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So You’re In Early Labor. Now What?

Monday, April 24th, 2017

 

One night, you are awakened from slumber at the beck and call of your compressed bladder. No, wait. That’s not it. There’s a crampy tightness that feels familiar. Where have you felt that before?

Menstrual cramps! It feels crampy. Weird. You decide to get up and move to the bathroom. After a few minutes, you get back and bed and feel more cramps. Hm. Weird.

Could this be it? It could be! This is it! You’re finally in early labor!

You know this because the contractions are coming, no matter what you do. You’ve had a big glass of water. You’ve gotten up to pee. You’ve had a snack. You’re content to let the rest of your house rest while you anticipate the birth day to come.

So you’re in early labor. Now what?

You think back to what your midwife told you, and you remember that she gave you several things to do during this slow building time.

  1. Let Your Midwife Know. As soon as you know you’re definitely in labor, she’ll want to know. She or her assistant might swing by to check on you and baby, or just triage you over the phone, depending on what’s happening and your needs.
  2. Rest. This is not the time to try and “get things moving” by taking a long walk, doing nipple stim, or anything else that is supposed to speed things along. This is the time to conserve energy. If you can talk through your contractions, you can sleep through them.
  3. Eat & Drink. Whatever time your labor starts, eat normally. One good meal is often enough to sustain you through the work to come. No food is off-limits, though it’s wise to keep in mind that you may throw up, so avoiding choking hazards or harsh foods might be a good idea. Comfort foods are wholesome, nourishing, and encourage happy hormones. Also, keep drinking. Water, juices, herbal teas that you enjoy, smoothies, and broth are all great candidates. Whatever sounds good.
  4. Do Life. There is no reason to put off that quick trip to the store to get milk and bread, or going to the movies. There is no reason to go out if you didn’t plan to, but just going about your day, doing your best to ignore what’s happening. At this point, it’s really no big deal, and it helps your progress if you can be content, happy, and moving.
  5. Distract Yourself. Sometimes, especially when it’s your first baby, it’s so hard to keep your mind off your contractions. But the rule of thumb is that you must ignore them until they demand all of your attention, whether you like it or not. Conserving energy in early labor is paramount! Don’t use breathing or coping techniques from your classes yet either. They contribute to the sense of time, and can make you far more tired than you need to be. Instead, watch funny movies, go to the park, go out on a date with your partner, bake a birthday cake, start a slow cooker meal for after the birth, or call a friend to chat.

I like to tell people to “be in denial” about their labor until their labor gets all up in their face! Just take care of yourself, pretend like everything is normal, that nothing is going on, and let your body keep the secret just a little while longer. You will be shouting to the world in your own way soon enough, so save your breath. Smile. 

“To move into active labor, a woman must give up ideas of how she thought labor might be; in other words, she must surrender.” ~Elizabeth Davis in Heart & Hands

Open up to the path your labor has chosen, and surrender time.

Grace & Peace,
Tiff

VBAC: You’re The Number One Stakeholder

Tuesday, April 19th, 2016

Add headingIn this line of work, informed consent and refusal is paramount. There is not one factor more ethically important than accurate fully informed consent. Without it, a care provider is practicing unethically, and patients are deciding blindly. Without it, it is far too easy for doctors, hospitals, and insurance companies to steamroll patients in their desire to protect the so-called “greater good.” The greater good argument is just a nicer way of saying “The end justifies the means.” An argument most people dismiss as childish at best and despotic at worst.

Nowhere is this more true than in making medical decisions. No government has the right or the jurisdiction to decide ahead of time what would be in anyone’s best interests to choose one course of action over another. The only exception to this is when one’s decision would interfere directly with the safety or life of another human being. Very few medical decisions will directly result in putting another human in mortal danger. Even smoking isn’t guaranteed to produce cancer in every individual. Rather, there are risk factors linked to smoking that make it far more likely. Yet, we don’t ban smoking entirely! We understand that each individual has a right to do with their lungs what they like.

