...........fast forward to 5p, Pitocin on 30, and still no pain. It was scary! The nurse kept mentioning breaking my water, which I was sooooo opposed to, because as y’all know once the bag has burst, you are really on the clock!!! Finally the doc came in to discuss our next step. 

(According to the package insert that accompanies Pitocin, dosage is .5-1mU/min to start and increase 1-2mU/min every 30-60 minutes until the desired contraction pattern is reached.  It goes on to say that “infusion rates up to 6mU/min give the same oxytocin level found in spontaneous labor.  At term, higher rates should be given with great care, and rates exceeding 9-10mU/min are rarely required.”  Starting at 2 and going up by 2 every 15-30 minutes is typically what I have observed as a doula. In my experience the rates often go to 16, 20 or 24 with an induction.  However, that is not the dosage recommended by the manufacturer.  The rate of increase that Sarah Beth received was not particularly slower than is typical with an induction.  But it did go higher than I have ever seen. I genuinely surprised that it was not causing painful contractions. As a doula and childbirth educator, I had never heard of someone receiving pitocin at such a high rate of infusion and not feeling contractions. Contractions caused by Pitocin are known for being more difficult to cope with than natural labor. ) 

I love my doctor! I do. But (now mind you he had 8 inductions Christmas Eve! EIGHT!!!!!! 8!!! Freaking 8!!!! The entire L&D floor was packed. There were 11 mothers giving birth total. 🤬Anyways...) he got short with me. He said, “We need to break your water and we need to break your water now, basically.” 
And my baby, John, went head to head with him....
John questioned him, “If we don’t want to have water broke, what is our next step? Can we turn off Pitocin, cut it in half and restart it. What are our other options???” 
I was total deer in headlights. I cried.
John was my hero, my champion, my biggest advocate. 🤪🤩😍 it was really freakin sweet. 
So, Bianca spoke up and said let us have a few moments to discuss. Doc and nurse left the room. I cried. They nurtured me. We realized the moment we got to the hospital we were “on the clock”   Sooooo, this was our best option. This was happening. My water was about to get burst. And Lord please let him come down my birth canal. Please!!!! 

(Every birthing person has their own priorities and values.  For Sarah Beth, not having her water broken artificially was a big priority to her.  Just as she struggled with the decision to go in for the Pitocin, she had to face the decision of having her water broken (AROM).) 

Doc came in. I told him not to nick my babies sweet head!!!! Water burst. And I sat up in bed with the bottom half lowered all the way down. Was told to stay that way for 15 minutes or so because we didn’t want a prolapsed cord. 

That happened at 4:52. By 5:30 the fun began!!!! And I mean boy, was it fun!!!! Full on contractions. We moving and jiving. Mind you, I’m still plugged up to the Pit. So every new position required Bianca and jOhn to reposition my IV. Also, because of the high bp every 15 minutes I had to be plugged up to check that also. But....we made it work. Me, in my raggedy gown working through each one. They really got intense. I went to the restroom. Bianca told me to try and relax on the commode (I miss that warm seated commode.) That helped. Then all of a sudden, I needed to brush my teeth. Did that. Then I threw up! Nurse was concerned I was going to push little Waylon out on the bathroom floor. Ha! Transition was bloody awful. There was no comfortable position. I think I was mostly on all fours with my face buried into a blanky we brought from home. 
The two of them created counterpressure which was wonderful. I didn’t get much rest inbetween to the next hard contraction. ​

Vitamin D is important - as we all know it makes strong bones. But there is so much much more. Vitamin D is actually a hormone and plays a critical role in our immune systems.

When you are pregnant, you are building an amazing little human from the resources in your own body. If you have low vitamin D, you are building a baby that will be born with low vitamin D levels. But perhaps even more critical is what happens at the very beginning of pregnancy - the development of the placenta. Researchers are now learning that low vitamin D levels in a mother puts her at higher risk for placental problems. And the placenta is the organ that keeps your baby growing and thriving in the womb. When the placenta isn’t working right health problems show up for mom and baby.

When you have your own Vitamin D at a healthy level- you reduce the risk of preeclampsia, reduce the risk of pre term birth and deliver a baby with a healthy vitamin D level (which is critical for the immune system).

Here is what you do: Get your Vitamin D Levels where they should be.

Just go ahead and take the supplement, not knowing what your current level is. Research tells us that pregnant women who 4,000iu/day and get enough vitamin D for everything to function as it should.

