Lisa and Bill lived across the street from the hospital, and were hoping to labor at home as long as possible with me there as their doula. When she called me around 5pm on Friday her water had just broken, and she reported that her contractions had kept her up most of the night before. When I arrived at their home, she was up and about, and they were both excited about things moving along. I suggested that she might like to get some rest as it could be another long night. We put on some music and I helped her to relax and lie down, and her contractions sped up and intensified rather quickly. She got up to move around, and went to the bathroom, but didn’t seem to settle in. She was anxious to get to where she was planning to have her waterbirth, in the tub at the hospital. Contractions were 4 or 5 minutes apart when we decided to walk over. They monitored and checked her, which was a bit frustrating for her, but soon she was allowed to get in the tub In the water, she was immediately in her primal power, and not afraid to make noise. Bill got in with her after about an hour, when things were getting more intense. Very soon after that, she was bearing down and asking where her doctor was. She looked right into my eyes with a question. I can’t remember if she spoke. She wanted to make sure she could go ahead with what her body was asking her to do, even though her doctor hadn’t yet arrived. The nurse and I told her to listen to her body and not hold back, and she trusted. Baby crowned and his head came out, without anyone’s knowledge but Lisa's. She helped him as he turned, and then he shot out into the water. The nurse was there to help her bring him up to her chest, and her doctor arrived soon afterwards!

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“ Why didn’t I know about this?” 

I’ve probably heard this question at each Fertility Awareness class I’ve taught over the last seven years. 

“Why don’t they teach this in school?” 

There is sometimes a hint of sadness in their voice, sometimes resentment or anger.  I’ve witnessed this humble moment of reckoning so many times.  Luckily, it is often followed by a deep inhalation of empowerment as the class continues and the information settles in to its’ rightful place, the body of the woman.  This is one of the many, many reasons I love to teach women (and their partners) about Fertility Awareness.... because a woman has the right to know about her fertility.... to know that she has all the tools within her to monitor her cycle; to know when she is fertile, when she is not, and to use this wisdom to choose when and if she would like to conceive a child.  Why DIDN’T we learn this in school?   

 

Women hear about FAM and often associate it with the rhythm method or Catholic based methods of Natural Family Planning.  Perhaps they have heard stories of a mother with 7 children who “used NFP”... or they are happy with their current form of birth control and don’t really give the class a second thought.  But FAM isn’t anything like the rhythm method, and it certainly is not only about birth control.  (Though recent studies find FAM to be equally effective to the birth control pill, with a 99.6% effectiveness rating!)  It is about making a choice to be conscious and a choice to find power in being a fertile woman in a body designed to reproduce. 

 

In the Fertility Awareness Method a woman learns what hormones are the main players in the dance of fertility she experiences each cycle during her reproductive years.  She learns how these hormones have dozens of health promoting actions and are intricately woven into many other systems of the body.  With a basic lesson on reproductive anatomy a woman can then be instructed on how to observe and chart the ways in which these hormones present and express themselves in her body.... such as how estrogens are cell producers and make your skin and hair shine, or how they increase the wetness you feel in your genitals when they are at their height.... Or how progesterone warms up your body and increases your metabolism... which explains how hungry women can get before their period... or why seeing their temperature rise (and stay high) is confirmation of ovulation.  With FAM a woman can discover if her irregular cycles are a variation of normal or if her hormones could serve to have some support in becoming more balanced... She can perhaps even learn if other discomforts might be easily resolved with similar hormonal support (and at my class she’ll even learn how diet and lifestyle changes can do this!).  She can learn why she is not getting pregnant though she’s been trying for months... or she can learn how to not get pregnant by following simple rules of the method.

 

With this education, a woman is gifting herself with a deep personal intimacy and the empowering discovery of her own personal ebb and flow.  Perhaps this is all she will use the method for, or maybe she will choose to use FAM to avoid pregnancy or to conceive consciously when she is ready.... 

 

I am a firm believer that each and every young woman should be given this information when they begin to cycle during puberty.  It is my goal to help make this happen.  Until this time comes, I will do my best to help educate women, one by one, of the brilliant, ancient and proven practice that has changed my life, my sexuality, my health and my relationship to my body for good.  I LOVE FAM!

 

Please check out the following links for more information!

 

~For statistics on this method, showing an effectiveness rating of over 99%, check out:    

   (Note that both are slight variations from what I teach.) http://humrep.oxfordjournals.org/cgi/content/abstract/dem003v1 (sympto-thermal) -http://www.woomb.org/omrrca/bulletin/vol27/no4/chinaEvaluation.html (BOMA)

   

~For a recent article published on the FAM in an online publication: http://www.doublex.com/section/health-science/your-grandmother%E2%80%99s-birth-control-might-actually-work?page=3,1

 

~For a great and very informative website from my colleague Mikhal in Israel:

http://www.poriutivit.com/page.asp?p=10

 

~To see my website: http://www.graceofthemoon.com (check again in a month to see the

  new and improved site!)

 

 

 

Sarah Bly is a certified Fertility Awareness Educator who lives outside of Ashland, Oregon.  She is trained as a midwife but finds her passion in FAM.  She offers workshops up and down the west coast (and sometimes elsewhere) and she does private consultations for pre-conception and fertility optimization.  You can find her at 541-821-2522 or sarah@graceofthemoon.com .  Her next FAM workshop in the Ashland area begins on November 2^nd, 2009.

 

We are here to love.  We are made to reproduce.  Why not do it with conscience?