“Unless we put medical freedom into the Constitution, the time will come
when medicine will organize into an undercover dictatorship to restrict
the art of healing to one class of Men and deny equal privileges to
others; the Constitution of the Republic should make a Special
privilege for medical freedoms as well as religious freedom.”
~Benjamin Rush
(one of our Founding Fathers)

Why does this change when it involves a uterus? Medical institutions seem to have the mindset that women give up their rights when they cross the threshold of the labor & delivery room. Up for discussion in Colorado are the midwifery regulations. Up until last week, everything was going smoothly, and midwives were going to be given some reasonable freedoms to better care for the women who choose home birth. At the last minute, ACOG tacked on an amendment to HB-1360 to remove the option for midwives to care for women desiring a VBAC at home. It passed the House, and is now on the Senate floor this week.

Rewinding a bit back to decisions that interfere directly with the safety or life of another human being. Doesn’t VBAC do that very thing?

No.

It does not.

Most medical decisions fall on a spectrum. They are not black and white, right or wrong. There are degrees of risk. And those degrees vary among different women. They even vary among different pregnancies in the same woman! How on earth can there be any government regulation that allows for every possible variation in these risks? How can any government regulation account for every arbitrary circumstance? Every irregularity?

They can’t.

And they should not.

Who then, is best equipped to balance the risks of VBAC against the risks of a repeat cesarean? The woman who is pregnant is the number one stakeholder. Period. End of story.

“But what about the baby?” Yes. What about the baby, indeed. That baby has a mother more intimately connected to him than anyone else. There is no one more fit to make decisions in regards to the risks baby may incur during any given birth than his or her fully and accurately informed mother. Not the doctor. Not the hospital. Not the insurance company. And certainly not the government.

That’s my story, and I’m sticking to it.

Please — do your homework. Educate yourself. Speak up! Start here:

VBAC Facts
International Cesarean Awareness Network
Science & Sensibility: Too bad we can’t just ban accreta…

Want to do something about it? Visit the Colorado Midwives Association Facebook page, and follow their posts. They are posting updates regularly. They are sharing specifics like who to call, and what to say. Easy peasy.

When it comes to VBAC consent: You are the number one stakeholder.

Thank you!

Grace & Peace,
Tiff Miller, CCCE, Student Midwife

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30 Days of Gratitude, day 19: Vivian Harmon

Thursday, November 19th, 2015

Copy of thankful 2015 day 19Vivan Harmon, Student Midwife extraordinaire! I do not exaggerate when I say that I am most grateful for my fellow student and assistant. The more I get to know Vivian, the more I admire, respect, and love her.

When I first started assisting Desirre, she and Vivian had already worked together as assistants under Merrie MacDowell, the midwife who caught my two youngest babies. They had a rhythm in their work that was like a choreographed ballet. I wondered in my insecurity if I would ever attain that kind of synchronicity.

Thanks to Vivian, I have.

From the beginning, she taught me efficiently and kindly how to do what she does, and brought me up to speed faster than I would have thought possible. She has had nothing but grace and kindness for me during our entire professional relationship, and I feel blessed to now count her among my friends.

Ain't she purty, too?

Ain’t she purty, too?

She has been open to my questions, taught me how to do things before they are asked for, and shown me little tips and tricks that make the work we do so much easier and more efficient. She knows how to cooperate and work together, how to correct mistakes graciously, and how to lead and ask for what she needs. She and I work together so well, and I couldn’t be more grateful for her calm presence.

Vivian is intelligent, honest, loyal, professional, honest, capable, humble, confident, kind, funny, and pretty much just amazing all around. I kinda want to be more like her when I grow up.

As we face separate paths this coming New Year, I couldn’t let this old year pass by without expressing my gratitude for her presence in my life. Thank you, Vivian. I heart you with many hearts.

Who are you thankful for in your life?

Warmly,
Tiffany Miller
Student Midwife and Childbirth Educator

30 Days of Gratitude, day 18: Scrubs.

Wednesday, November 18th, 2015

thankful 2015 day 18Scrubs. Those ubiquitous uniforms worn by most health care workers. Whether they are hospital issued, color-coded for security, or fun designs to please the kiddos, they are a genius invention.

