Growing up I never really thought about feeding babies. Honestly I didn’t think much about babies at all. I remember seeing formula mixes & bottles, but I don’t remember seeing a baby nurse. I was breastfed for 6 months & my younger sister was nursed for 3 months. I must have seen my mother put my sister to her breast, I was 6 years old and I remember changing a diaper & watching my mother mix formula.
My first memory of seeing a woman breastfeed is sadly much more recent. 3 years ago my sister-in-law had her first baby. We went to visit her & her new little boy about a week after his birth. She was nursing him on the couch in their living room, but wearing a cover. In her own home she felt she needed to cover herself up for visiting family. I wish I had known better at the time & encouraged her to only worry about her own comfort level. I wish she hadn’t worn a cover so I could learn. She had to change a diaper & encouraged us to follow her into the nursery to continue our conversation. She laughed about the mess her son was making & joked about how seeing a new baby like this was the perfect birth control. We had planned to wait to tell people, but that’s when my fiancé just blurted out “too late”. We had found out the month before that we were expecting our first. She promptly congratulated us & grabbed two books from her room. A baby name book & a what to expect book.
Pregnancy comes with plenty of unsolicited advice from well-meaning friends, family & strangers. Everything that is related to being pregnant, giving birth, having a baby, & feeding the baby is the main topic of every conversation with anyone (& it gets worse the bigger the belly). I read the what to expect book, I read pamphlets from the office where we confirmed our pregnancy, I read printouts from the CNMs office, I read tons online, I talked to every woman I knew who had procreated & asked some of the nosiest questions. And yet this is only a fraction of the information that was available to me. When I asked my CNM or the nurses they spoke up for breastfeeding, I would call it encouraging, but they didn’t give me any of the grit or reality of it. They just said it’s good for the baby & you should try it. No suggestions on where to find help should I need it. Just do it, or don’t. When I asked family I got nearly the same information. It’s good for the baby, you should try to & then how long they nursed or why they were unable to. No further on why they couldn’t, which I understand could be a touchy subject for them but it would also be helpful for me to know. What if they had an issue that I later experienced? I could come to them for help, I could connect with someone. I never got the “important” advice; people only shared the basic & scary.
At the birth of our first child we had our doula help us get her latched right away, then she left. Our little girl latched great, ate well. No one at the birthing center said anything more about it. I never got a photo of her first latch, I never realized I would want one, but now I’ve learned how beautiful & important a moment that was and regret not having it. A few weeks after birth my mother-in-law came to visit & we all went out to the mall. I packed a bottle of expressed milk that was specifically for public use. How pointless that hassle was. After being at the mall for a while my daughter stared to root. We found a bench by the children’s play area & I offered her the bottle. I fought with her to take that bottle; it ended with a crying baby & a mama near tears. Yet still the baby would not eat from the artificial nipple being caressed to her cheek dribbling liquid gold. I pulled my tee up & my breast out, my daughter latched instantly & greedily chowed down, eyes drifting closed as she enjoyed her meal. My fiancé paced in front of us back & forth, standing to block us slightly. My MIL took off to a store, & returned with a baby towel to cover us. I tried, but it was difficult to get it to stay in the first place, & impossible with a baby kicking at it. In the end I didn’t care, my baby ate & was now full & happy snuggled in the sling sleeping. I never used the rest of that pumped bottle, I didn’t pump for public ever again, I nursed in public whenever my babies got hungry & without covering. I do believe this one pumping/not feeding on demand screwed up my supply enough that my period returned early, something I was disappointed with.
When I first decided I would nurse our daughter my goal was 6 months. I was breastfed for 6 months & I’m pretty awesome, plus that is the stage where you can start introducing things other than liquid. How fun! 6 months came, we fiddled with rice cereal & Gerber jars. She didn’t eat much of them, they smelled funny, they made a mess, and she still nursed often. We ditched that method & started offering her baby-safe solids. That’s when her food fun began, she loved exploring new foods & I loved not having to sit & spoon feed her. Dump a few things on her tray & she’d taste test & nibble, then come to me for sustenance when she was done (remember food before 1 is just for fun). We had a very good nursing relationship, although she did get a bit grabby. I picked out my wedding dress, & made sure to get a dress & bra I could nurse from.
