Haiti-Day 5

Day 5- Monday

I woke up early as usual and took a shower, a real one the power was on, and it was cold but in Haiti that is a marvelous thing. I was trying not to wake up my late riser roommates but I was unsuccessful. Breakfast was delicious French toast with peanut butter and syrup and bananas. Ironically a banana in Creole is "Pini" and a pineapple in "anana". As far as my Creole is coming I feel like the only words I can remember are foods and labor words like push, shower, baby and urinate. :) Midwife meeting at 8 we talked about who would be doing initial prenatals for moms coming for the first time to the clinic and who would be on call for births. I was going to be doing prenatals and be second for Martha who was going to do her first catch in Haiti. I was very excited for her!  

At 9 am Marie started the prenatal classes at 9 explaining about how the baby grows, nutrition, body parts and labor. At 10 prenatals began. We had to do a full initial exam and questionnaire so it took a lot longer especially through an interpreter. I got mostly through with one when Mary came and told me a laboring mom, Sebine, was here and her bulging bag was hanging between her legs. I finished up quickly. Almost every mom complained of a UTI and vaginal itching. Haitian people are very clean but UTI's are common due to not drinking enough water and not having toilet paper.  They go home with probiotics and cranberry pills. About half were married, another 25% in a relationship and the rest the dad split when the pregnancy was announced. These statistics are about the same as the clients I serve at home. Even in a conservative state like Utah. When asked if they ever felt sad as part of a depression screening all but one of the 12 I interviewed said yes. When asked why, the answer was usually "I look at my life and the status of Haiti and feel sad". One said she felt sad because she couldn't return to school pregnant and other was sad because her mother wouldn't stop yelling at her about getting pregnant. The interesting thing is that I get similar answers from many of my moms in the United States. Unhappy about the relationship with the father, unhappy about the state of the country. So are people just generally unhappy even if hey have enough food to eat??? 

When I finished the one prenatal I joined Mary and Martha in the birth room. Sure enough mom was on the bed with a softball sized bag of waters between her legs. Mary ruptured it with an amnicot and checked mom to find her complete but baby was still high. She walked stairs for the next 3 hours while we finished prenatals. After a while she felt like pushing and Martha got into position with Mary and I guiding her she delivered the baby. I did pit, charting, mom care and baby APGAR. Mary left right after the birth to check on another labor so I showed Martha how to do gentle fundal massage to expel clots and do a newborn exam. The baby was beautiful. Dressed in a cute white and blue dress.

A sister for her big brother. We moved her to postpartum. All moms stay at least 4 hours but if we have the beds they often stay overnight. They are in a clean environment away from other children and they are fed three meals a day.  Lunch was beans and millet with sauce. I almost always skip the sauce which has a mismatch of different foods in it usually onions and peppers plus some sort of meat or fish or crab. It would be heaven for my husband who loves spicy, highly flavored foods and a surprise. Harder for me who eats almost the same thing every day. The food is always delicious though and there is always enough.

 Another labor came in the middle of the day. A 5th time mom who was 29 weeks was complaining that she had been having contractions for 24 hours and she felt like she needed to push. Mary did an exam and found her closed at -3 station. She continued to have contraction like pain. After some discussion she claimed she had not had any food for 3 days since she had none, she had 4 children to feed and her husband had left her. She complained of being dizzy with no energy. We gave her some food and kept her to monitor for several hours. She still complained of pain. We suspected a UTI so we did an IV to hydrate her well and cranberry and kept her overnight and fed her, and fed her, and fed her.

 Martha and I walked to the gas station a few blocks away for some ice cream. It was heaven! I am drinking 4-5 quarts of water a day. I fill it up and I swear someone else is drinking my water. When sweat runs down my face into my mouth, which is all the time, it just tastes like water. I constantly carry a washcloth with me to wipe my face other wise I drip on the patients. It is actually embarrassing  I am used to heat. Where I live it is always above 100 degrees in the summer often 110, but we have 0% humidity. Haiti is hot and humid which is why it is so beautifully green contrasted to the amazing red desert I come from. After a birth it is the worst. I am dripping sweat everywhere and the native staff midwife always jokes that I had "douche" shower, in my "rad" clothes. And she was right, that is exactly what I looked like. As soon as clinic was over every day I would change out of my scrubs, bucket shower and dress in a pair of capri length goucho pants and a t-shirt. We came home and picked up trash that had blown into the yard before eating a dinner of fried plantains, potatoes, hot dogs  and bread fruit. I took a bucket shower and prepared for bed. It started to rain so I had to move in my beloved outside bed, At 11 it had stopped so I moved it back out again.