Today, I am thankful for scrubs.

Many midwives don’t feel quite comfortable wearing them to births, as they feel it brings a too-clinical/medical air to the home birth environment. I get that, in some ways, and can empathize. However, I happen to disagree.

Here are a few reasons why:

1) I have yet to meet a mother who takes issue with scrubs being worn in her home. (That’s not to say there aren’t any, just that it doesn’t seem to be the norm in our area. I’m sure I would accommodate if a request were made. Though, I’d insist on the pants at least…)

2) Our job is, in fact, clinical. It just happens to come from an entirely different worldview and care model. A midwife’s responsibility is still rooted in clinical health and safety, though it goes far beyond that into supporting wellness. It makes sense to wear clinical duds.

3) At a birth, we are often likely to be “baptized” with various bodily fluids, and you can’t beat a good pair of scrubs for drying time. Not even a bathing suit dries faster. I can’t imagine having to finish work at a birth in sopping wet jeans.

4) They are snazzy. We can express ourselves with the wide variety of options available though I have yet to find TARDIS scrubs…help me out?

5) They are easy to clean. Seriously. It’s like they’re incapable of holding stains. So, I can essentially guarantee that I will look professional.

Their only downside? Those elastic waistbands like to migrate downwards. A lot. So, midwife’s crack might be a thing. Totally worth it, though.

What are you thankful for this fine fall day?

Warmly,
Tiffany Miller
Childbirth Educator, Student Midwife

30 Days of Gratitude, days 11-17: Teaching Tools

Tuesday, November 17th, 2015

Copy of thankful 2015 day 11-17Wow! Has it really been a week since I posted? Thank you all for your patience. Turns out being off-call doesn’t necessarily make me more efficient at getting blog posts up, does it? Ha! Well, now you all know that I’m a real person, and I make mistakes too, and that can’t be a bad thing to know. So many people look at my life and think that I have it all together, but I very  much do not! I am just doing the best I can, with what I have, where I am, and that, by necessity, has to be enough.

That said, I am delighted to share with you some teaching tools that I am so very thankful for in my work. Without good teaching tools, I would just sit in front of a classroom full of people and yap. Not that I couldn’t do that, but how fun would that be? Not much. (I do enough of that anyway…) So, without further ado, my favorite teaching tools:

Most of all, I am thankful for a great classroom space, that I can arrange and rearrange how I see fit, every time. It’s so much fun to anticipate class needs, and to enhance the group dynamic by making the space our own while we are there.

What are you thankful for today?

Warmly,
Tiffany Miller
Childbirth Educator & Student Midwife

Image links:
Day 11, Day 12, Day 13, Day 14, Day 15, Day 16, Day 17.

 

30 Days of Gratitude, day 10: Time Off-Call.

Tuesday, November 10th, 2015

There is nothing a doula or a midwife looks forward to more than time off-call throughout the year.

Since we have chosen this line of work, you won’t often hear us complaining of being on-call 24 hours a day, 7 days a week, year round. Yet, this work is demanding. It stretches our minds, our bodies, our emotions, and our relationships. It affects every area of our lives profoundly, and we must make sure we find the balance we need in order to keep ourselves from burning out.

Ideally, we want more than that. We want to thrive in this work, in our personal lives, and in our relationships. So, we schedule time off-call. Here at Preparing for Birth, we choose to set aside two months a year in which we take no clients. We still have prenatal and postpartum appointments, but we will have a glorious 3-4 weeks in which we can turn our phones off sometimes!

We can take time for family vacations, field trips with the kids, or days to just do nothing. We can enjoy more than one margarita if we feel so inclined, and not worry about a late night of karaoke.

For us to be at our best in serving our clients, we must take this time. It is not a luxury. It is a necessity. And we are so grateful that there are enough midwives and doulas in this town to go around, so we are free to take that time off and not worry that any clients will be left without a care provider.