6 months had come & gone. I heard from people to wean her when she asks for it…isn’t the hungry cry asking for it? So as soon as I learned my babies cue to eat I’m supposed to wean her? That didn’t sound right at all. Wean her when she gets teeth they say. Her first tooth erupted around 7 months old. That didn’t seem right either. I followed my mama instincts & said 1 year. She’ll be a walking, talking toddler, she’ll be ready to wean.
We hit the 1 year marker. I was pressured by family to wean my big baby girl, my husband also thought she was getting too big & old. I had learned by now the benefits to breastfeeding are many. My daughter continues to benefit from my milk, no matter her age. I benefit because nursing her reduces my risks of certain cancers. I benefit because she was helping me lose weight. We benefit because we have an excuse to cuddle each other (not like an excuse is ever needed).
A few months before my daughter’s second birthday we found out we were expecting another baby. I knew I’d be determined to breastfeed our new child as well. I’d be better prepared, I’d be experienced, I’d know things. My 2 year old was still nursing. We had no reason to stop, she enjoyed it & I knew it was good for us, but now I was pregnant. I suffered from hyperemesis gravidarum again this pregnancy. There were very few days I wasn’t throwing up all day, & on those days I was still plagued by nausea. It was a challenge to stay hydrated for the 3 of us. I struggled daily on simple things. The beginning of the second trimester I had a slight drop in supply & I discovered a lump in the underneath of my right breast. I scheduled an appointment with a family doctor who is associated with our birthing center. He examined it & diagnosed it as fibrocystic breast disease (symptoms/tissue/lumps…there are several names floating around for it). Not worrisome, just can make it more difficult to diagnose dangerous lumps because you have pre-existing “normal” lumps. Although my lump wasn’t painful (most are) he recommended weaning my toddler so I wouldn’t hurt my current pregnancy. “It won’t make her a bank robber or anything” were his exact words. I had liked him until that point. I half laughed & shrugged him off. At my next midwife appointment I brought up my new concerns. She assured me my baby was fine, and that many women (including one of her assistants) can successfully nurse through a pregnancy, it was not going to “hurt” my baby. As a few more weeks passed my lumps flared up, they became huge & painful. Hugging or picking up my daughter would almost bring me to tears on a bad day. I avoided the “triggers” of caffeine, chocolate, & underwire bras. The lumps had ideas of their own. I still nursed my daughter even though it had become so painful for me, she wasn’t ready to wean & I wasn’t willing to force her. While nursing her I would focus on all the great things about what I was doing, talk myself through the pain.
My second daughter was born at 37 weeks 4 days gestation at home, weighing 8 pounds. I’m pretty sure nursing through pregnancy did NOT hurt that baby. She was a great size & a very healthy gal. She latched & ate shortly after birth, with her cord still attached. I got our first latch photos. The next day she nursed side by side with her older sister, while her sister stroked her arm & hair. That was one of the sweetest moments I’ve ever witnessed.
We have learned how to nurse in the wrap, making our nursing in public much easier & more mobile. We are still struggling with fibrocystic lumps & the pain they bring, most days are fine & I resort back to my breastfeeding affirmations when I have a particularly rough time. My SIL has also had her second child, a month before mine, & we nursed our new babes side by side in my home, without our covers & joking about leaking through our washcloths that were sopping up boob juice from the unused side. My family has stopped asking about weaning my older daughter, & nearing 3 years she doesn’t seem interested in stopping. She still nurses for bed or naps, when she gets hurt, when she wants to snuggle, & sometimes just because. My husband still feels a little awkward about nursing in public, & nursing an older child but only because he knows the stigma associated with both. If it weren’t for public projections about it he’d have no qualms. He does realize that the popular opinion is misguided, & knows that we are doing best by our children. We have all learned so much from my breastfeeding experience, & we continue to grow & learn.