Or.....If you can, get your vitamin D level checked. (If it’s costly or not feasible with your Care provider, order a kit directly from Grass Roots Health). Then, supplement appropriately to get you into a healthy level. You want to be at least 40ng/ml. (The vitamin D Council has this great chart to help you determine how much supplement you need or this calculator that takes into account your body weight)

So, what if pregnancy is a thing of the past and you are breastfeeding. Same idea: An exclusively breastfed baby is relying on the resources of your body to get what they need. The American Academy of Pediatrics recommends that all breastfed babies receive a Vitamin D supplement. Why is that? Because sooo many mothers are vitamin D deficient.



But you are now officially informed. If you, the breastfeeding parent, has healthy Vitamin D levels, then your baby does not need a supplement. Why give the baby a supplement (which is a pain to do by the way), when you can give your self a supplement and take care of two people at once. Yay! 

Research shows that a breastfeeding mother should take 6,400iu of Vitamin D per day. When she does this - both her and her baby have the amount of Vitamin D they need for their body to function as it was designed.

Learn more on this great podcast on "Born to be Breastfed" with Dr. Carol Wagner - Vitamin D expert 
Or, here is the link for apple podcasts

For information and support during pregnancy, birth or breastfeeding, contact Bianca Wooden, IBCLC for a consultation. 
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Of course, I am not a physician.  Every person and every situation is different.  I am providing some general information, no a diagnosis or specific recommendation for you.  Take the information you learn here and talk to your care team about how it applies to you. 

A note before we get started:  I had two lovely, vaginal births with very little medical intervention prior to this birth.  This was a traumatic experience for me.  Despite having a healthy baby. Despite having compassionate and professional care. Despite surviving.  Yes, there is much worse in this world than a difficult birth.  That is beside the point.  This birth was hard for me.  It led to a hard postpartum period and it causes me to mother differently.  I share this story for all the women who are disappointed, angry or depressed.  It is OK to have negative feelings about your birth and at the same time be thankful.  We, as humans, are complicated, able to feel a variety of emotions.  You are not alone in your difficult birth. 


Thursday, February 16, 34w2d
“The baby is laying with his head on one side and his butt on the other”, but “no need to worry” I calmly texted my husband while my mind raced. Minutes earlier, I had finished my 34 week prenatal appointment. My midwife, Wendy Shaw CNM, assured me that as baby grows, he will run out of room and either his head or butt will go down. When she said it, her calm confidence was convincing, but as the hours passed my anxiety grew. By the afternoon, I was feeling panicked. Sure, he will turn one way or the other, but which way? I was certain, I could push a baby out head first or butt first, but I didn’t want to have to convince an OB that I could (and would). Head first would definitely make everything easier.
That afternoon, I came up with a plan. I would see my chiropractor several times a week, if needed. I would do stretching and exercises from my Spinning Babies training and all would be fine. Do the work and get the results, right?

Friday, February 17, 34w3d
I met my friend and Doula bestie, Natasha Woodard for lunch. I was telling her how overwhelming it felt to be the patient reading the Spinning babies website, rather than the professional. I had even been to a Spinning Babies doula training – yet suddenly figuring out what to do for myself seemed impossible. Natasha did her doula thing and reminded me that there was no need to panic. Exactly what I would tell my own clients. I spoke with Dr Pitchford, my chiropractor, and we made an appointment for Monday. And, I spoke with my Doula, Lindsay Huckabee who also assured me not to worry. Friday afternoon, I walked into my knitting class at the library with mixed emotions.  Wondering if sitting in that chair knitting was a waste of valuable time to coax this baby head down. But, I was determined to learn to knit before baby arrived so I could make him a Christmas stocking.
 At this point in the pregnancy, I was pretty used to people telling me not to worry. My previous pregnancy ended in a miscarriage at 15 weeks. This pregnancy was clouded in fear. Every single time I went to the restroom, through my entire pregnancy, I looked at the toilet paper with trepidation, worrying that I would see pink (and quite a few times I did). I protected my heart and would not give myself over to this baby. I longed for my first pregnancy. Thirteen years earlier, I didn’t appreciate the wild optimism that comes with youth. With my first pregnancy, I couldn’t have imagined anything going wrong. This time, I worried and then worried about worrying.
 Step 1- swim more. Swimming is great for pregnancy and helps baby get into an optimal position. So, I swam. My body was achy, and I was tired, but I went to the pool Friday night. The girls were playing happily and I found myself alternating between swimming and then resting in front of the water jet. The thought of having a baby early never crossed my mind. So, rhythmic visits to have the water jet on my back, didn’t register either. I was having contractions and didn’t notice. After work, my husband, Graham joined us at the pool.  I told him I was just worn out, but was figuring out what to do to get our baby head down.  We were walking laps back and forth in the pool, just chatting and relaxing. Eventually, I told him, that I was going to get out and take a long hot shower. He could get the kids out in a few minutes.
I rushed into the freezing cold locker room to gather my towel and head into the shower. Every few minutes, I felt water trickle down my thigh. “Ignore it” I repeated to myself. I got out of the shower and stood on a towel in the Kroc Center locker room. “Ignore it” I repeated.
Ignore it
Ignore it
Ignore it
Ignore it
That’s amniotic fluid
Ignore it
Ignore it
Ignore it
It’s just a little leak
Ignore it
Ignore it
Ignore it
It will just seal right up
No big deal
Just a droplet
This happens

