eat them.  It wouldn’t have mattered if they had! I was hungry and no one was stopping the ingestion of my favourite berries freshly picked! Anyway, my mom showed up (not exactly invited) and my friend, whom we had previously discussed witnessing this birth. I spent the next couple hours pretty much in our room, moving about, just getting as comfortable in whatever position I could through the contractions.

Our older, calm OB doctor had pretty much been around most of the evening– for a period of time just sitting quietly on a stool next to the bed, suggested around 11pm the option of rupturing the amniotic sac.  He said labour was progressing nicely, but it was an option to speed up the labour so I wouldn’t have to (likely) go all night.  Considering it was Friday night, Dave had worked his 40-60hr week, we decided to go ahead.   That fancy looking crochet hook came out, a disappointing little splash happened, and things got intense real quick.  Although we hadn’t completed our childbirth classes, we HAD covered the breathing lessons and some comfort measures. I spent the next hour in the shower – AMAZING! It was at this point I remember not caring that I was naked.  

Once I started feeling that “pushy” sensation, the nurse got me back to bed in “the” (not-so) traditional birthing position with the stirrups and everything.  They told me it was time to push and so I followed their direction with a big, held breath and pushing until I almost blacked out, while the nurses held my legs. After an hour of this, one nurse gently leaned over and said, “Push like you’re having a good poop.”  Well, I looked at her like ‘it took you that long to tell me this?!?’ Our son was born twenty minutes later at 1:21am, weighing 7lbs 1oz with a second degree tear.   Knowing how much weight a baby normally gains in the last month, I was happy he was four weeks early!

When my husband and I took our son home, we laid him on the couch, looked at him and then each other, and kind of giggled. We said, “Now what?”  A first time parent’s rite of passage.

About a week later, I woke from a good sleep in the middle of the night with a stabbing pain in my abdomen.  I didn’t think it was normal and it hurt, bad.  We got dressed, got Jefferson tucked into the car seat, and walked the half block to the ER.  My GP, now back from holidays, met me in one of the ER hallways to ask about the pain level.  I simply told him, “I’d rather give birth again!” His eyes got bigger, quickly ordered some Demerol for me, and admitted me into the hospital with a uterine infection.  My boy and I spent several days in hospital with me on IV antibiotics trying to learn to breastfeed a preterm babe, with the added factors of an IV in the wrist and a large bust.  Challenging to say the least! But we made it.  I breastfed until he was about 9 months when he was no longer interested.  At that time I didn’t realize breastmilk changed flavour when you got pregnant again…

Yes, I remember distinctly the night I realized that I could well be pregnant again, which explained  the tiredness I had been feeling.  I looked at my 9 month old son sitting in his bath ring in the tub wondering what I was going to do with 2 babies!!??  You know that panic thing?  Well, yes, we wanted more than one child, but not quite this close together.  And at that moment, not comprehending the advanced development stage he would be at when baby two was born, there was some panic!  In the months following though, I enjoyed the extra rest and napped with him frequently.  Again, I had an uneventful pregnancy, but could NOT eat enough watermelon.  The funniest part was Dave’s announcement to our friends one night we were out for dinner together.  Looking at the menus, she asked, “What are you guys having?” Dave calmly replied, “Another baby.”

My due date was early December 1998.  I was in the care of the same GP as with my first pregnancy, just hoping that he’d be around for this birth.  Dave and I had investigated donating cord blood for research.  We had done everything necessary and had our kit ready with the hospital bag. I’d gone in for assessment a couple times already because it felt like I was starting early labour. Obviously not.  On the morning of Wednesday, December 9, I did my normal volunteer time making braille books with a group of ladies. Dave was on afternoon shift so he was hanging out with Jefferson for the morning.  When I got home, I suggested we go to the local greenhouse and pick a Christmas tree because we had no idea when this baby was going to make “her” appearance. (I was the only one who knew she was a girl from the ultrasound.) We wandered the greenhouse, picked a tree, and a new Christmas decoration for each of the kids.  After we got home, I’m sure there was lunch and probably a nap in there somewhere, but Dave left at about 2:45 for his 3pm shift.  My mom was the on-call person to take Jefferson when I was ready to head to the hospital for this baby.  Everything was fine.

