Spring Babies!

One of the things we’re most proud of at Alma is the community that we’ve built here. We have monthly get-togethers during pregnancy, organized by the season in which the baby is born. After all the babies from that season are on the outside, we have a potluck party here at the birth center.

When you have a bunch of babies in a room, it’s pretty hard not to do fun things with them like make baby flowers:


Thanks to all the parents and babies who were able to make it, and hoping to see you at our annual picnic in September!

What is a birth expert?

With a sweet picture of baby Jay (born just yesterday!) to send you on your weekend, we at the Alma blog have a question!


Are obstetricians experts in normal birth? Are midwives the experts? Or are women the experts on their own bodies?

Let us know in the comments what you think the answer to that question is, and have a great weekend!

Oops! I didn’t Know I Was Pregnant!

It’s not all that uncommon: many of us know someone (or know someone who knows someone) who didn’t know she was pregnant right away. In most of these stories the women find out at some point further along in pregnancy: 16 weeks, 20 weeks, or even 24 weeks along. In many cases, they have irregular periods or continue to spot and may not have many pregnancy symptoms.

The Discovery Health channel has been airing a “documentary” series entitled I Didn’t Know I Was Pregnant. In this show, the women in question have no idea that they are pregnant until they go into labor. First things first: it’s a silly show, full of awkward re-enactments and doctor consultants saying things like, “prenatal care is important”. There are lots of comical reactions like a father in one episode I saw asking the 911 dispatcher on the phone if he should try to “put the baby back in”. It’s embarrassing to admit that I watch it, though I sometimes can’t turn away from the stories of women not gaining any weight or feeling their babies move and then being stunned by a baby coming out of their bodies.

Anyway: all that aside, the take home message from this show is big for me, and if you’ve been a client in the past year you may have already heard me talk about this. Why? Because I think it’s totally incredible that none of the women think anything is terribly wrong–or seek medical attention at all– until their babies are actually coming out of their bodies. This says so much about fear and anticipation and its effect on the interpretation of pain and labor sensations, and also about the way in which our society has conditioned women to perceive their labors.

Adrienne B. Lieberman, in her book Easing Labor Pain, discusses several studies that address women’s perceptions of pain in labor. “Another recent study compared Dutch and American women giving birth. American women were much more likely to expect labor to be painful and to assume that they would need medication for it… only one in six American women received no medication compared to almost two-thirds of the Dutch women… The biggest difference among people, however, isn’t in their perception of pain but in their ability and motivation to withstand it… Your pain threshold can also be lowered or raised by the type of attention you focus on a sensation. In one pain experiment, simply reading the word “pain” in the instructions made subjects find a low-level of electric shock painful. They didn’t report the same level of shock painful when the suggestive word “pain” was left out of the instructions. This, of course, is the reason childbirth teachers refer to “labor contractions” and not to “labor pains.” By the same token, if your anxiety is reduced instead of built up, your pain threshold may be increased. Another pain experiment gave subjects control over the painful stimulus, an electric shock. With a sense of control, subjects found the stimulus less painful, probably because they experienced less anxiety about what would happen to them.”

Our perception of what’s going on has such an intense effect on our interpretation of the stimulus. One of my favorite episodes profiled a woman in labor for five days. Every night for those five days, she would get a “stomach ache”, sometimes vomit, and then by morning she’d be feeling better. Some of those days she even went to work! By the fifth day, the pain got worse and didn’t go away, so she finally went in to the emergency room. Shortly after that, her baby was born. A five-day labor, especially one that stops and starts in that way, is just not that uncommon for first-time moms. If you picture that scenario with a woman knowing she’s been in labor for five days, you can easily imagine her getting tired and frustrated every morning as the contractions back-off. In an out-of-hospital birth setting, this can also lead to a concern or fear that something is “wrong” or that “this can’t be right!” In our society, where only 2% of babies are born outside of the hospital, it’s easy to get used to time-based protocols, and to think that long births are unusual. The truth is, most first babies take a long time! And most of the time, the length of the labor has no bearing on health or safety. I could say lots more about that, but we’ll save it for another post.

