Birth Story: The Difference

Monday: why we chose to plan a home birth. Yesterday: the birth story.

Peanut was born in Haarlem, in the Netherlands; Pumpkin in Chicago, in the United States. Both have dual citizenship. He's kind of fair, like his father. She's kind of dark, like her mother. We're all perfectly balanced out in a silly story book kind of way. I love that our dual-nationality family has one child born in each country. We didn't plan it that way, but it happened and it's nifty.

It means that we did a pregnancy in the Netherlands and one in the United States. Can two countries be much farther apart? The US has a C-Section rate approaching 35%. In the Netherlands, most women go to a midwife unless they have a high-risk pregnancy. Perhaps most importantly, these countries see each other as opposite ends of the spectrum. In the US, a number of natural birth advocates were thrilled to hear I had given birth in the Netherlands. This is in part due to the fact that people like Ina May Gaskin often refer to the Netherlands as the golden land of natural child birth. In the Netherlands, people assume that birth in the US is all epidurals and scheduled C-sections. Neither is entirely true, and neither is entirely wrong. But the differences are far more nuanced

When I was pregnant with Peanut, I went to the local midwives. They took good care of me. It was a practice with six ladies and they were all nice to talk to. My visits were brief – they checked my blood pressure, felt the baby, measured my belly, listened for a heart tone, asked me how things were going, and sent me on my way. I met all but one of the women in the practice. They were patient with my questions and concerns concerning the birth. It was nice.

We elected to have a midwife assisted hospital birth (in the Netherlands, if you are low risk, you can choose whether you want a home birth or a hospital birth) and it was fine. We had a large, well furnished room to ourselves. Everything was there for the baby and husband to stay in the room. The room has double doors (a door, a hall, a second door) for privacy. The lighting was adjustable from low to operating room bright. There was even a refrigerator (for champagne, of course).

During the birth, we were assigned one nurse. She was the only person aside from our midwife who came into the room. When her shift ended, the next nurse took over. We ended up seeing an OB/Gyn at the very end because Peanut ended up being a vacuum-assisted birth, but they way they transformed the room was amazing – apparatus and people rolled in, Peanut was born, and everything went away – all within about half an hour. We ended up staying for 24 hours as a result, but we could all stay and sleep in the room together.

All of this sounds and was lovely, but I'm one of those women who want a natural birth. I was in the hospital, so when we needed the doctor, it was easy. But it's not all beautiful bellies and happy mamas over here. For instance, about half of all home births (for first time mothers) end up in the hospital. That usually means a transport to the hospital in a later stage of labor. If you haven't been in a Dutch house lately – the stairs are often as steep as ladders. Sometimes people are lowered out of windows because a stretcher can't go up and down the stairs. Imagine that.

Up until about three years ago, pain relief in the form of an epidural was not guaranteed. If a laboring woman requested pain relief outside of office hours (Monday through Friday, 9-5), it was at the anesthesiologist's discretion. Why interrupt a family meal or a good night sleep because some woman can't manage her birth pain? This has changed, thank goodness. But back when Peanut was born, I knew one woman who went home to Germany for her birth because she was afraid of not being able to get pain relief. There is a lot of support here for breastfeeding moms, but I've also heard women refer to the breastfeeding mafia – the pressure to breastfeed, whether you want to or not. Most women start, but not many keep it up.

There's also an ongoing debate between midwives and gynecologists over who should be in charge. Midwives aren't always eager to take their laboring mothers to the hospital and I've heard such transfers referred to as regrettable as opposed to necessary. I think it has to do with payments and power, but I'm not sure about the details there.

On the other hand, in the United States, pregnancy and birth are basically in the hands of doctors. This thanks in part to the insurance companies for reasons maybe someone can explain to me because it makes no sense. There's a clear (statistical) tendency towards more intervention and more pain treatment. Women are the objects of a birth, not necessarily the actors. In other words, birth is seen as something that happens to women, not something that women do. Instead of a process, it is an inconvenience between the rose-colored pregnancy and baby shower stage and the rose-colored new mother stage (neither of which are rose-colored, but the cupcakes might be).

If you decide that you do want a midwife or a birth center, the resources are out there. It takes more work on the mother-to-be's part (and partner), but it is possible. If you decide on a home birth, you may have your fair share of “what on earth are you thinking” conversations, as well. It's making a statement to choose for a home birth. The advantage here is that midwives who choose to offer their services to support home births (at least the ones I met) are very dedicated to their work, in part because their work is part cause.

So there are some of my thoughts. I'm curious to know about what birth is like in other countries or cultures. And how closely my observations match the experiences of other mamas. Do tell!

Birth Story: The Birth

Yesterday: why we chose to plan a home birth.

My midwife, Midwife S, took me on despite the fact that she had been planning vacation time for herself. She was out of town for two weekends right around my due date, but had a back up midwife and general practitioner lined up.