Shortly after 3pm I tried to call my mom to see if she could come over. She wasn’t home!! (Cell phones were not common at this time.)  I called my in-laws.  They were able to come right away and she insisted that she drive me to the hospital – half a block away. I told her that I really was ok to walk. I called Dave at work and said he should probably come home. He asked me, “Why?”  In all fairness, he HAD just started his shift.  It wasn’t 3:30pm yet.  I told him I was going to walk to the hospital and go get assessed, but contractions were picking up intensity pretty quickly. 

I got to the L&D suite about 3:45pm where they took me into the assessment room to put me on the external fetal monitor.  They called my GP with details and I was being admitted.  Dave showed up after 4pm sometime, all nicely showered, just before the nurses were ready to move me into a delivery room. Again, it was quiet on the unit with maybe only one other family. I got up from the bed and it felt like I had peed myself. I told the nurse and she quickly put a pH strip in the puddle. Nope, it wasn’t pee. My water had broken.  I only had to walk about 30 meters to the delivery room, but it was the longest walk of my life! By the time I got into the room I was so out of control with contractions and breathing I asked if I could have something for the pain.  The nurse just giggled and said there was no time.  I was going through transition already! She told me to just get up on the bed.  It was almost time to start pushing.  I was very surprised, but up on the bed I got.   Somewhere in those last few minutes a nurse had called my doctor back to update him on the situation and I was told me he was on his way.

Within minutes he was standing in the doorway asking if he had time to gown up. The nurse told him, “Not if you keep standing there.”   He was there to catch our oldest daughter at 4:56pm. But only because he had blown a few red lights and the speed limit driving from his west side clinic to the hospital. Johanna was only a couple days early of her due date and weighed 7lb 8oz. 

As wonderful as life was with two littles, there were some struggles for me in the first couple months.  Breastfeeding was going better than the first time around –a different baby generally makes for a different breastfeeding experience. But I really felt like I was not ready to have another one so dependent on me again.  The oldest had only been walking for a few months, was not really talking yet, and I was finally able to have a little more freedom.  Now I had another newborn and I just wasn’t mentally prepared for that fourth trimester transition.  I wouldn’t say I had postpartum depression, but I would say that I wasn’t as emotionally/mentally available to my baby girl as I had been to our oldest. 

As we got past those first three months, things evened out, both kids napped and I felt like I had a little more time to myself.  Sometimes that just meant laundry, cooking, and cleaning, but it was MY time.  The two of them became great friends.  She started walking at 9 months and gave up breastfeeding about the same time.  Then she started to climb! Then she started talking. She started talking for her older brother.  A couple years into this stage we decided to add to the family.

My due date for baby #3 was end of November 2001. Oops, hunting season.  About three months into this pregnancy, I ended up with a bulging disk in my lower back. I was visiting a new family to the community, bent to pick up their youngest and then couldn’t stand up. It took me 20 minutes to get from their backyard with my two kids, to our car. Then I needed to get them in their car seats, me buckled into mine, all the while trying not to literally cry tears of pain.  I’m not sure I was successful with the tears.  I stopped by my chiropractor’s office on the way home. He looked at me and said to go home, lie down, ice it for a few days, and then come back.  Well, that was the beginning of an extremely long, pain filled pregnancy. And just to make things a little more challenging, we put our house up for sale and moved! Hmm, packing and cleaning with a bulging disc while pregnant with two preschoolers.  Oy.

After we got settled in our new home in a town an hour away, the pain was a day to day reality. Generally, I was able to keep it under control – until bedtime. The third trimester was the worst.  There were days when after supper Dave cleaned up and I would crawl onto our bed with my feet up the wall to relieve the weight and pain in my lower back.  Then to try to sleep for the last 3-4 weeks, I had to stack pillows under me to support myself on my hands and knees. I was lucky to get a couple of hours of sleep at a time. Sleep deprivation has never been something I’ve handled well. And then…she waited until after her due date to arrive!!

My brother and his family had moved to the same town shortly after us, with a due date of baby #5 within days of our due date. It was kind of a race to see which one of us would give birth first.  It wasn’t me.  On Sunday, December 2, we went over to visit the newest cousin.  While visiting, my brother said to go have lunch, just the two of us.  We took them up on that offer, as I wasn’t feeling quite right. I had grown quite anxious and nervous about this birth. It had been almost three years since Johanna was born and the whole experience with my back was awful that I just couldn’t fathom how I would manage this time. I had cried more than once over having to labour with this bulging disc and the whole birth idea.