Day 4:Haiti

Day 4- Sunday

I was up most of the night with Kesseley and her baby girl but I decided to eat my pumpkin soup which was delicious.

 The history of pumpkin soup begins with the celebration of Haitian Independence in 1804. On Jan. 1, 1804, Haitians worked together to create a unique soup to celebrate their independence from the French Colonists. Until that time, the Colonists believed that the blacks under their rule could never work together to create anything. Today, the traditional pumpkin soup known as "soup joumou," is made and served to friends and family in Haiti in remembrance of their fight for freedom. While under French Colonial rule, Haitians were limited to eating a bland bread soup. They would not have been permitted to eat such an extravagant meal comprised of pumpkin, beef stock and other vegetables. This unique soup was created as a symbol of unity in the face of adversity. It was served to everyone at the first Independence celebration and Haitians continue this tradition today.  

 Haiti was the first independent nation in Latin America, the first post-colonial independent black-led nation in the world, and the only nation whose independence was gained as part of a successful slave rebellion.

I decided to go to the local Baptist church with Santo and Mary even though I was exhausted. There were about 60 people in a cement building. It had no door or glass windows just an opening for each. They were all dressed in their Sunday best. The children were very well behaved. Shockingly well behaved compared to American children. They were happy to sit on their mothers laps. Something I noticed that was different was how parents held sleeping babies. In the US babies are often held in the cradle position while they sleep or occasionally over a shoulder. In Haiti as they lay the child over their knees similarly to how you would position them for a spanking and they would happily fall asleep there. I saw one mother at the church scowl at a 6 or 7 year old boy several times as he was getting restless before she laid him over her knees and he fell asleep with his mother patting his back. It made a lot of since as Haiti is hot an humid and that position was far less body contact and much cooler as they could fan the child while they slept. 

Photo courtesy of latimes.com
There was about an hour of worship singing and prayer followed by the preacher asking Mary and  I to come up and say or sing something. We sang How Great Thou Art.  It is such a beautiful universal hymn. It brought tears to my eyes as we sang it. The smiles from all of the lovely people was well worth the embarrassment.

 

A guest speaker, and American missionary fluent in Creole, spoke for the next 2.5 hours. About 2 hours in I was just done with sitting on the cement bench. The way the speaker spoke was different than I am used to being preached at and while I was attentive for quite a bit of time it started to get to me after a while. That combined with smoke coming in from the nearby door drove me to go sit outside. There is not real sanitation set up in Haiti so in order to deal with the trash many people have trash burn piles regularly. It smells awful and makes the air very smoky but it is preferable to the alternative. 

There I watched a 4 year old boy fill up his water containers for his family. Each plastic container, similar to a very large vegetable oil container, held about 2 gallons of water and I couldn't help but think how my children complain when I ask them to carry one gallon of milk in from the car. He pumped and filled the containers but the pressure coming out of the faucet was so great it left a good 25% of the container empty. He remedied this solution by  proceededing to fill up the tiny caps with water and poor it into the container. 50 fill ups later the containers were perfectly filled and he lugged the water back home. His eyes never left mine. Clean water is probably the number one problem in Haiti. The water from the pumps still needs to be boiled to be safe.

The water at the clinic is all braught in large 5 gallon jugs and dispersed from a cooler. Water for toilets and washing comes from a well on the property. Electric pumps pump it to the roof and store it in large containers to be used later.

                         This is similar to the ones at the clinic.

Most people get almost all of their drinking water from little plastic bags filled with water. The huge disposable water bottles used in the US seem very wasteful in comparison.