And then my mind gave in and my heart spoke up:
My amniotic sac is broken, something must be terribly wrong. Is my baby alive? My fear from the moment I saw the positive pregnancy test months earlier.

I texted Lindsay (7p) and after some back and forth we came to an assessment: My water was leaking, It is clear, I don’t know if I can feel the baby, I don’t know if I am having contractions. I am going home to drink water, lie down and listen to my body. I walked out to the pool and told Graham. My deameanor was calm and my conversation to the point.  This was not my first time acting this way –  This is my “survival mode” that I deploy when I am really, deeply scared. I went ahead in his car while he got the girls cleaned up and followed after me.

It only took a few minutes in the quiet car. I hadn’t even gotten out of Bioxi. It was obvious, I was having consistent contractions. This could definitely not be ignored. Lindsay and Graham met me at home. Lindsay’s role changed from doula to healthcare provider when I asked her to use the dopplar to listen for the baby’s heartbeat. There it was strong, and steady as always. Breathe, Bianca. Your baby is ok, I said to myself. Over and over.

8:20p Lindsay called Wendy with an update. Wendy was able to answer my questions: Is there medical treatment for preterm labor at 34w3d? YES, steroids and magnesium. and Should I go to Garden Park Hospital as planned? NO. If I do not have the baby immediately, I would be transferred to Memorial or if I have the baby and he needs NICU care, he would be transferred. I needed to go to the hospital best equipped for preterm birth. And, with OBs providing care, rather than a midwife.

Standing at the foot of my bed there was a moment of stillness as reality sunk in. The decision was made. I was going to the hospital, in labor. “I guess we need to take the car seat?” It hit me, next time I was in this house, I would have our new baby with us.  Not what we were expecting at all.

By 9:30p Graham and I were driving down the beach toward Gulfport, with Lindsey following close behind. In 2 1/2 hours, I had packaged up my big emotions and was focused on the work of preparing for the arrival of our baby boy. I was in work mode. I texted my friend Tina Fritz (NICU nurse and IBCLC) asking, “Where can I find documentation for the best care for a baby in the NICU?” If only such a document existed... I did read a few research articles and quickly realized I could not prepare from what was ahead. I would have to trust and depend on the professionals at Memorial Hospital. Contractions continued.

Since Caprie was born in 2009, I have been at over 30 births as a doula. I have helped about 100 families prepare for the birth of their baby. Of course, I had a vision of how I hoped my baby would enter the world. I wasn’t at all concerned about managing painful contractions. In fact, I was looking forward to the hard work of labor. My dreams for this birth were all about greeting my baby. I hoped to be more “aware” at the end of labor, then I had been at the births of my daughters. I wanted to feel my baby crowning. I wanted my daughter Caprie to catch her baby brother. I wanted to lift my baby to my chest and cover him with warm, soft blankets. I wanted to greet my baby in total peace. I wanted my daughter Luci to cut the umbilical cord. All of this had been discussed with my midwife and doula. Now, I was thrown into an entirely different world of possibilities.

We arrived at the hospital and I was still hopeful that my baby would be born in peace. I had my family, an excellent doula, and the confidence to communicate with my new care providers.

With a mix of confidence and fear, I walked into Memorial Hospital. The security guard proceeded to ask questions for what felt like forever, until my Doula did her Doula duties and said “She is in preterm labor, we are going up to L&D now” and off we went. We walked into labor and delivery and a wave of familiarity washed over me. I remembered standing confident next to my laboring clients as they moaned through contractions, eager to be assigned to a room. Now, here I was, feeling vulnerable and not interested in speaking for myself. The nurses spoke back and forth about which room to put me in. Standing, waiting, worrying for just a minute and yet I felt like I was intruding in something, interrupting their plans for the night. I just wanted someone to take care of me, to take care of my baby.