In the meantime, if you are a pregnant mama: take care of yourself in early labor! Ignore your contractions if you can. Go out for dinner, take a walk, see a movie, and do everything you can to not start looking at your watch and wondering how much longer it’s going to be. pretend you don’t even know you’re pregnant! 🙂

Interview on “Everything Birth”

In April, the director of Alma Laura Erickson did an interview with the Everything Birth blog. Here it is, reprinted for your enjoyment!

What a better way to start our series on Midwives and Doula’s than to interview My own midwife Laura Erickson CPM/LDM. Laura was with us with both pregnancies and she has a gentle, caring and guiding spirit. She held my hand during my cesarean section and stayed with me until they put the last stitch in all the while serving as my voice. And during my HBAC (home birth after cesarean) she spent the whole night applying pressure on my lower back during each contraction. She let my two-day labor take it’s own course. I needed to be mothered and she was there. Thank you Laura!

What inspired you to become a doula/midwife?

My heart always leaned toward the very young. As a child I was drawn to young critters. I was curious about the magic of birth. How could this fat dog waddling in the yard one day be a skinny Mama with ten wiggly, grunting puppies hanging off her tits in a big cardboard box the next day? What happened in between? How did those puppies get out? I would watch my Mom’s friends bellies grow and tried to imagine a baby under that big smock. With that inclination, I thought I had to become a nurse and then earn a masters degree in midwifery in order to make a career of my passion. Old time midwives who attended homebirths and used herbal medicine were as extinct to me as pioneers (like Laura Ingalls WIlder). I had missed the opportunity of being a midwife riding through the Appalachian Mountains to catch a baby in a cabin. Nursing school wasn’t alive to me at the time. I had zero passion for sickness or allopathic medicine. Six years of college studying something without interest seemed like a soul-suck. One day in the book store I found a copy of Elizabeth Davis’s Heart and Hands. My college room-mate was startled to find me dancing the euphoric dance of one who spontaneously finds her life’s work! Oh sweet rapture, midwifery still exists outside of the institution! Bye Bye nursing school and hello midwifery.

What did you do before you chose the path of a doula/midwife?

I babysat, taught children’s swimming, lifegaurded, and worked in restaurants. There has been midwifery all my adult life. My first births were attended as a 16 year old!

What services do you provide to a mother to be and her partner?

Alma Midwifery in Portland Oregon provides relationship based care. We attend to women during their prenatal, birth and postpartum periods using the Midwifery Model Of Care. We are a blend of Certified Professional Midwives and Certified Nurse Midwives. We attend women who choose to birth as close to nature as possible and without unneccessary intervention.

We honor women in their choices throughout pregnancy and also as they begin to parent their newborn. An example of how we honor women’s choices is in the use of informed choice agreements for about a dozen tests. Group Beta Strep (GBS) culture is an example of a test that is done near the end of pregnancy. We offer the culture to all women and most choose to find out if they have GBS because it can cause a newborn infection. If a woman knows all about GBS and the possible risks to her newborn by not knowing her GBS status, we will ask her to sign an informed choice agreement. She can decline GBS testing if she knows the risks.

At Alma we also have massage, acupuncture, belly dancing, several classes, and yoga available. There are four support groups happening throughout the year: Winter Mama, Spring Mama, Summer Mama and the Autumn Mama group. It is nourishing for women to spend time with others who are due in their season. There is a Dad’s group too.

Can you tell me about the birth that stands out most in your memory?