Time off-call. It’s a beautiful thing.

How do you take time off? What are you thankful for today?

Warmly,
Tiffany Miller,
Student Midwife & Childbirth Educator

30 Days of Gratitude, Days 8 & 9: Shared Nerdiness & Geeky Culture

Monday, November 9th, 2015

thankful 2015 days 8-9 aBirth professionals are a unique breed. Nerdiness is a built-in feature of each of us. We tend to be counter-cultural in a lot of ways, and our passions extend beyond the bounds of birth, babies, and breastfeeding in surprising ways. Today, we are all thankful for this ability we have to bond in our shared nerdiness and geeky culture.

We all geek out over things which the rest of the world will just back away from. We have all squealed in delight at the latest and greatest fake boob, because we can use it to demonstrate a pump. We have each sighed longingly over a new model pelvis, because ours is missing its tailbone. Our Amazon wish lists are filled with midwifery texts, cute scrubs, birth books, and tools of the trade. And don’t even get me started on the awesomeness of placentas!

We go all fangirl when we hear that Ina May Gaskin, Penny Simkin, or Michel Odent has agreed to speak anywhere in our near vicinity. They are the rock stars of the birth world, and we just can’t handle the awesomeness.

And yet…our geekiness doesn’t stop there. Our ridiculous passion for birth extends to a lot of other areas. Did you know Colorado Springs has a stormtrooper midwife? Yet, she is not the only out and proud nerd in town! Our very own Desirre Andrews has quite a large, geeky following on her Dram of Outlander blog, and is writing reviews for a few different SyFy shows. Seriously, we are a geeky bunch, and we were geeks before being a geek was cool! (So, we’re like…hipster geeks. *snort*)

“I’m thankful for nerd girlfriends! Doctor Who, LOTR, Books, Sherlock, all things geeky and nerdy!” -Sabrina Stewart, Pregnancy Fitness & Breastfeeding Educator and CLC

Not only do birth professionals connect over all things birth, we connect over fandoms. Everything from Marvel to Star Trek to Doctor Who, to Outlander to Downton Abbey to Sherlock to Firefly, you can find us geeking out over something.

A geek is a geek is a geek, and while we’re not all the same, we find our common ground in our fandoms!

Today, we are thankful for our sisterhood being built on more than birth and breastfeeding. We are thankful that geek culture is in, and that it’s finally okay to be wildly passionate about anything! Here’s to the comic book nerds, the cosplayers, the bookworms, the gamers, the Marvel fanatics, the BBC fangirls, and all other nerdy passions!

What are you geeking out over today?

Warmly,
Tiffany Miller
Childbirth Educator and Student Midwife

30 Days of Gratitude, Day 7: Support

Saturday, November 7th, 2015

thankful 2015 day 7One thing that all of us have been able to join together in gratitude for is the support inherent in Preparing for Birth. Desirre has built not only a strong community in the Pikes Peak Region, but has been a mentor and steady support for anyone who decides to join Team Preparing for Birth. When we sign an agreement with Desirre, we can feel confident that we can reach out and gain the support we need, whether it’s discussing a sticky situation regarding a client or student, or help in organizing our business finances.

Following her example, I have tried to step into the mentor’s shoes to ease Desirre’s workload, and I find myself delighting in this role. It’s challenging and new for me, because I never thought I would be in a place in which I became the mentor, rather than the mentoree. Even in this role, I’m still able to reach out and get the support I need in order to succeed at mentoring others.