During our brunch, I felt a couple contractions. They weren’t intense, nor were they regular.  We just chilled out and enjoyed some quiet time together.  We picked up the kids and went home for a while.  We ended up calling a relative of Dave’s to come sit with the kids; we thought it was time to as least get assessed at the hospital.  They admitted me into the hospital, and again, it was a quiet unit.  The on-call physician was not the doctor I had been seeing for maternity care, but a lovely, petite, South Afrikaner woman who ended up staying through the labour and birth, instead of calling the next shift doctor. This was something I was extremely thankful for in the end.

My labour progressed fairly well considering I got myself comfortable in literally one position – sitting cross-legged  on the bed for the duration of the labour - and employed the physical relaxation and yoga breathing I had recently learned in an introductory yoga class.  The problems came when I needed to go to the washroom to empty my bladder. Ouch! Movement.  But shortly after dinner time, contractions progressed into active labour and my doctor noticed my inward focus and breathing. She made a point of quieting the rest of the staff during my contractions!  Once I got through transition and it was time to push (I have no memory of any cervical exams), the doctor instructed the nurses to drop the end of the bed in preparation for the birth. Well, the movement just about made me flip a lid.  I said, “Stop moving!”, and she stopped that process.  I birthed our second daughter on a flat bed in a semi-sitting position at 7:57pm.  Because of the position I was in, the doctor could not remove the cord from around her neck until she was completely birthed.  She was a blue baby. 

Being in a small town hospital, our baby girl stayed in the room with us with an oxygen hose clasped in her fist, right under her nose.  Dave was holding her and I remember his worried look. I told him that she’d be fine.  “And look at that red hair! Even her eyebrows are red.  She doesn’t look like a Naomi.  She’s a Danae.”  Thus she was named before I had birthed the placenta.

Then I looked to see what the doctor was doing. Amazingly, I realized that I felt no back pain anymore! But I was starting to feel kind of weird. I told the doctor. She started assessing me and asking questions.  I don’t know for a fact what happened, but I suspect I started to hemorrhage. I do know the staff made comments about her hand size versus the actual on-call doctor and I was awfully thankful at the time for her petite hands and the job she had to do with them!  She must have done what needed to be done, because there was no further issue that day or in the following days and weeks of recovery.

Then we were a family of five. Phew! That’s my story of three pregnancies and births in four and a half years.  Each one was different but not without their struggles.  And I would still consider them good births!  Why?  It’s not because they were all un-medicated vaginal births.

A birth that is perceived to be “good” has several factors, and my stories have a mix of them which is why I call them good.  First, I wasn’t fearful of the birth process.  I had confidence in my body to do what it was made to do: grow, labour, birth, and feed a baby.  I wasn’t opposed to using pain medication if needed, but it wasn’t something I had predetermined to use out of fear of the labour process.  My husband and I also took the time and opportunity to learn what to expect and be better prepared for the experience with a childbirth education class.   I’m pretty sure most labour and delivery nurses would mandate those classes if they could, and I would agree. They are the best spent six hours of your time preparing for such a life-changing event.  Another factor was that I had caring, respectful medical care during each of my births.  The L&D units were all slow and quiet, so the staff had time to just go through the flow with me; there was also a patience and respect for the labour process that I felt from the two doctors with my first and third babies.  Their experience and perspective on birth can make a big difference when they attend your birth. And last, but not least, I had the confidence to use my voice. (I know. You’re surprised by that.)  This was MY birth, MY baby, MY family, MY body. I was prepared to ask questions and advocate for myself when needed. And I had to a couple of times.  The best part of that though was the fact that the doctors listened, they observed, they respected my voice.  That’s so affirming! Yes, staffing can be the luck of the draw as can the circumstances on the unit. But the knowledge, mindset, and confidence with which I went into those experiences also contributed to the outcomes. In the end, they are our experiences and life-time memories.

          If you’ve had a “good” birth, why do you perceive it that way?  If you’re approaching a birth, I hope my stories have encouraged you to own your experience. Take a childbirth prep class, make sure you have the support you need, and be confident in communicating with the staff.  Have a good birth!

