Well … not quite true, I actually put a lot of emphasis on physical preparations. Natural birth champion Ina May Gaskin said “squat 300 times a day, you are going to give birth quickly”, so off I went and enrolled myself in the nearest CrossFit box. Eventually I might not have done 300 squats a day and not even daily, but I did do more squats in the six months I was working out in the CrossFit gym than I ever did altogether up to that point in my life. However, even though my gym membership was partially motivated by childbirth preparations, it still felt like I was working out for health and well-being in general and not so much as a conscious effort towards giving birth. Compared to the mothers I was working with as a doula, who were laboriously reading books, creating birth plans and watching inspiring birth videos, I was surprised to observe myself not doing any of the above. I guess there is a limit as to how much information one can take, especially when attending real life birth is part of your daily reality.
The first thing that needed to be figured out was the location. Having given birth to my first daughter Delphina at home, the daunting reality that it wouldn't be possible the second time around because of the home birth ban ordinance in Quezon City was a bitter pill to swallow. I understand the ban was passed in an effort to curb maternal and infant mortality rate among the most underprivileged communities by encouraging mothers to seek skilled prenatal care and promoting facility based deliveries, but there is always more than one side to a story. So here I found myself restricted in my birthing options and wondering what to do. What I also realized with increasing clarity is that I only wanted to work with my midwife Deborah towards my second birth. I think I could have worked something out with other QC based midwives regarding home birth, but not with the Shiphrah team who is based in Taytay. As long as the ordinance is in place they will not attend a home birth in QC, period. In practical terms it meant that if I wanted Deb to be my midwife I had to give birth in Shiphrah. As a doula I always emphasize that the choice of your main care provider as one most important decision you can make in your birthing journey. It should be someone whom you connect with on heart to heart level, who is completely aligned with your birth vision and whose professional skills don't leave any room for questioning. Deborah is the person whom I can entrust my life to, and it meant I was going to give birth in Shiphrah.
In many cultures a birth of a child is regarded as a rite of passage for a woman. It is one crucial event in her life, which can repeat several times with each child she conceived, that gives her an opportunity to transcend, reach deeper inside herself for strength and rise above her fears. This is why childbirth in traditional cultures is surrounded by a ceremony, which in the days leading up to labour and birth commonly involves a circle of women who share their wisdom, serve as a sounding board for her fears and anxieties and offer support to their sister’s birthing. I realized that I needed a ritual space, a ceremony with women sisters during which we would share our fears and anxieties, where we would find healing and accept blessings for our pregnancy and birthing journeys. Fortunately, soon after this realization I had a reunion with my doula Betty at the end of which we had a plan for a very unique one of the kind event – The Blessingway: A Journey into Motherhood.
The Blessingway event turned out to be my answered prayer. It is truly miraculous to observe what happens in a ritual place. We were joined by six other beautiful women mostly all pregnant mamas, some seeking a first time gentle birth experience and others a healing VBAC or simply a birth on their own terms. I had a double role, that of a co-facilitator and a participant myself. During the first part of the three-part ceremony, we let things go. With the symbolic help of the salt bowl and water we had an intimate sharing of our worries and concerns in regards to pregnancy and birth and life in general because everything is interconnected. I had to search deeply within myself for my deepest worry in order to offer it to the salt bowl and luckily it came out to the surface.
Having attended close to 70 births ever since embracing my calling as a doula I witnessed a lot of different birth scenarios. The majority resulted in beautiful gentle deliveries but some for one reason or another required medical interventions and eventually Cesarean births. This usually happens after we have tried out everything under the sun to correct a complicated situation. So many factors play out during the birth – baby’s size, position, angle; mother’s anatomy, spirit, mobility, endurance; gestational age, medical history, the way labour started; location – time limits in the hospital are different from the sense of time in a birthing center or home; attitude and support of the medical care provider and so much more. It is a great honour and joy to accompany each mother through her birthing journey, however approaching my own birth I realized that the births I had attended as a doula did change me and my perception of birth. Inevitably it became more nuanced and accommodating of different birth scenarios, even less desirable ones. I had to learn how to separate myself from my projected ideal birth scenarios for the mamas I am working with and accept what is being given in the journey of a particular mother while supporting her in her birth vision as much as possible. However, while acceptance of the changing birth scenarios in light of the difficult circumstances during birthing is great for professional work, what I needed for myself was a reaffirmation of my steadfast trust in the ability of my own body to give birth. In this regard dwelling on the complicated birth scenarios I witnessed as a doula was not helping me to find it. Through the ceremonies and rituals of the Blessingway I was able to unravel these very subtle doubts, bring them to the surface, articulate them and let them go. And not only this! The Blessingway also offered replenishment of positive energy through a special session of sound healing, reaffirmation of my birth vision through creation of my own power rocks and a shift of energy in my spirit when walking the symbolic birthing labyrinth surrounded by candle lights and women sisters. This process was a huge relief and a blessing!
April 13, 2017
38 weeks and 6 days
When I woke up in the morning, it felt like it was going to be another busy pregnant day. Just a few days ago I received a piece of extra equipment I needed for the breastmilk jewelry processing, so the plan for the day was to process around ten remaining breastmilk orders for preservation in the morning and to conduct a postpartum mama care session with a client in the afternoon. It was going to be a busy hot day and I was up to it!
Around 10 am I started having regular surges. They were of the same intensity as my practice surges for the last month as I was having lots of Braxton Hicks starting at the 30th week of my pregnancy. A few times they got really intense and regular that I thought it was already labour, but somehow I managed to slow them down with the change of position. On Thursday, however, the change of position no longer worked. With a tinge of excitement I continued working on the milk. Soon the process of work came to alternate with regular breaks every five minutes to breathe, moan and move my hips from side to side.