I hope that by nursing in public, at family gatherings, in front of my own children that more & more people will learn how beautiful a relationship it can be, how beneficial breastfeeding is, & that it’s not something that needs to be hidden or whispered about. It’s a natural (but not always easy) lovely journey between you & your child.
We often don't think of doing anything for our perineum prior to birth, we don't look past what our doctor or midwife can do for us to help us avoid an episiotomy. One of the biggest factors in preventing tears (and possible episiotomy) can be a daily 5 minute session of vaginal stretching starting 5 weeks before your due date. Its purpose is to encourage elasticity and help the mother learn to relax and feel comfortable with the sensation of stretching and burning which occur as the baby's head distends the perineum. In addition, perineal massage may have the effect of focusing the mother's determination, giving the mother something proactive to do as she waits for the birth to begin. The better you prepare your perineal tissues for the stretching of birth, the less likely they will tear, and the better they will heal. Mothers with a more conditioned perineum are less likely to tear or get an episiotomy. Perineal massage has been particularly effective in women over the age of 20 and in women having their first baby, but it is something that can't hurt to try with subsequent children. Pelvic floor exercises (kegals!) should also continue through these last weeks of your pregnancy as well, so that elasticity, not laxness, is encouraged.
Vaginal stretching should not be started too early in the pregnancy. The hormones will not have sufficiently softened the tissue. it will be more traumatic, than helpful.
A hot bath before each session will soften the tissues. To begin, have the partner place lubricated fingers in both sides of the vaginal opening to the depth of the deep transverse muscle: about 3 to 4 cm. The mother tightens her muscles around the fingers to assure that the proper landmark is identified. Now the stretcher directs bilateral pressure down and outward toward each ischial tuberosity or "sit bone" (at about 4 and 8 o'clock) while the mother consciously exaggerates the relaxation of her muscles. When she begins to feel stretching or burning discomfort, the partner holds the stretch for thirty seconds to a minute and then relaxes tension. To minimize shoulder discomfort for partners doing the stretching with two hands, cross the forearms at the wrists. The stretch can then be held longer and more steadily.
To lubricate fingers, use either a water-based product (K-Y jelly) or pure vegetable oil. If you tend to be troubled by yeast infections, use the water-based lubricant. Petroleum-based products (mineral oil or petroleum jelly) should not be used. They clog pores and leach vitamins from the tissue.
Some woman have previous scars that are thick or painful. They can massage a mixture of vitamin E and Evening Primrose oils from opened capsules into the scar tissue during stretching. This helps make the scar more flexible.
If the partner is unwilling or unavailable, the woman can stretch her vagina herself. Either squatting, or lying down with her legs up, she reaches around under her thighs on either side and stretches down and out with her index fingers. Or, she can reach between her legs and stretch with her thumbs. Many women find hot baths are the perfect place to practice.
Massage alone will not protect your perineum. Perineal integrity has more to do with race, parity, age, and overall state of health than it does to perineal massage but that doesn't mean you can't benefit from it. Warm compresses between pushes and perineal stretching during active labor can help. Water birth outcomes have been seen to be preferable in the preservation of intact perineum. Slow controlled delivery is also key to an intact perineum and reduced incidence of laceration. The baby must not suffer any form of fetal distress and the mother and partner must listen closely to the midwife or health care provider on when to push and when to stop pushing. Choosing a position for birth that is more upright (kneeling, squatting, sitting) will allow the perineum to evenly distribute the pressure. If you choose a side lying position this will also prevent enormous amounts of strain on the perineum. Lying flat on your back creates the most stress on the perineum, making a tear or episiotomy almost impossible to avoid.
