Sometimes, despite all of our planning and preparation, things can unexpectedly change in the early weeks of pregnancy and miscarriage can follow. However, many aren't aware, there are just as many, if not more unexpected outcomes in the last few weeks of pregnancy. Many of which, are also out of our control. I often share with women who have suffered loss, infertility or other obstacles, the next time around, FOCUS ON WHAT YOU CAN CONTROL. There are so many unknowns and women particularly who spend their time mulling over all the "what if's" will create elevated levels of anxiety in which she doesn't have to endure. The best analogy I often share with clients, "Stop viewing the entire forest and all that could happen and simply face the tree that is in front of you right now." It is a much easier way to live and a much more relaxed state of being, if so.
As most laboring women would share at the time of contractions, RELAXATION does NOT come easy. It must be practiced and mastered. There is more to relaxation than just turning off muscles. We call it physical relaxation. But, to master the unknowns in the mind... well, the battle is real for soooo many pregnant moms and even a lot of fathers too. We call that one mental relaxation. And, it doesn't stop there! Then there is this thing called, Emotional relaxation. This one is one of the most important forms of relaxation, because mom has to be okay with what she feel about what is happening to her.
Previously, Amber and Brian unfortunately had lost a baby at 10 weeks. She had a history of uterine fibroids, but no one could determine why specially she had experienced loss of her first baby. At her very first appointment, she was not measuring accurately based on how far along was speculated. In the weeks following, Amber had began cramping and spotting. Her bleeding continued to increase and the OB/GYN appointment confirmed their loss. It was a big blow to the couple as it is for anyone who loses a baby at any point of pregnancy. The doctor failed to administer a RoGAM shot at the time despite her being RH-. She bled for 6 weeks following to the point of saturating adult diapers. Upon following up with her medical team, she was advised to go straight to the hospital and tell them she needed a RoGAM shot.
I had the privilege to train the couple 12 weeks in The Bradley Method® at the farm. Their goal remained low intervention, natural birth, or at the very least only experience what is truly medically necessary to safely give birth to their rainbow baby.
When the couple learned they were pregnant again, they knew they needed to educate themselves and become advocates for their own healthcare and the well-being of their unborn baby. About 7 weeks into their training and after creating their birth plan, they realized they needed to choose a different practice to increase their odds of meeting their personal birthing goals. The couple selected Women's Healthcare Associates and birthing at Piedmont Athens instead of Eastside Snellville. They were very pleased with the change (especially during the pandemic) not just the individualized personal care she received with WHCA Athens midwives, but also the time with Dr. Allen in reviewing informed consent for her treatment plan. And, especially for giving personal attention and consideration to Amber's pain management preferences.
How do you feel the pandemic affected your overall pregnancy and birth experience?
- I tested positive for the virus and then Doctor Allen ordered the COVID-19 blood test and it showed I had the antibodies. They didn't have to use the COVID surgery room nor the surgical COVID protocol. My baby was also tested for COVID-19 after birth, as well. The pandemic restrictions made my hospital stay shorter which was great, and also limited visitors which was also a blessing since I was recovering from surgery. However, it also robbed me of my planned doula experience and the hospital denied me doula services before and after planned surgery, which was sad. Piedmont Athens was allowing doulas for labor only at the time, but since my baby was breech and I had to have a belly birth, they did not allow her to attend. Pam was also very sad, but she planned a relaxation day for us at the farm and we enjoyed a lunch out before my scheduled surgery. as well. She also offered us some extra TLC at a later time in the form of a postpartum relaxation day in months following.