At 12 noon I am done with the milk. The reality of the immanent birthing time is sinking in and I message Deborah, Betty and Aisa, my birth photographer. “Yes, having regular contraction; yes, can still talk and smile through them; most likely later today”. As their “ready for duty” answers roll back in, I decide to get myself comfortable and that means stop working. With a bit of disappointment I cancel my afternoon postpartum mama care appointment with a client. I arrange a nice pillow nest on the bed and to my surprise hear myself moan as the next surge rolls in. It is still very tolerable, so I decide to stream the first episode of the mini-series “The Truth about Vaccines”. Care as I do about the vaccine safety issue I was looking forward to the release of the series and was not intending to miss a single episode, each only available for 24 hours for free viewing. Comfortable in my own bed I take in the pieces of valuable information in the documentary and hear myself moaning with an increasing intensity every five minutes. Delphina is getting fidgety with every moan and covers me in thousand of kisses to help me ease the discomfort.
At 3 pm my midwife Deborah is checking on me through text. My response: “Doing well. Can’t talk through the surges anymore, but can right after!” She points out that the roads to Taytay will be closed in a few hours because of Alay Lakad – a special procession to the churches located in Antipolo that takes place every year on a Maunday Thursday. I heard about those processions before but never for a moment have I considered that the traffic information in connection to Alay Lakad would be of any relevance in my life. Well, on that day it was and Deborah was strongly suggesting that we would move towards Shiphrah as soon as possible.
4 pm – the surges are getting stronger and I am hanging for my life on Brady and not letting him take his hand of my sacrum. His massage is such a sweet relief to now real discomfort in my back. Oh dear, I am having a back labour!!! It means I am having a baby in a posterior position. Gosh, all these spinning babies inversions every day did not help me to turn the baby into a neatly occiput anterior presentation. Again!!! The memory of my three hours pushing marathon with Delphina because she was a posterior baby does not give me any comfort.
The household is in commotion - our house helpers are loading the car, Delphina is asking one million questions about what is going on and where we are going, and whether it hurts and what more. Why all these questions to me? Can’t someone else talk to the four-year old child? But everyone is busy packing the car and I keep hanging on Brady for my life …and massage. All over sudden the prospect of him driving and no longer being in position to massage my back becomes the picture of hell.
5 pm – the car is loaded and we set off to Shiphrah birthing home. I assume an all-four position at the back seat surrounded by the pillows from home. I instructed my helper to bring all my pillows to the birthing center as to make it even homier. No massage on my back does indeed feel horrible, so my moaning becomes a sort of squealing while I try to soothe myself. Delphina in excitement crawls over to me and tries to comfort by kissing and stroking. It is very sweet but it’s not the back massage that I badly need, so I squeal again when the next surge rolls in. “Mama, I already kissed you, can you stop screaming now?!” “My sweet big girl, thank you, but NO I CAN’T” and I moan again to my heart’s content. Surprised, I take a mental note that I am much more into vocalizing my discomfort this time around and it feels good to make these sounds.
6 pm - we walk into Shiphrah, me with a pillow in one hand and a huge stuffed pig toy in my other hand. Betty, my doula is already there and meets me by the gate. We pass by the water birthing room and I notice the works of inflating the pool in progress. Automatically I turn left to the next room and thanks God, it’s empty and it feels like my sweet spot where I am going to labour. Contractions come in strong and it is nice to have Betty by my side. Deborah follows shortly after and checks in on how I am doing and feeling. I request her to assess the baby’s position and check me internally. For this I have to lie down on my back. If there is one least comfortable position for a birthing woman with a back labour, it is precisely that – laying down on her back. How do they do it in the hospitals? Of course it would be unbearable and epidural would be the sweetest drug in the world! Deborah assesses the baby’s position and as the next surge come in I jump on my feet, it would be impossible to stay on my back a second longer. In the vertical position the sensations are very bearable but no longer fun. For the internal exam I get positioned vertically on the birthing stool. Deborah tries to reach the cervix but it is far away, posterior and dilation can’t be assessed accurately, but it feels like 4-5 cm to her. And yeah, the baby is in transverse posterior position. With my suspicion confirmed we work out a plan of doing Lift and Tuck routine for ten contractions as suggested by Spinning Babies to help the baby rotate in a more favourable position and hopefully apply better pressure on the cervix.
Amazed at the speed of the events we keep laughing and reminiscing on the recent intense moments. Yes, the second time births do tend to be much quicker and easier. One of my power rocks that I created during the Blessingway featured this magic work – “Easy”! I was sincerely hoping that it would be much easier the second time around and fortunately this visualization paid off. I got to experience the "spontaneous ejection reflex". Instead of intentional pushing, and in the hospital settings it is often times pushing with people around coaching you how to the count from one to ten. The spontaneous ejection reflex is about timing when the body is ready to release the baby, which consequently it does. Physiologically birthing is like voiding the bowels, it's an involuntary process, something that your body does for you no matter what. When the mother is relaxed during labour and well supported, her natural hormonal cocktail will enable her body to release the baby when her body and the baby are ripe for this moment.
And bravo to the Lift and Tuck routine from Spinning Babies! Up to the day of my own birth I did not use much of this technique in my practice, but I will definitely do from now on. It is often recommended for the situations when the baby is not yet engaged in the pelvis, but can also be useful to turn posterior babies. What it did to me was to turn a transverse posterior baby (the baby’s back towards the left side and back instead of towards my tummy) to completely occiput posterior (baby’s back aligned straight to my back). Apparently this was the most favourable angle for the baby to come out, more so without the rupture of membranes. Movement at birth matters a lot!