There was once this woman with a gentle smile and long sandy blond hair who had twin girls already and was in labor with her third child. She worked really hard to open her mind to this child exiting her body through her vagina since her girls were born by cesarean. Sometimes she would just labor with her sweet partner and sometimes she wanted the midwives to encourage her. As midwives we have a low cesarean rate because we mostly ignore the clock and the calendar. We know that things in nature take more time than things that machines do. We don’t see a long labor as a broken machine, we see it as a slow bloom. So back to this Mama… Her labor was long even by midwife standards. She continued to eat, drink and rest between contractions for her two-day labor. There was a wee hour discussion in which her stamina was questioned by her partner. She responded to his concern by vomiting and expressing fears, “My body didn’t do it last time and I don’t think it knows how”. The midwives listened to her and closely monitored the babies heart beat and all the mom’s vital signs. Her midwives know that she needed to stay hydrated and so they hung a bag of IV fluids and made her a smoothie. Sleep came to this exhausted Mama and she was restored a bit. She used this new energy to call to her unborn child,”Come on Noodle” Noodle was the fetus’s nickname. She marched around her tiny Portland home. She swung her hips and squatted deeply. She had found her courage to allow this baby to enter her pelvis! She took a shower to try to get the contractions to become stronger. Now that her will was to give birth her contractions were still lagging. In the hospital an IV of Pitocin is used to augment the uterine contractions. This is called a “Pit Drip”. At home midwives don’t use pitocin to kick a sleepy uterus into action. Midwives will use nipple stimulation to increase the mother’s own oxytocin. The woman or her partner will roll the nipples in the rhythmic way that a baby nurses to cause uterine contractions. The joke is that it isn’t a pit drip but a tit drip! Nipple stimulation worked for our heroine and her contractions grew closer. By eleven AM on day two she was nine cm dilated. She opted to have her sac (the bag around the baby full of salt water) ruptured to see if that will move things along.
Soon she said, I wanna push, I’m pushing! She took her time learning to push and finding her power. The waterbirth tub was freshened up and she got in and pushed some more. When labors last a long time the contractions can be weak and very spaced out. This Mama was determined to push out this baby. By 1:30 PM the top of the babies head was showing! By 2:25 the baby was in a full crown (the widest part of the head stretching the vagina-think “ring of fire”) and at 2:29 she had pushed his whole head out. We waited… we waited… no contractions! This baby needs to come all the way out.

He wasn’t really stuck but the uterus thought it was done. His Mama found the strength to get out of the tub with the head out and go to the sofa a foot away. By 2:34 PM the rest of this baby splashed out into his Dad’s waiting hands. His APGAR scores were 7,8,9. That is shop talk meaning this kid was breathing for himself and turned pink and cried. He was in good shape. The midwives were so proud of this strong Mother who had just had a vaginal birth after cesarean in her own living room on a rainy November day in Portland, OR! His Daddy was in love with his new son and very amazed at the stamina of his woman.

Although this woman was extra stong and brave, midwives get to see women as hero every day!

What advice do you have for a mother to be?

Observe nature-see how long it takes a stick to grow buds and for those buds to grow leaves. Notice how the seasons change slowly. Do stuff that takes a long time: grow a garden, play monopoly, do a 3000 piece puzzle, cook meals from scratch. Grow your patience. Write letters and email/text less. Watch less TV. Don’t believe the bullshit births in movies and TV. Move a lot! Dance, hike, swim and make love. Have fun and laugh a lot!

Babies, babies, everywhere!

Alma is glad to be welcoming so many beautiful babies this month!

As part of our newly revamped website, we’re attempting to post photos, names, and weights on the babies page of our site. It’s going to take a couple weeks to get into the habit of taking the photos consistently, so if you welcome an Alma baby in the next few weeks, remind your midwives to take a picture!

Here is the latest babe, Dahlia Evangelia:


And just a few days before her, we welcomed C’thyllia Morningstar:


Check them out on the babies page soon!

Also, have you seen our birth stories page? We’re adding new birth stories as they come in, and just received a lovely one from a sweet mama whose baby is already nine months old! Go read baby Reilly‘s birth story when you can, and don’t miss the photos from his birth. Here is just one of the amazing photos his mama was generous enough to share with us. It shows Reilly’s head coming out with his hand right by his face!