Service let out and we headed home. Lunch was chicken, so delicious, rice, potatoes and salad. I then spent the next 3 hours napping in my favorite place on the love seat. It has a cross breeze so even when the power is off, which it was again, I can be cool enough to sleep. Claudin came and we did our Creole lessons with Martha and Mary. A little known secret about me is that I really struggle with foreign languages. I almost didn't graduate from college because I started and dropped Spanish 4 times. Ultimately I took American Sign Language from another school and had the credits transferred in. Between the foreign language, my cold and missing my family so much I was just in tears. Wondering if I made a huge mistake in coming here. When we are busy I felt better but these two days off with no clinic and no births were really difficult.  Dinner was a packet of tuna and a Luna bar since the cooks have Sunday nights off.  I started the night inside but there were three mosquitoes in my net that I couldn't catch and I knew I would be miserable in the morning. I took a Benadryl and slept wonderfully in my bed under the stars. 

I finally perfected my bed under the stars. I got a lot of flack about sleeping out side. Another volunteer claimed she was going to "Suck it up inside with the heat and the bugs because she would acclimate quicker and be a true Haitian." I thought she was crazy and sure enough I was the intelligent one. 

I would get ready for bed every night which was quite the order

 *drag out the matress

* use clothes pins to hand the mosquito net

*tuck net under the matress
*twist openings and use close pins to keep out mosquitoes and check for holes

* gather my supplies which included my Nook, Jounal,eye mask, ear plugs, water bottle, flash light and hand fan (yes I was a little high maintanence)

*spray myself with repellant

* fan myself incestinatly as the DEET ate away my skin and gave me the worst hot flashes ever

*cry a little bit and miss my family

* say a prayer and beg for strentgth

*stare at the stars until I slept or if it was raining pull my fleece blanket I brought with me over my head and ignore the wetness.

I slept out side from then on. It became quite the routine and as I settled in I watched all of my Haitian neighbors settle in with similar routines on their roofs. They would wave or say hello. So who was the crazy one? Who would acclimate quicker? I am an avid camper and often sleep outside but this was the longest consecutive length of time I slept under the stars. I felt very claustrophobic when I got home.

Day 2:Haiti

Day 2
I woke up earlier than I would have liked but I heard voices and felt guilty being in bed. It was around 6 am. I must have had a few mosquitoes in my net last night as I woke with a dozen new bites. These ones are mean and the itch was driving me mad. I walked out on the deck to Mary doing her daily devotional. We talked a bit and got ready for the day. I went down to discharge the mom who came in false labor again last night. She headed home. I was not feeling well at all.Some sort of cold probably caught on the plane. Breakfast was scrambled eggs and the most delicious pineapple I have ever tasted. 

Friday is the day MBH teaches Family Planning and Mama Baby classes. We also saw a few kids for a national program called Medika Mamba. Mary went to teach the baby class with an interpreter, and Martha who is a nurse, helped do informed consent and screening for women wanting the Depo-Provera injections for birth control. Two new women came, and six returned who had come before. Of those 6, 2 were risked out due to high BP. It is amazing to me how often high blood pressure is a problem here. It leads me to ponder everything I have studied. Is it nutriton, genetics, stress or a combination?

It got really busy quickly. I helped with the Medika Mamba program. Medika Mamba means "peanut butter medicine" in Haitian Creole. Each child is weighed and measured and then compared to a chart that rates their malnutrition, severe, moderate, or mild. There were 6 children today. Two of them were in the healthy range and sent home. The others were given a certain number of Mamba packets and instructed to mix the peanut, oil, sugar and vitamin formula in clean water and administer several times a day before meals. They are expected to gain a certain amount per week. To learn more about the Medika Mamba program visit http://mfkhaiti.org/index.php/the_solution1/treatment/

 

Photo Meds and Foods for Kids

They are also administered amoxicillin and a deworming pill the first visit to eliminate bacterial or parasite issues. I got to snuggle a 10 month old little girl for almost 20 minutes while her mama went to go get some food. She was a doll and after she would fuss and I would get her calmed down she would do that little shutter babies do when they relax. Melted my heart. A very young mom, my guess would be 15 brought in 12 month old twins a boy and girl. 