Our Team PFB doula puts it this way:

“So grateful to be a part of Prep for birth. I have been so blessed to work with Desirre and Tiffany who believe in me more than I believe in myself at times. I have learned so much from them and am thankful everyday for their mentorship.” -Tanya Park, Labor Doula & Midwife Assistant

Early this year, Sabrina Stewart joined our team as a breastfeeding educator and pregnancy fitness educator. This area has been the most challenging for all of us, but we have all learned so much together as we seek to reach women in every area of need in their perinatal year. We are very proud of Sabrina’s milestones, and the work she is learning to do as she walks out the rigorous educational path she has chosen for herself. She’s beginning to find herself strong, because of support. She expressed it this way:

“I am grateful that we have the group at Prep for Birth where we can ask for help or talk about births, breastfeeding, pregnancy, and education for the moms we serve without rudeness. The ladies here lift up, support, and encourage each other to be successful.” -Sabrina Stewart, Pregnancy Fitness & Breastfeeding Educator, and Certified Lactation Counselor

We none of us could do this work without solid support. In Team Preparing for Birth, it’s one thing we can all count on. And for this, we are each thankful.

What kind of support have you received this year?

Warmly,
Tiffany Miller
Student Midwife, Childbirth Educator

30 Days of Gratitude, Day 6: A Warm Bed

Friday, November 6th, 2015

thankful 2015 day 6The days may have been warm, but the nights are getting pretty darn chilly in these parts, so we are all finding ourselves thankful for our warm beds. There is nothing more satisfying to on-call birth professionals than falling into our own warm bed after an all-nighter. Except, maybe, that first cup of coffee upon awakening. I think it might be a tie.

“It includes lots of my favorite things: my pillow, quilts, sleeping, and (usually) solitude,” quothe Erin, one of our midwife assistants and childbirth educators.

I think it’s safe to say that it goes for all of us.

Beds are incredible places, full of dreams, cuddles, and the cool side of the pillow. Our beds are our havens. Some of us have a little coffee station close by, so as to be able to drink that first cuppa without leaving the cozy sanctuary.

Some have beds full to the brim with children, those natural hot water bottles of cuteness.

Some have beds that move, making reading in bed more luxurious, and lower back pain less noticeable.

Many have bedside tables stacked with books, and have a hard time choosing which ones we’ll be reading from evening to evening.

Some have our beds gloriously to ourselves, and it has become our haven when we are overstimulated and touched out from a day caring for other humans–whether they be our own tiny humans, or our clients is immaterial.

Beds, beds, glorious beds on a cold and biting autumn night, or a crisp day after a long birth. They are things of beauty, whether made or unmade, spartan or covered in fancy pillows, king size or queen or full or twin. They are our beds, and we thank God for them on this lovely day in November.

What are you thankful for today?

Warmly (possibly from my bed),
Tiffany Miller
Student Midwife, Childbirth Educator

30 Days of Gratitude, Days 4 & 5: Beautiful Weather & Colors of Fall

Thursday, November 5th, 2015

thankful 2015 day 4Several of us in the Preparing for Birth office space are grateful for the gorgeous Indian-summer sunshine we have experienced in the past week! The weather has been truly delightful, with blue skies, incredible cloud formations, perfect temperatures, and just the right amount of crisp in the air to justify boots and hoodies.

The vivid yellows that characterize fall leaves in Colorado (thank you, high altitude and aspens) are an added source of light, and bathe us in sunny hues even on the days that bring some overcast skies.

Jennifer Green and Ramona Webb have both expressed their gratitude for the sunny weather we’ve had, and the colorful leaves presiding in radiant glory over our parks and lawns and gardens all across the city. Their thankfulness has reminded each one of us that, no matter the season, there is always beauty to be had.

Our steps have been lighter, our hearts more ready to receive the message of surrender that autumn brings us.

11231161_10206638472333892_3252314865851918149_oWe all anticipate this winter to be especially cold, with a lot of heavy snowfall. Who knows, really? So, enjoying the dying days of autumn help all of us to slow down, breathe in the scent of earth and wind and leaves, and let go. Even Desirre, who detests the parting of summer, has been inspired to find hope in the falling leaves.

In our hearts, though we know that autumn is but a preparation for the death of frost and winter, we also know that Spring will surely come. That resurrection is the rule, not the exception on God’s green earth.

And that is truly something to be grateful for.

What do you like best about autumn? What are you thankful for today?

Warmly,
Tiffany Miller
Childbirth Educator, Student Midwife