Always keep in mind that birth is unpredictable by nature. Tears do often happen, and episiotomies sometimes become necessary, even during the most prepared of births.
CAUTION: Check with your care provider before beginning perineal massage. Avoid if you have a history of preterm labor, premature rupture of membranes, a vaginal infection, if the massage induces contractions, or if the procedure makes you sore or uncomfortable. Avoid the the urinary opening to prevent urinary tract infections (at the top of the vaginal opening). Do not massage the perineum if you have active herpes lesions, this can cause the lesions to spread.
Around 4 A.M. Thursday the 29th of September, at 37 weeks 4 days gestation. After 3 days of using evening primrose oil capsules to help ripen my cervix in preparation for labor I woke up with horrible back, hip, pelvic & upper thigh pain. The back pain is normal for me, but this morning it was very intense and had spread to the other areas. I can normally deal with the pain using a heating pad, warm bath, change of positions, but this time I couldn’t get the pain to let up at all. Laying in any position was awful, & sitting or walking weren’t that great either.
6:14 A.M. the pain started to break up. I woke my husband Tucker & warned him, but said I wasn’t sure if this was “it”, he asked me to wake him when I knew he should call in for work. I climbed in the bath & I started timing the pains & it seemed like these were just going to be what my contractions felt like this time round. They were about 4-5 minutes apart & 40-60 seconds long. After an hour of timing them I decided to call my midwife Susan to let her access the situation (I was afraid of waiting too long & her not making it here in time, she lived 20 minutes away & my last labor had been 4 hours from start to finish so we suspected this one may also be quick). She let me know she would eat breakfast & head on over. I went & woke up Tucker, let him know she was on her way. My maternity photos were supposed to be this coming weekend, disappointed that I didn’t get to do them again I took one final belly shot between contractions.
I bounced around & rocked on the birth ball in between contractions, leaning over it & having Tuck apply pressure to my back during the contractions. Unfortunately it was back labor…again. Susan arrived & asked if I wanted to be checked, sure why not. 100% effaced & 5 cm dilated. She also checked on baby, 144 heart rate. Annie (our 2 year old) woke up & Tucker got her dressed & occupied her in her room with some toys & a movie. Susan put pressure on the back of my hips for my contractions until Tucker could come back. I had been throwing up, pounding water, throwing it back up since my contractions had started breaking up this morning so Susan suggested a tablespoon of honey. I hate honey but I did want to stop throwing up so I gagged down a tablespoon, it was awful but I stopped throwing up for a little while. Susans assistant Shonda was on her way over with the birth pool. When Shonda arrived they wanted to check me again to see if we had time for the birth pool to be set up. 8 cm. Maybe if we hurry.
There was some fumbling to get the tub hooked up, they tried the bathroom, kitchen, & laundry room before they were able to start filling it. They were able to get the pool set up in our living room (of our upstairs apartment) & I climbed in. It wasn’t the comfort I was hoping for but it did help some. Annie came & peeked in every once in a while, she really thought that my bath needed some toys so she threw in a tugboat, a duck & a couple of balls. When I insisted I didn’t want them she gave up & went back to her bedroom. I tried laying back & relaxing in the pool but it seemed the best way to deal with the contractions was hands & knees or on my knees hanging over the side of the tub with someone putting the pressure on my back &/or hips. In between contractions I would sit kneeling in the center of the tub. I threw up, pounded ice water, & threw up again. I don’t remember how many times I repeated the process. Someone was also always wetting a cold rag for my forehead & back of my neck, I felt like I was overheating.