Severely malnurished little tiffi twin

Moderately malnurished gason twin

The girl was severely malnutritioned and the boy moderate. They were both so cute but their little skinny legs didn't look like they had enough muscle to ever support them.The little girl vomited up the dewormer and I had to go get a syringe and figure out a different way to help her take it.  She was a good attentive mother and still breastfeeding them both. There was a Mama Baby Class taught by Mary after clinic that day with about fiveteen mothers and infants. The other mothers were so impressed when this young mom easily and with little fuss breastfed her two 12 month old twins while listening intently.

After Medico Mamba was done I helped with 2 postpartum visits. A 1 month old had gained a whole kg since birth and mom was so proud. A second mom was having high blood pressure at 1 week post partum and had me check her sutures. She was healing well but we asked her to return next week after cutting MSG from her diet to recheck her blood pressure. 

 I was doing an exam of a 6 month old baby with a cough when they announced a laboring mom came in, Madeline. I admitted her quickly. She had only had one visit and had never returned with hey HIV or syphilis testing so we did a rapid HIV test. We had trouble getting enough blood and the first one was inconclusive, but maybe positive so we did a second that came up negative. I checked her to be 1 cm so I told her and her friends to go walk around the yard. This was her second child. I have been surprised how most of the Haitians I have met only have 2 or maybe 3 children and they are spaced often 4 or more years apart. The average Haitian breast feeds for 18 months. 

I helped with the rest of the sick child visits, gave some opthamalic eye ointment, amoxicillin, and vitamin C. Then ate lunch, rice and beans, and stripped all the beds and changed them. Mary noticed I was still not feeling well despite all of my water and Emergence c packets so she told me to go lay down. I took a nap out the outside deck after covering myself with bug spray. The power has been off since yesterday and that means no fans. It is really hot with no airflow. Medeline was more active after my nap. After she vomited I checked her again, 2 cm. Her friends all left, she had bad back labor and a terrible headache but didn't want me to help. She was much poorer than the other women who have been in. As I wrote earlier most of the women who come in are very clean and although poor their clothes are well kept. Medeline was different. She was very dusty and just looked plain exhausted like she had had a harder than average life, even for a Haitian. She labored mostly naked out in the yard after the sound and smell from the generator pushed her out of the labor room. A few of her very young teen age cousins came for a visit. They laughed a lot and Medeline basically ignored them. They poked fun at her labor noises and nakedness. She had had some mild bloody show that was concerning to her but she labored along.

 I continued to feel worse and worse physically. Dinner was some sort of spicy green soup with fish and crab. Just the smell made me feel nauseous. We all climbed up on top of the roof and spent some time looking at the cities and countryside around us. The houses are all made out of concrete and many of them are huge but almost all of them are unfinished.

Next door neighbors house

 I asked Claudin about it and he said that is the legacy parents leave their children, a huge unfinished house. At around 8 pm a friend of the mamas came and gave her a hard time for just laying in the bed. I checked her again, no change. We told her that she needed to either drink and eat or we would have to start an IV. She drank a little water and Emegcen-c and we put her to bed with Martha checking on her every few hours through the night. The power was still out and the center was hotter than it had been since I had been there with the power out for 36 hours. I made a cup of chicken noodle soup and instant oatmeal, took a bucket shower and headed to bed. It was so miserable. I moved from bed to bed trying to find a cross breeze. Nothing worked. I was probably the most physically miserable I had ever been without pain. I felt like my skin was burning up from the insect repellant I covered myself with. Finally some time after midnight I felt the fan start up and the power was on. With Martha downstairs I moved the fan right next to my head and between the cool  breeze and white noise, I couldn't wear my ear plugs due to my cold, I finally fell asleep

Haiti Travel Day

Haiti by the Numbers:

•  Less than 45% have clean water
• 74 babies due per 1000 births
• 12% of all babies die before their 1st birthday
• 1/3 of all children die before they reach the age of 5
• 1 in 71 women will die in pregnancy or childbirth
• 50% of the population earns less than $60 per year
• The average life expectancy is 53  

Haiti

Travel day July 2011

I was so anxious I hardly slept. The kids and I were very emotional when I left. Ben drove me to the airport. It was nice to spend the time with him alone. He was kind enough to help me with the 150 pounds of luggage I had to carry. The first flight from Vegas to Miami was uneventful. I had a window seat over the wing which is my favorite place to sit. I love watching the wing adjust as we fly. The plane had substantial hail damage which was a bit concerning. My two seat mates were two late twenty something brothers from Australia. A third brother sat across the isle.  They reminded me of my boys. There were two that were very similar in height and one suave looking youngest one who was much shorter. They were very nice and we spent a good amount of the time discussing similar places we had traveled over the world. 