I went into labor on a Monday while Midwife S was out of town. By 9 am, Midwife M, who was Midwife S's assistant, was at our house, along with Midwife #3 (to assist), Dr. W (a general practitioner, required by Illinois state law if the attending midwife is not a certified nurse), and Dr. #2 (a young general practitioner who wanted to attend home deliveries) were at our house. In case you're having a hard time with the parentheses, that's two midwives and two general practitioners at our house, all for me and Pumpkin.

That morning, Peanut and his grandma went to music class. Someone cooked eggs for the group. The doctors read through our stack of New York Times newspapers. Midwife S, started driving back from her weekend away. Midwife #3 left. Dr. W left. Midwife S arrived with daughter in tow. Peanut and grandma got home, and it was two midwives, a general practitioner, and one nice young lady that stayed until the birth.

I remember a few special moments of the birth particularly clearly – like Peanut holding my hand through a contraction, and then going back to the living room to play. I remember a husband watching, waiting, holding, encouraging. She arrived at six in the evening, just as the sun was going down. Moments later, Peanut walked in the room and said, “That's the baby from inside your belly,” and fell in love with his little sister. We all did.

Pumpkin's birth at home was a wonderful experience. It's hard to articulate what made it so special. Those moments with Peanut probably sum it up. The birth of a child is a moment when the mundane meets the sublime. The physicality is overwhelming and the magic of a life is incomprehensible. And it happens every day in every place – including our apartment in Chicago one day last March.

Tomorrow: pregnancy and birth in the USA vs. in the Netherlands.

Birth Story: The Choice

37 weeks pregnant and looking for a midwife – that was me this spring. This is the story of how we ended up having a planned home birth in Chicago. A home birth was never part of the master plan. My prenatal care was at a university hospital with a fine OB/GYN. We lived close by (perhaps even laboring walking distance). Insurance would cover a hospital birth. But it gradually became clear that a hospital birth wasn't going to work for me.

I arrived in Chicago early in my pregnancy and went to all my prenatal appointments at the hospital. It was my second pregnancy. My first pregnancy and the birth of Peanut all took place in the Netherlands under the care of a midwife – except for the last 15 minutes, but that's another story. The appointments in the Netherlands were friendly and decidedly non-invasive.

The hospital approach was more medical (no surprise there), but that was OK. Sometimes it made me giggle. Before every appointment, I had to fill out a form that included two questions (1) are you pregnant? (2) what was the date of your last period. I had to pee in a cup every time. Except the one time I went to the toilet and forgot to fill the cup. Oops.

As my due date neared, I began asking questions about the birth. Questions like, will I be allowed to eat? How do you feel about me laboring in the bathroom? Will I be able to move around? The answers were not encouraging. Popsicles were fine, I would have to ask permission, and only if I happened to be in one of the two rooms with a cordless monitor.

It also became apparent that some policies were not up for negotiation at all. A fetal monitor was mandatory. Intermittent or cordless monitoring might be an option, but that would all have to be discussed on the day of delivery. Triage would take up to an hour and a half, during which time I would be expected to stay on a monitor. A heplock (an IV starter in my hand) was mandatory. They also expected me and required the baby to stay in the hospital for 48 hours.

Where I had hoped we would be able to negotiate the circumstances surrounding the birth, it became clear that it wasn't going to work out the way I hoped. So I did what I always do – I went on-line. I googled midwives in Chicago. I checked in on a couple of forum, posted questions and got really lovely, caring responses.

In the end, I met with a midwife and liked her. She was patient, curious, flexible, and didn't mind any of my questions. That's something, considering my first question was something like, “who cleans up?” When I walked out the door, it was with a good feeling. When I got in the car with Peanut and pulled out, I knew for sure. I wanted this home birth. It was important. It was right.

Tomorrow: the birth story.

Summer evenings...

We had a shocking development tonight. Two children were in bed at 7:30. Two children were asleep in their beds at 7:30. We went sat out on the balcony with coffee and date walnut cake and enjoyed the moment, talked about life, talked about changes coming and going, and took just a few deep breaths. Then we went inside and responsible Papa discovered Pumpkin, screaming in her crib, just out of hearing range. And thus ended our blissful evening...

But it didn't end before a few minutes of very important and thought-provoking discussion. We manage this every once in a while. It's the "who do you want to be when you grow up" talk. This year has been a hard and fascinating journey. I went from working mom to stay-at-home mama. "Mama" seems more appropriate now. I feel more connected to my mama-ness now. More connected to my children, my family, and our needs. I'm learning that this work is not about accomplishing or crossing-things on a list, but about trying (and it is so hard) to be present and flexible.

It's been hard to find my own path on this journey. There are plenty of people who inspire me. Some of them I know personally. Others, I admire at a distance. It's taken time to realize that our family's path will be different than all of theirs and that it will work and that it will be alright. It's taken time for me to realize that my path will be different from the one I dreamed of and that it will work and that it will be alright. So maybe that's me giving me permission to breathe more often.