(This is the point that my memories get really fuzzy, perhaps a mix of medications and self preservation)

I went into room 1. I was offered a hospital gown but explained that I would continue to wear what I was wearing. I would just lift it up for monitoring. My nurse was Michelle. She did a vaginal exam. I felt relieved before she even told me what she was feeling – I knew right away that I had some time before the baby would be born because my cervix was still posterior (she had to really reach to do the exam). I don’t know how dilated I was, but I later sent a text to loved ones saying “I was so relieved to find out that I had dilated very little. As this meant I had some time to wrap my head around this change of plans AND get the medications going to help give this baby a good start.”

It felt weird not seeing a doctor to discuss the care plan. I know that is how it goes, but I was eager to speak to a doctor. I was connected to continuous electronic fetal monitoring, given a shot of steroids, and started on a drip of magnesium sulfate. Steroid shots help the baby’s lungs develop. Magnesium Sulfate does two things, it can slow or stop contractions and it helps develop the baby’s neural system. My baby’s transverse position was a blessing. If his head had been pressing on my cervix, those contractions would have resulted in dilation. His position helped delay birth and give us time to administer these beneficial medications.

Magnesium Sulfate impacts people differently, but it almost always has side effects. The best I can remember was that kind of discomfort when you have a fever. I seemed to be fading in and out of lucidity. I was hot (my nurse was kind enough to bring in a box fan that was blowing directly on me). My skin was sensitive and hurt. I couldn’t think clearly. I was just miserable. I have asked my husband if he remembered if we slept any that night. Neither of us can remember.
​

One month ago I was traveling to Polycastro, Greece a step into the unknown.  I left my wonderful husband and two children at home in Mississippi to do something I had never done before.  I was going to provide lactation support to Syrian refugees.

That last sentence sounds so simple and straight forward.   I am a mother who breastfed her own children.  I am a volunteer lactation counselor with La Leche League.  I have helped many mothers breastfeed.  I knew the two weeks in Greece would be full of new experiences.  What I did not know was the intensity with which my heart and spirit would change.
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Last year, my dad died unexpectedly and a few weeks later I miscarried a baby girl at 15 weeks gestation. Both came with such a shock, my happy world was changed.  As I emerged from those devastating events, I found myself with a feeling that is difficult to describe.  I was restless.  I didn’t trust what I had previously believed to be true.  I wanted more from life. I had discovered emotions deeper than I knew existed. I wanted to put the depth of my heart to good use.  

While mindlessly scrolling through facebook, the ad shown above appeared.  It was speaking to me.  Someone, somewhere needed the skills I had.  Someone needed my raw heart. Someone was in a deep unexpected pain and I knew what that felt like.

I didn’t know anything about Syria, Greece, refugees or the entire Middle East.  I stopped watching the news years ago. I quickly discovered that Syria was in ongoing, complicated war.  After years of fighting and hoping for a resolution, thousands upon thousands of Syrians were leaving.  They packed a bag, picked up their kids and walked out their door in search of a safer place.  I know if I had to do that, I would want a friendly face on the other end of that journey.  I decided to go to Greece to offer an empathetic smile and a hug to the mothers who made that journey.

I am happy that Nurture Project International found me.  As an organization, we share the same values. We respect mothers and recognize that through supporting mothers we can make the world a better place for generations to come. We know that breastfeeding not only saves lives though better health, but has the power to build strong mothers.  While working in refugee camps, I met with mothers one on one.  I offered technical assistance and breastfeeding support.  But more often, I showed that I cared.  The refugees are in terrible circumstances and the kindness of a Nurture Project International volunteer can give them hope to keep going – to keep hugging their children – to keep waking up – to keep hoping for a bright future.  Nurture Project International volunteers save lives.

When I told people about my trip to Greece, they wanted to send things.  Baby carriers, diapers, clothes, formula, bottles.  There are all kinds of important reasons not to send stuff.  More importantly, I can tell you what the refugees in Greece need:  They need YOU. 

I know you have reasons why you can’t go.  I had reasons too.  You don’t have money.  You have family to take care of.  You have school.  You have work.  You don’t have a passport.  You don’t speak Greek or Arabic or Farsi.  You are scared to travel overseas.  You have people at home that need you.  You feely panicky when you think about walking into a refugee camp.  You don’t know about refugees.  You don’t know about Muslims. You are scared.

Take a breath.  Breath in Peace.  Breath out fear, pain, anything that is not love and peace. The families in refugee camps escaped a terrible war.  They ran away from terrorists.  The world is stuck.  Tens of thousands of people are looking for a peaceful home and the world was not ready for that.  World leaders don’t know what to do.  But, you can do something.  You can save a life.  You can spread love and peace simply by your presence. 

​I am asking you to go to raise your hand.  Be brave.  Be part of the change.  I will help you.
​
Bianca
me@biancawooden.com
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