Finally at 11:50 A.M. during a contraction I felt my water pop in the tub and I announced it. I could feel the baby was right there, ready to come out. Susan checked me one last time to make sure I could push, I rolled over & let her check, a bit of a lip of cervix but she said she would hold it back & I could push whenever I was ready. So push I did. 1 minute & 4 pushes later (2 for the head, 1 for the shoulders & 1 for the body she came out left occiput anterior she had spun from posterior sometime near the end) I let out a single scream & my baby came out of my body & into my hands (later on I would wonder if any of our neighbors had heard me). No tearing! I pulled my baby up to me. She cried as soon as she left the water. I couldn’t get her to my chest because of a short cord that was wrapped around her legs but easily untangled. The cord also prevented me from being able to see the sex so I just asked & Susan told me we had another baby girl! She had generous amounts of vernix covering her body (so we knew she was a bit early), some dark fuzz for hair, and she was beautiful & plump. We threw a few towels around her & I asked Tucker if we had a Sophelia August. He confirmed our name choice. Annie came out & met her new sister for the first time. She wasn’t very interested.
I sat on the birthing stool & held her low on my abdomen wrapped in towels. When her cord stopped pulsing Susan clamped it & Tucker cut it. I offered her the breast & she took to it right away. 9 minutes after she had been birthed the placenta came & I moved to the couch to relax & continue skin to skin breastfeeding. Shonda had to dig in a storage tote for baby clothes, I wasn’t at all prepared for this baby to come at this time. Even when I had been in the birthing tub I was in denial that I was actually having a baby today, I kept expecting the contractions to die off & everyone to head home.
After Susan & Shonda had cleaned things up they checked Sophie out. She had received 10s on all apgars. Weight was 8 pounds even, length 20 3/4”, head circumference 34cm, chest 33.5cm. Her heart rate was 144, which was also what it had been at my last couple appointments & all through labor. Respiratory rate was a 48. I had thrown up the entire pregnancy, sometimes vomiting several times a day due to hyperemesis gravidarum (we suspect it is also why I threw up for 6 months with my first). Plus my baby girl was early, we knew from my dates (that I was sure of), her heavy vernix covering, & the fact that the lines on the bottom of her feet were not complete. She wasn’t too early though because the cartilage in her ears was finished forming. I had been told early in my pregnancy by a family practitioner to stop nursing my toddler, that it would hurt the baby I was carrying. He was so wrong, she was perfectly healthy & a great weight for her gestational age.
We are both doing great. I’m feeling super, I feel like my recovery this time has been so much smoother & quicker (even though last time wasn’t that bad either), not to mention it’s awesome to just be able to crawl into my own bed! My leg muscles have been pretty sore from kneeling on them during labor & the fact that the contractions could be felt into my thighs, I knew during labor I would be feeling that the next day but I had to do what felt best in the moment & not worry about afterwards. Sophie is a breastfeeding pro & has the chubby cheeks to prove it! She sleeps wonderfully & we’ve gone on a few walks around the neighborhood with her in the moby wrap. Her older sister Annie has finally warmed up and now loves to stroke her hair, arms & belly and seems to always want to hold her. We have been blessed!
Read about my husband's version of Annie's birth
Around 10:30pm April 24th, 4 days before my due date, I was getting off the phone with my mother. The conversation was a lot of ”I’m going to go over due” & “Nothings happening this baby will never come out”. I had been sitting at 4cm & 80% effaced with a bulging bag of waters for weeks, but I knew that didn't really tell us anything. At my last appointment I had my membranes stripped, this was 3 days ago & they had told me if it didn't work in 24 hours it hadn't worked. 2 days before I had walked the 8 miles with my fiance to my aunts house hoping to coax the baby out, & at 38 weeks I had started inserting an evening primrose oil capsule to try & soften my cervix. After hanging up with my mom I went to the bathroom & when I stood to pull up my shorts “POP!” my water broke all over my aunts bathroom floor. I was thinking I had wet myself at first, but the loud pop & the amount of fluid on the floor, I soon realized what it was. I poked my head out the door & told my aunt I needed a towel & explained what had happened. She didn't believe me until she came to the door, then she ran to get a towel & called for my fiance who was downstairs playing madden with my cousin. He came laughing up the stairs thinking we were kidding. When he realized it was actually go time he became a panicked mess. I had to call my mom back & tell her I was a liar.