 I arrived safely and got my bags only to have several urgent emails from Mamababy Haiti saying my flight must be wrong since the only 1130 flight arriving in cap Haitian was a cargo plane. Of course the ticket office wasn't open so that began the anxious night of attempted sleep. Every 15 minutes a loud speaker would come on and announce the time in both English and Spanish. There were several other repeating announcements in between. I had three sleep options. To try to sleep sitting up in the divided chair, to sleep alone right under a large speaker or to sleep with a bunch of traveling hitch hiker hippie surfing guys. I tried my luck by myself and got a little intermittent sleep. Evidently the Miami airport goes dead at 12 am only to wake up fully at 2 am. So I was up then as well sharing the airport Dunkin doughnuts line with cops and foreign travelers. I woke to these men walking around wearing black jumpsuits with wide green stripes running down the legs.I could not figure out who they were or what they were doing. They started pulling covers off of these contraptions that I assumed were napping pods (yes I think these napping pods to not exist but they seemed like a great idea to my exhausted body at the time.  A little pod you could climb into and nap with a secure place to hold your luggage. Why not?)  Turns out they are baggage wrappers. Wrapping you luggage in green saran wrap to keep it safe from theft. It cracked me up to see every ones luggage a bright green color.

 After walking for over an hour I finally found the tiny ticket counter in what looked like the Miami airport basement. I stood in line with many colorful Haitian people and eves dropped a bit. They were obviously wealthy in order to be able to fly to the states. I got to the ticket counter and everything was explained regarding my ticket. We would be stopping over in a city called Marsh in the Bahamas to drop off some people and refuel. The plane was small and we had to pay a ton for extra baggage and they weighed us before we boarded.  You always know the plane is small when they weigh the passengers this I learned while traveling in Africa. We proceeded to sit and wait. Two  Haitian business men started up conversations with me about what I did and what they did. One in particular worked for the better part of an hour trying to convince me that my time in Haiti would be better spent with him getting the royal tour of the city than at the clinic. I never wear jewelry when I travel internationally but sometimes a wedding ring would be nice. Our conversation ended when I showed him adorable pictures of my family and he commented that I looked too young to have a 9 year old.

The flight was very bumpy and I nearly vomited several times. An extra take off and landing didn't help much with the air sickness. I don't hate flying but I don't love it either especially flying over open ocean. The seats were so small I don't know how anyone larger than me could have folded themselves into them.

I arrived safely greeted by Mary the Mamababy Haiti site director and Martha a student intern and Otair an interpreter. They were lovely and helped me make it through customs easily.  They even got it cleared that customs did not examine by bags which turned out to be a fortunate thing. It trying to save space and weight I had taken all of the probiotics, garlic pills, cranberry pills, and prenatal vitamins out of their original packages and jars and placed them in huge gallon sized bags. I had four gallon sized bags full of questionable material. I had also taken a gallon sized bag of vanilla protein powder. It looked like a bag of cocaine and even felt like it through the bag until you opened it and vanilla filled the air. Do they make vanilla scented cocaine? They would have been confiscated for sure and I would have been detained for who knows how long if they had searched them. The men in the airport were very helpful with luggage and eager for their $1 tips almost ripping the heavy 150 pounds of luggage out of my hands. 

 

We rode to the clinic in the MBH ambulance, a Tan Landrover, was intense with many near death experiences and gawking people.  We stopped to get native cassava bread which they baked from cassava ground and cooked on large round flat stones. It is delicious and interesting to watch then make. Things are very expensive here. Gas $5 a gallon. I joked with Otair that he liked honking the horn and siren on the ambulance when he smiled and said "We are here and this is how they know to open the gate." Sure enough a compound on my right with bright red doors swung open to welcome me to Mamababy Haiti. 