*Shameless plug: check out my webpage for information on my private Childbirth Prep and Prenatal  Breastfeeding classes, and of course birth doula support. Stack the odds of a “good” birth in your favour!

Wisdom of the Past

Happy New Year 2020! It is time to bring yet another Christmas season to a close and look forward to the coming year. It’s time to breathe some life into my blog. To start, I’d like to share a particular realization I had about a year ago.  Perhaps my traditional thoughts may challenge your own.

In December 2018 I watched a media presentation of the nativity story.  The birth of Jesus is not an unfamiliar story to me, as it probably isn’t to you. I’ve heard it and celebrated it every year of my life. But last December, that dramatic presentation caught my attention in a whole new way. It specifically made me think about that birth from a cultural and historical perspective, as well as from the perspective of a doula.  Whoa! Lights went on!

Mary birthed alone. Mary birthed ALONE! (This was my Aha moment.) That was not the cultural norm! Now, I’m not discounting Joseph’s role in this story, but culturally his presence at the birth was definitely NOT the norm. Men were simply not a part of the birthing process then.  (Have you ever read The Red Tent? It’s a great read and very culturally relevant to the nativity story.)  Labouring women were surrounded by other women.  Yes, plural. One would have been the identified midwife, possibly with an assistant (doula?), and historically, it may well have included her mother, a sister (or two) and even friends.  I like to refer to them as the sisterhood. The women would have come together to mentally, emotionally, and physically support Mary, to help her pass the time of especially the early labour.

Mary had…Joseph.  Imagine how difficult that must have been for her!

Anthropology shows us repeatedly, that globally, women did not birth alone. It takes only a little research to see consistent representations of birthing women as at least a tri-union of women.  There are almost always three figures represented in every birth scene from every ancient culture of the world.  Central in each image is the birthing woman. She is looking at or birthing into the awaiting hands of the second woman, the one we describe as the midwife.  The third woman is beside or behind supporting the birthing woman.  This is the doula. We get the word doula from ancient Greece – “the helper”.  

There are still many cultures around the globe today which retain the sisterhood surrounding a birthing woman.  However, there has been a significant shift in this practice in especially North America in the last 100 -150 years. Typically, midwives have been replaced by doctors (GPs), if not specialist doctors (OB/Gyns); supporters are much more likely to be husband or partner.

Mary’s birth experience was abnormal for her time; our western culture has turned an abnormal circumstance into the norm.  We’ve isolated ourselves. We have become dependent on the medical establishment and caregivers for all of our care and yet whose job is simply to give medical care when needed.   And we also can’t forget that with this shift to strict medical focused labour and births, much wisdom has been lost about the physiological birthing process, including breech births, multiples and self-directed pushing.  Sadly, most hospital protocol now requires surgery for breech and multiples, and birthing moms rely on the doctor to direct their birth, regardless if they have an epidural and can’t feel the natural surges created by their own body.

Most people will argue the shift to medical focused care is due to medical and technological advances making hospital births safer. Not true.  In fact, the three factors that have had the most impact in decreasing infant mortality rates in the last 100 years or so has been better hygiene practices, better nutrition making women healthier overall, and the invention of penicillin for fighting infections. Recent evidence actually shows that home-births are just as safe as hospital births.

Mary was abnormally ill supported because of her specific circumstances.  She would have been supported by a local midwife and a “doula” or other experienced female(s) known to her.  Here’s another point to consider.  The female support were mostly (or all) women who were familiar to the birthing mother.

Comparatively, most births in North America (minus the <10% of women who choose to hire a doula) are supported by medically qualified staff who are typically unknown to the birthing woman, and whose primary role is dictated by hospital protocol.  It’s not uncommon for women who work in a hospital setting to choose a different facility to birth so her caregivers (specifically nurses) ARE unknown to her. She may or may not have further support from a partner or female family member, but they often do not present an unbiased, knowledgeable, experienced presence for her.  These support people may well have the same mindset that birth is a medical issue to be treated, and the medical team is the priority. Her body is not trusted to do what it has done for thousands of years with little to no intervention.  Even though we now have a better understanding of how her amazing body works to birth a baby – thanks to advancements in technology and research – medically, her body and the birth process are not trusted, are too often rushed,  and she often feels isolated, unsupported, and unheard.