We drove across town to labor at our apartment for a while before heading into the birthing center, I called the doula on the way but she was attending a birth about 45 minutes away & they had just finished up. She was now heading our direction. I had imagined my water would break although my Certified Nurse Midwife (CNM), friends, family, & nurses all told me it would never happen, & in my imagination I was a complete wreck & Tucker was calm. In reality it was the opposite. I should have been driving us. We made it to the apartment & he starts frantically stripping our bed & throwing our sheets into the washer. I asked him what in the world he was doing “Well the bed needs to be clean if the baby will be sleeping with us”. Honey, we didn’t buy a $300 pack n play/bassinet combo for nothing (okay well maybe it ended up that we did cosleep & never really have used that thing, for now it's good cloth diaper storage). He was too cute. I labored in the shower & on the toilet for a while at our apartment but after about an hour I felt we couldn’t wait any longer & we headed in.
At the birthing center we got checked in & I can’t believe they expected me to talk & sign things when I was trying to HAVE A BABY! You’d think they’d understand. We got to our room & the nurse checked us on the monitors real quick. Looking good. She asked if I wanted an epidural & I said that I wanted to try to do it all naturally to that she responded “Oh I’ve never seen a natural birth before”. Awesome. My doula showed up almost as soon as we had made it to our room. My aunt & cousins wife showed up soon after. We all took a quick walk down to the nursery but the contractions were too close together & too intense to do it again so we went back to the room.
I labored on the toilet some more & then in the jet showers for a while with Tucker providing counter pressure for my back labor. My aunt & cousins wife went & waited down the hall. I hit transition getting out of the shower & told Tuck I wanted the epidural, that I needed something for the pain. I don’t recall what he said exactly, something along the lines of if I really felt that's what I wanted it was fine, but when we came out of the bathroom the thought of pain medication had slipped my mind. I never asked for it again. My doula asked the nurse for a birthing ball which I loved. I rocked in Tuckers arms on the ball, passing out between contractions (something I thought only would happen with drugs so I was scared something was going wrong with me), leaning forward onto the bed during them, Tuck continued to give counter pressure that the doula showed him.
The CNM came in & determined it was about time to push. I was told to climb up into the bed, she checked for dilation & determined I had a slight lip which the CNM proceeded to stretch out to complete dilation. They checked me with monitors again, still great.
Pushing started, about 10 minutes & she was crowning. During the pushing I wanted to squat but I couldn’t vocalize what I wanted & I was unable to sit up and get in that position either. They coached me to push & I did so involuntarily, my body was just doing it, but I was crying & shaking my head no to Tucker, I wanted to move! On my back being forced to hold my legs behind the knees and pull them up, I moaned & grunted deeply. My doula offered for me to touch the head & I said “I just want it out!”, that’s the ring of fire right there. After her head came out she got stuck sideways at the shoulders (she had been posterior, the reason for the back labor). I was told to stop pushing but it’s nearly impossible, she came out with a couple more contractions anyways & I tore a little bit front & back. The CNM announced it was a girl & she was placed on my belly. She didn’t cry immediately so after a few moments of silence that seemed to stretch forever they patted her on the butt & she started in. Loud & healthy set of lungs. Tucker cut the cord & I pulled her up against my bare chest & she latched on.
The nurse stabbed me with a shot of Pitocin not telling me what it was until afterwards. It was unnecessary as my daughter was latched & the placenta came out right away. The CNM stitched up my 2 tears. They checked apghars, weighed her & bathed her, she loved her bath & went from screaming to sleeping right away.
Our beautiful baby girl Annelyse Jean was 7 pounds 4.6 ounces 18.5 inches long and entered this world after less than 4 hours of natural back labor at 2:14A.M. 4/25/09.