 

 

 

There was a birth going on when I arrived attended by the two native midwives. I was quickly oriented and unpacked. I share a room with 3 other midwives. It is so hot and humid. I struggle with claustrophobia from the bottom bunk and mosquito net. Dinner of black beans and rice with some sauce was served and it is delicious. I crash early around 8 pm only to wake up delirious several hours later in a hot sweat. The city power had gone off, something that happens nearly every night, and with the lack of power went my fan and my sanity.   I stumbled out to the people talking on the porch and moved my bed to a top bunk in the overflow staff room which is attached to the dinning room and family room and is much more open.  Much less claustrophobic. It slept restlessly until I was woken at 5 am with two moms in labor.

4 Types of Midwives that Attend Homebirths in Utah

There are a lot of misconceptions about the types of midwives who attend births in Utah including Southern Utah. Every woman has the right to know the credentials and skills of the midwife who may be attending her birth. Each type has it's positives and negatives.  This video is a basic break down of the 4 different types of midwives to help you make the best choice for your family.

How Many Hours to Become a Homebirth Midwife?

I came to my midwifery journey in a round about basis. I can't say that I always knew I would be a midwife but my life experiences have definitely helped bring me to this place. I looked into becoming a Certified Nurse Midwife briefly while on I was on the nursing track. After the birth of my second in 2005 I looked at different distance education options including Midwifery College of Utah and National College of Midwifery. My midwife for my second offered to be my preceptor if I went with a school she was familiar with. I also looked into finishing my nursing degree and then doing my CNM through Frontier School of Midwifery which would be relatively easy since I already had a Bachelors of Science Degree. In the end we moved away and I resolved myself not to do midwifery or other birth work. We moved to an area that had no CNM's or licensed midwives that did home births. I was very grossly misinformed regarding the education it took to become a traditional midwife and thought I would never want to train with any of the midwives locally.

I took a little over a year off. Few people even knew I had ever been involved with birth work and it was a much needed break. After the difficult birth of my third I knew that in order to be sure that quality midwifery care was offered in the area I would need to help by providing it myself so my midwifery journey began. I attended a few births of mutual friends with a local midwife I had been friends with for a few years. We hit it off and before I knew it I had transitioned from assistant to apprentice.

I still struggled about whether or not I needed a more traditional school. In the end it came down to a few things. 1- I had already done the traditional college route and done it well graduating with and A- average and learned and retained very little compared to the amount of time spent. 2- Money. We already have so much student loan debt for my husbands law degree that the thought of spending more money on my school for a career that wasn't a huge money maker just wasn't possible for my family. 3- I wanted to be able to tailor what I learned and avoid the busy work. I eventually developed my own curriculum and study system and passed the NARM exam on the first time with flying colors.

It took me a little over 3 1/2 years to complete all of the things needed to sit for the NARM (I had more than enough numbers and experience a year earlier but I had some documentation problems) and then an additional 6 months of waiting for the next exam. For those years of my life I spent time studying individually, studying and discussing with my preceptor, teaching childbirth classes, attending doula births, attending prenatals, births, and postpartum visits, doing skills classes, attending workshops, and forming and attending a local and several online study groups. 

In the end the time spent in my apprenticeship ended up looking something like this:

Time spent studying individually, reading, writing protocols etc.
8 hrs a week x 208 weeks =1664 hours

Time spent doing prenatals and postpartum visits
6 hrs a week x 208 = 1248 hours

Time spent in skills class (suturing practice, exams, etc.)
5 hrs a month x 48 months = 240 hours

Discussion, review and study with my preceptor
2 hrs a week x 208 = 416 hours

Birth attendance
2 births a month at an average of 8 hours per birth x 48 months = 768 hours

Additional workshops
24 hours total

Study Groups
2 hours a week x 52 weeks x 48 months = 416 hours

Childbirth classes and doula births
3 series a year at 18 hours per series plus another 20 hours a year doing doula births x 4 years =296

Total: 5072 hours of study and instruction

Approximate cost for books, workshops, gas, food, childcare and supplies $12,000

NARM the national midwifery association that provides the test for your Certified Professional Midwife required a minimum of 1350 hours.