  

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     Sofia was at 5 cm when I arrived at the birth center. She had been at the hospital since the afternoon and seemed fairly comfortable at 7:30 when I arrived. She had been checked in the morning at her appointment and was at 4 or 5cm then, too. Sofia seemed to not want too much attention.  She was asking how her husband was feeling, checking to see who was with my children, and so concerned about her dog that she sent her husband home to feed him.

    Things seemed pretty mellow, and Sofia was very polite, thanking me for being there and responding positively when I suggested we stretch a little and practice breathing. She expressed some concern about transition; she was afraid that she wouldn’t be able to handle more intensity. I said we could practice now, while things were more comfortable, and that she could find a ritual and stay with whatever was working for her. She liked the birth ball, stretching felt good, and when she got in the tub, she really relaxed. After a couple of hours she got out to pee. The nurses were changing shifts, and Barbara came on as Yvette went home. Before getting back in the tub, Barbara wanted to check her. She was still at 5cm.

     The mood shifted then, and I could feel the tension of Barbara's concern that Sofia was not progressing. She was told that her doctor would be called and she would most likely want to rupture her membranes (break her water) to get things to speed up. "We want to figure out what the problem is,” she said. When Sofia heard there was a problem, she got scared. Soon her doctor arrived and ruptured her membranes. She also inserted an IUPC (intra uterine pressure catheter) to read the strength of the contractions. Sofia started to crumble when she heard there was a problem. She couldn't get back in the tub because of the IUPC, and couldn't get up into one of the positions that was working for her.   Her contractions seemed a lot more intense, but the catheter wasn't showing that.  It seemed possible that she was just having a harder time because she wasn't comfortable and was afraid.  They tried replacing the catheter, thinking that it could be malfunctioning or not placed correctly.

     According to the IUPC,  her contractions were just not strong enough, so her doctor  suggested pitocin or nipple stimulation.  Between contractions, I helped with rhythmic stimulation of her nipples, and after awhile, she began to respond to her contractions with less reserve, making sound and getting lost in the sensation as they clearly were intensifying.  She couldn't get back to her peaceful state of mind, though, and started asking for something for the pain. The nurse checked her and found her cervix had dilated to 6cm, but she wasn't cheered by the news.   

     Her doctor told her she could have an epidural at this point, and Sofia wanted it NOW. They wheeled her into the other room, away from the tub, and she was barely hanging in, not communicating, very internal. By the time the epidural was in place and she was comfortable, her cervix was completely dilated. Her epidural took the edge off but allowed her to move freely, so she squatted and pushed, and after a couple of hours, her beautiful baby was born. 

     I learned an important lesson at this birth about the power of suggestion.  Sofia was very sensitive, and nervous, and when she heard there was a "problem,"  her confidence was shattered.  Although her body was still working its magic, she couldn't trust that things were going alright.  She was hearing that although her contractions felt incredibly intense, they were not strong enough. 

     I saw in this labor experience that it is extremely important for doulas, nurses, and doctors to use positive language.  Instead of naming a problem, name a solution; such as, "We would like to help get things moving for you, and perhaps your doctor can help by breaking your water."  I also see that I could have been a better bridge of communication between the nurses and the doctor.   I was there through the change of shift, and saw clearly that her contractions were getting stronger, and that she was definitely making progress.  It is up to me in that situation to communicate to the doctor what I have seen, and the changes that are occuring.   Although the IUPC results did not seem to support my observations, her body signals were strong, and my job is to help her, and the medical staff, to feel confident in that.   The most difficult part of supporting a woman in labor can be to help her feel positive, hopeful, and safe, so that her body can relax into its natural rhythm and give birth.

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      The birth center at Ashland Community Hospital called at 10:45 today with a VBAC patient dilated at 2 or 3 cm, whose water had just broken. They said she had requested a doula, and asked me to come right in.  Five years ago, Julia had labored with her first baby to 8cm, then the doctor realized the baby was breech and did a ceasarean section.

       When I arrived at 11:45, Julia was in the bathroom with her husband. She was pretty uncomfortable, and wanted to get in the shower. They stayed in there together for about half and hour, until things had obviously intensified, and she just wanted to go lie down.  We wrapped her in a warm blanket and helped her back to the room.  She was starting to panic, to say she didn't think she could do this.  She was afraid, and unsure if she could go on, if things would be okay, if she could deliver this baby vaginally.  We helped her focus on her breath, its rhythm, and assured her that things were intensifying because everything was going the way it should.  Her body was making space for baby to pass through.  The nurse checked her again and she was now at 5 or 6 cm. 

       In the bed we tried a few different positions, but she just couldn’t get comfortable, and was having a hard time staying on top of her breath. Her father, husband and I coached her with every breath to find her rhythm, to stay with it, to reassure her that things were going just as they should. I found a place to press on her lower back, which felt good when she laid on her side.  She seemed to stay with her breath as long as she had consistant support, but she was having a hard time handling her dicomfort.  I thought she could be in transition, and although, as a VBAC patient, they would not let her give birth in the tub, I thought it could help her to get in a relax for a little while.  She agreed and I went to turn on the water.

     By the time I got down the hall to the tub room and turned it on, the nurse signaled to me that her cervix was dilated and she was complete.    Very soon, Julia was having a hard time not pushing. Her doctor was on the way, and the nurses were getting ready.  She pushed her baby out in about half an hour with incredible strength and even moments of humor.  I held her leg, and took pictures as her little one was crowning and emerging into the world.  It was 1:50 pm, so I was there for only about three hours before the birth. Julia had been in labor since 5:30 am.

     This was my first successful VBAC experience.  I felt a layer of doubt and fear, as though she had some expectation, formed through her experience, that her baby could not come out of her vagina.   She had the support she needed, though, and her body and baby worked their magic! The baby was at least 9 lbs. and gorgeous!

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