The pandemic created many obstacles and not just for couples, but also for doula's and medical staff, as well. I, personally, do not like to miss a baby born as in ever! It hurts me. I love my job and I have spent months helping the couple prepare for their big day only to be denied access to assisting when the big day arrives. We Your Birth Helper Doula's live for labor day! However, Piedmont Athens was far from the only hospital restricting doula's from attending during the pandemic. In fact, I personally had clients in my tri-state area who sadly endured such restrictions in every direction from Gwinnett county and beyond, to Greenville, SC and even Charlotte, NC. It seemed overnight the birth of COVID-19 became the death of doula support as we knew it during 2020. It was extremely challenging for couples during pregnancy in 2020, because their spouses/ partners could not even attend monthly prenatal visits together, in person. Then you had us doulas having to switch to virtual support by text, call and facetime in most hospital birth locations during the pandemic and some till to date, not allowing us bedside. Many nurses and other hospital personnel have had to remain in masks, shields, scrub suits and even respirators for a 12+ hour shifts, etc. had to limit the number of hospital locations they practice in to cut exposure. Also, attempting to convince every single patient who enters into labor and delivery even if ready to give birth to take a COVID-19 test. Couples, who feared being cheated out of Doula bedside support by their individual hospital restrictions, even reverted to switching birth places and even considering home birth, who ordinarily would not have. They liked the fact the out of hospital midwife could do their prenatal care during the pandemic madness and that Dad/Partner could be present during appointments. As for labor, they liked the fact that in an out of hospital birth experience, other family members and siblings could still be present for the birth. However, readers should consider carefully this decision as every mom is not a prime candidate to give birth at home or in an out of hospital birth center. If mom or baby is high risk or a higher that average risk applies, the couple should re-evaluate are they in the right place for them and baby, pandemic or not? This was the case in Amber's situation with several increased risk factors including: maternal age, a history of former bleeding scare, now breech baby, these variations alone could potentially result in increased medical complications at time of labor and birth. Simply put, the pandemic alone is not a valid single reason for a woman to give birth at home. One should carefully evaluate all the pros and cons of birth place locations: home, out of hospital centers and in hospital facilities and make the decisions best for them and their baby of where and with whom (midwife or doctor) to safely give birth.
Remember, regardless of near term unexpected changes you can still find the JOY in your baby's birth no matter how the baby exits your body. My YBH trained couples just find it way easier to find JOY and be way less stressful after being educated and knowing how to acquire informed consent. Much anxiety is removed when you know how to determine if the offered test, procedure, intervention, drug, surgery, etc. is medically necessary or not. And, even in the worst possible outcomes, you will sleep better at night knowing you did your part to do everything in your power to avoid such an outcome that wasn't part of your "birth plan."
When you reached out to Your Birth Helper regarding navigating belly birth after learning baby was breech, what fears or concerns did you have initially and what helped you overcome those fears?
- My main fear was the surgery and the drugs. I chose The Bradley Method®, because I wanted a drug-free birth. After speaking with my doula, Pam and learning there are a variety of medication choices, I was able to speak with my doctor and request options regarding pain management. In having the knowledge of what drugs I could choose from allowed me to both advocate for and help execute the safest birth for Sawyer and the best recovery for me. All of which helped overcome the fears surrounding cesarean.
Amber had learned baby was breech when they sent her to a specialist appointment around 30 weeks gestation. I had her begin spinning babies exercises. She also tried external version at her doctors office. Dr. Allen tried her best, but attempts to turn baby failed. It was so very painful for mom as baby boy was buried deep in her pelvis. That was when the couple made their decision for gentle c-section. If you look closely below you can see one obvious issue... baby seemed to get a little tangled up with the cord wrapped over the top of his right shoulder and seems to come out looking at mom like, "whew thanks for the help, it was a tight squeeze in there!"
What aspects of your natural birth training in The Bradley Method® do you two feel contributed to a more enjoyable belly birth?
- I would say knowing what we learned about medication and what is medically necessary and what isn't, helped us make medical decisions more easily and knowledgeably which helped me relax. I wanted as drug free a birth as I could get even with surgery.
What would you want to relay to an expectant mom or dad who may feel childbirth education is irrelevant if they think they want epidural or surgery to give birth?
- I would say they still need to know what to expect when it comes to baby care choices in the hospital (skin to skin, to bathe or not to bathe, etc.) and postpartum (how long you will bleed, what you should and shouldn't do). That doesn't change just because of an epidural. Also, that there are still medication choices to make even with an epidural, which most don't even realize there are options.
Congratulations Fleming Family! It was my utmost pleasure to assist you with your childbirth training and preparing your body for the best possible outcome. Even when surgery is required, women will still heal better and faster having been physically, mentally and emotionally prepared for labor and to "give birth!" (Even when the OBGYN is handling the "giving you a baby part"). Welcome Sawyer John born just in time for a 2020 tax deduction on December 28th! Special thanks again to Dr. Stephanie Allen, OBGYN also named Doctor of Year in Athens, Ga for her support, as well as, all the staff of Women's Healthcare Associates and the supportive nurses of Piedmont Athens Regional Medical Center.