Community School of Midwifery

Midwifery School

I went through quite the ordeal in order for me to sit for the national NARM exam and finally receive my Certified Professional Midwife credential. I did self study and had much hands on support from my preceptors but little help with book learning. I vowed to do everything I could to make it easier for all my midwifery sisters who came after me. I was asked to join this amazing midwifery school and assist them as the Academic Dean. I am both humbled and excited by the opportunity. The school provided weekly in person education for midwifery students at several Utah locations. 

Please visit http://www.thecommunitymidwife.com/ for more details.

St. George Magazine Article December 2011

Options and Benefits abound for Mothers Wanting a Natural Childbirth Experience in Southern Utah

            In conversations with elderly women, I have been surprised to find that while some couldn't remember what they had eaten for breakfast that day, all had detailed memories of the births of their children, both the treasured parts and more difficult parts.  The experience of giving birth profoundly impacts a woman forever.  Many women had little choice in their birth experiences.  Either they gave birth before the advent of modern anesthesia techniques, or gave birth during the time of “twilight sleep birth” when women were given pain medication that rendered them unconscious or into such a trance that they would not remember what they went through to birth their babies.

            In the modern world, women have more options.  They can choose a “natural birth,” without any type of medication to start, stop, or numb the pain of labor, or an epidural, anesthesia placed in the epidural space in the woman’s spinal column, causing a cessation of pain below her waist. Epidurals can be a lifesaver for women who need cesarean sections and a very useful tool for those with long or drawn out labors.  However, natural childbirth offers tremendous benefits for the laboring woman and her baby:

·         Reduced chance of cesarean section

·         Easier time breastfeeding

·         Increased bonding between mother and infant and less separation

·         Increased participation by the mothers partner in the birth experience

·         Increased maternal sense of accomplishment

Natural childbirth also helps avoid many side effects that can occur from epidurals:

·         Reduced maternal blood pressure and fetal heart rate

·         Labor slowing, leading to additional medication to augment labor

·         Increased maternal temperature

·         Difficulty pushing

·         Increased likelihood of having a cut made (episiotomy) to birth the baby

·         Increased need for forceps or vacuum extractor to birth the baby

·         Increased cesarean section rate

·         Increase in infant hypoglycemia (low blood sugar)

·         Increased chance of baby having to spend time in the nursery

·         Maternal anesthesia headaches (“epidural headache”)

·         Increased incidence of postpartum maternal back pain and paralysis

            While a natural birth is not the only road to a positive birth experience in Southern Utah, it is easiest to have a positive natural birth with some preparation.  Here are some local options to help women achieve that goal. 

Natural Childbirth Classes

Understanding the birth process makes it easier to cope with labor.  Classes are offered by the hospital and by other trained instructors. There are different approaches to childbirth education, make sure your class is focused on natural childbirth. 

Doula Services

A doula is a trained professional birth coach.  They provide support to the laboring mother and her partner by providing information, massage, changing of positions, relaxation support and other techniques to help ease the pain of labor.

Careful Selection of a Care Provider

Several local obstetricians, family doctors, and hospital based certified nurse midwives support and encourage natural birth. Shop around. You are paying your provider for a service: choose someone who supports your wishes while safeguarding your health and your baby's. 

Out-of-Hospital Birth Options

Southern Utah has one of the highest homebirth rates in the nation. Many trained and qualified homebirth midwives serve the women in the area, providing wonderful, safe experiences for both the mother and baby. The benefits of homebirth include:

ñ  Midwives are trained professionals who know normal birth and how to handle complications and have good relationships with the hospital if it becomes safer for you to birth there

ñ  One on one attention

ñ  Birthing in the comfort of your own home with water birth as an option

ñ  A clean environment, free of many of the “super bugs” that reside at hospitals

There are also out-of-hospital birth suites available in both St. George and Cedar City.   Birth suites provide the benefits and resources of homebirth outside your home if you aren't comfortable birthing there. 

More and more Southern Utah women everyday are realizing the benefits of choosing a natural birth for themselves and their children. The right tools can make all the difference and change a potential frightening and overwhelming experience to one that is treasured.

DyAnna Gordon, BS, is a Southern Utah native, mother of 4, doula, childbirth educator, birth trauma support group facilitator and traditional midwife at Complete Beginnings Childbirth Services