One thing's for sure - I'm giving myself permission to blog without pictures. I'm terrible at taking them regularly. I'm terrible at uploading them. But I enjoy the writing. I enjoy the community. I enjoy the discussion. It's lovely, even without pictures.

Mother's Day

There was a surprise on the camera last week. This grandma and Peanut are special buddies. They spent a lot of time together this spring, partly because grandma came to visit for six weeks. She took amazing care of our whole family and the dinner guests we invited as well.

This is my mama. She taught me to sew, crochet, and knit. She's a great cook. She's a fearless traveler. She's kind, generous, adventurous, and fun. She's also a bit wicked (that's a warning to those of you who really believe she never plays poker). She can talk to anyone and taught me that "the road is in your mouth," which means you can always ask if you need to know something. She is always there for me when I need it. That's now with kids and years ago when she flew to DC to take care of me when I had my wisdom teeth taken out.

I've taken her for granted too many times and am sure to do it again in the future. But today, for just a moment - thank you, mom. And by the way, aren't I lucky to have a reminder of her good looks at home every day?

Guilt and Healing

This morning, a dear friend took Peanut to playgroup with her son. She's done this a fairly regularly for us and we both enjoy it tremendously. I usually try to be a good PhD candidate and spend the time working on research and writing. Today, I didn't. Instead, I went to my favorite cafe and had a hot cocoa and some reading time. Then I went for a wander in the bookstore. Didn't buy anything, of course. I rarely do. But it was healing. The cold doesn't get to me, but sunless days do. This mama has been in need of some rejuvenation lately and my decadent (what - time to do whatever I want? NO!) morning helped a lot. So I feel a bit bad about not making better use of my time. But I also feel better. Things are actually getting done today and that hasn't been the case for a while.

Now, about making the sun shine again....

Mama Corner

This year, we are living in a rented furnished apartment in Hyde Park. The location is great. The working part of the family can walk to work in ten minutes and the working-at-home part of the family has plenty of kid friendly resources within walking distance as well. What we don't have is much of our own stuff. Buying things is on the "don't do" list because one way or another, we are moving to a different home next year and the less we have to move, the better. That means plenty of time for dreaming and a need to be creative about how we use what is available to us.

Here in Hyde Park, a wonderful caregiver has come into our lives. She watches Peanut in her home on Friday mornings so Mama can get some library time. It turns out, Mama is getting as much care as Lucas. The hours in the library are truly valuable to me since they took so much work to organize. More than that, though, we have found someone who cares for Peanut and watches out for Mama as well. Over the holidays, we got to pick up a beautiful rocking chair to borrow for the next few months. It's taken up residence in our living room and has accidentally created a Mama corner.

Since Peanut was just a little tiny thing, I've spent a lot of time and energy trying to create good play areas for him. I've never thought much about creating a good space for myself. This space just happened and it makes me happy over and over again. The radio is within reach, so I can listen to my talk radio quietly without disturbing the rest of the family. It is also easy to play soft music for Peanut when he nurses at night. The bookshelf has a couple of less full shelves, so there is space for pens, pencils, glue stick, scissors, journals, and plenty of reading material - as well as a beverage. The window is right there for gazing out and daydreaming. For now, the Christmas tree is there as well, with it's lovely fairy lights and decorations. This rocking chair turned a corner into my corner and I love it. It's the perfect spot for reading, knitting, sewing, nursing, reading stories, and just relaxing.

It didn't take much to create a wonderful Mama Corner in this home of ours. Do you have a special spot in your home?

Mama day

I just finished whipping up a double batch of homemade deodorant following this simple recipe. Over the past few years, I've been slowly working towards a more natural lifestyle and the deodorant was another step in the right direction. I made some for myself about a month ago and am very happy with it. Works better than my old bar and only has four ingredients: corn starch, arrowroot powder, coconut oil, and a dash of vitamin E. I still sweat, but don't stink, not even after a 45 minute bike ride. So, one jar will be a potentially grossly inappropriate gift and the other is for a friend who'd like to try. Can't wait to hear what they think of it.

Today's a mama day. I work four days a week and have one at home with Peanut. We try to keep our weekends free for family fun (this week we're going to Brimingham, UK), so that means that Fridays are busy. We do a couple loads of laundry, change sheets, get groceries, and cook a good meal (with leftovers for the freezer). There's also usually a project in there like deodorant today.

Sometimes I feel bad that we don't do kiddy fun stuff - parks, pool, outings - but there just isn't time right now. Then I try to remind myself that despite having a mama who works four days a week, Peanut eats only homemade food, usually wears pants made by mama, and even plays with toys made by mama. Going to the park sounds great, but if it had to be at the expense of homemade meals, I think we'll pass for now. He won't remember the park, but his body is thriving on the good food and he's learning to appreciate all kinds of tastes. Besides, does this look like an unhappy child?



I think that me and the happy Peanut will be OK in the backyard for now.