That typical modern birth experience may be “the norm” but it is pretty biologically and culturally abnormal.  What about our mental and emotional care?

Why do we as women do this to ourselves?? Why do we fall into this mental and social trap? Well, that’s what happens in society as institutions become bigger and have more influence. And then even when the individuals within KNOW better, and understand the shortcomings of current protocol, the bottom line is money and efficiency of the institution.  Understandable? Yes. Best practice for mom and baby? Not so much.

I may be a traditionalist at heart, but I’m guilty of following the social thinking too. I had three hospital births with no support other than my husband.  There are many things I wasn’t aware of or didn’t understand the impact enough to advocate for in my own experiences.  In hindsight, I  would have “discussed”  in much more depth with hubby my desire to have a home birth with our first! Yes, regrets.

I believe there is wisdom from the past we can and should use in modern birth practices.  The determination that unbiased, knowledgeable and experienced support, a doula, as a normal part of any and every birth team is a significant shift in modern thinking.  And there is a growing movement within and outside the medical community on the value of doula support.  Families who choose a doula to be part of their birth team consistently report higher levels of satisfaction of their birth experience than families who do not have a doula.

Doulas are NOT a luxury.  The profession is an acknowledgement and acceptance of thousands of years of cultural wisdom.  Doulas are the bridge between the medical caregivers and the birthing mother and partner.  She is someone you can build a rapport with in the months leading up to the birth.  Her job is to support the choices – preferably well informed choices - made by the parents. She is also there to share the wisdom she has learned and believes in.   

Do you value the wisdom  of the past?

PS. The only reason I didn’t specifically include midwives in this article is because, locally, that option is not yet available to us without a huge commitment to driving. But if you have the opportunity and desire, DO IT! Hire a midwife, AND a doula. That would be capitalizing on some serious wisdom.

Photo Courtesy of Lem and June Collections LEM_2104-copy

Keep Smiling!

You might think that “keep smiling” is the most ridiculous piece of advice a doula can give any labouring woman. Well, is it really?!  I beg to differ and I’ll tell you why. 

How does the act of smiling or even laughing affect your body? Well, try it. Right now. Now pretend to be angry or scared. It’s pretty hard to have a genuine smile while you grit your teeth, squeeze your hands into fists, and breathe in rapid, short breaths. Tension within your body fights against everything your body is trying to do as it labours. In contrast, while smiling, your muscles are more relaxed and breathing becomes fuller and easier. Relaxed muscles are more efficient in their work, as are muscles which have the oxygen they need to work. Smiling is simply a mode of relaxation (or focused distraction) which can help your body labour easier.

Can smiling affect your body in other ways to help the labour process? Yes! Have you ever laughed while you cried after you stubbed a toe, twisted an ankle, or hit your funny bone? It doesn't hurt so bad then, does it? Well, smiling can shift your hormones from adrenaline released by the common fear/flight response of labour (which can slow your labour) to those called beta-endorphins, which are your body’s own pain killer. Yes, you read that correctly. Your body will release hormones that help your body manage the pain of contractions. If you let it. Sadly, any medication you choose to take to help manage pain in labour will disrupt your body’s hormonal system and they will become less or ineffective. So, smile and laugh for pain relief! 

Are there any other reasons to smile? Most importantly, you’re going to meet your baby soon! That in itself is worth smiling about. You have been waiting how long for this to happen? At least months, if not years. So, congratulations! Begin labour with a smile knowing the last step of this whole amazing experience is beginning. Continue through labour with a smile knowing your body is doing exactly what it was meant to do. Smile knowing this is an experience you will remember for the rest of your life. Your positive mindset (and smile) will influence your labour experience and hopefully, help you get through it just a little easier.  

In review, smiling can help you in labour by: 

1. Being a distraction - a common comfort measure used during labour.

2. Keeping your body relaxed to let it work easier, and hopefully faster. 

3. Letting the helpful hormones manage your pain level.

4. Helping you remember the positive memories of your experience for a very long time

There is much to smile about as you finish this journey. Keep smiling!

Note: I know the above is a simplistic explanation of an extremely fascinating and complicated hormonal process; for those who don’t have any background in the process, this is enough to make my point.