Wet Nurses and other Alternatives to Bonding

Only in our Western Society has anyone ever asked, ‘what will I feed my baby?’ and ‘where should my baby sleep?’ No other mammals dress their little mammals, nor has another mammal ever looked for an alternative to breast milk (or decided that breasts were for sex and not milk.) We are so very smart that we have thought up all these wonderful anti-bonding behaviors, probably while seeking our own convenience (or pleasure, or both) apart from our babies. This goes back in our history to at least the Middle Ages.

            I also wonder about the whole mindset behind employing wet nurses when it first became fashionable. Were the gentry too ‘dignified’ to nurse their babies? Did only animals do that, meaning breastfeeding?  During the 16th to 18th centuries, well-to-do mothers in Europe and the Colonies rarely nursed their own babies. The infants were given to wet nurses and returned home only when they were weaned, if they lived. Most fashionable women of the period wore corsets made of leather with stays of bone. The corsets not only broke ribs but often damaged breast tissue and nipples, making breastfeeding impossible. Employing wet nurses was also a sign of a family's elevated status in society. (A History of Wet Nursing, LLL International, March 2007.) Did wet nurses bond with their charges, and vice versa? And then were these babies weaned and abruptly separated once again, for the second time, from the one person they thought they could rely upon? I can understand employing a wet nurse in an emergency, for example if a mother died in childbirth. But to choose or refuse to nurse one's own baby intentionally and give him to a peasant, who, back in the Middle Ages hardly lived up to the same standards of hygiene and cleanliness as that of her mistress. Besides, the wet nurse would often abandon her own newborn in favor of this new, more economically advantageous arrangement: she would be housed, well fed, and paid for her 24-hour-a-day services, though the wet nurse would often have no child of her own in the end when all was said and done.

            About the same time, during the Middle Ages, the first pacifiers were invented. A rag soaked in chamomile tea would sedate a crying infant, replacing the much needed calories in mother’s breast milk. In Holland, I read in one book, the rag was knotted and dipped in whiskey. The infant mortality rate was known to be high during this era and I don’t doubt that practices like these contributed significantly.

            The cradle was employed during this era. A mother could multi-task finally: get another child to rock the baby to sleep so she could cook or clean. She could rock the cradle herself with her foot while spinning or weaving, another convenience. When the cradle went out of style it was the (un)doing of one doctor in particular whose thesis was that if infants were being trained to be rocked to sleep, they would never learn to sleep on their own, were smart enough to manipulate their mothers (sounds familiar?) and that the cradle was producing spoiled children, though adult size cradles were not being produced to accompany young adults to college that I know of. But I wonder again why cradles were replacing the important skin-to-skin contact babies needed? Another little piece of non-bonding trivia: In the 1700s, “…cabinetmaker Sheraton, in his Cabinet Dictionary, designed a cradle which included a spring mechanism designed to keep the cradle rocking for an hour and a half-- a function now accomplished by electric motors in this age of preoccupied childcare providers.” (Graham Blackburn, furniture maker, author, illustrator, and publisher of Blackburn Books, Bearsville, N.Y.)

            Exactly! Preoccupied childcare providers. Why do we value our non-bonding time and space above the needs of our children? I believe we honestly think we are not harming them otherwise how could we have been so oblivious for so long? To our small minds do we think we must be able to tangibly see abuse or harm before addressing it? The long-term effects of behaviors don’t cross our minds in most circumstances. I have written about it already, but I come back repeatedly to my observations of the researchers in Minnesota turning over every single minute pebble in their search for the hidden cause(s) of autism. (Genetic flaws in specific races is now on the top of the researchers’ lists at this time.) Everywhere except the broken bond we have created ourselves, perhaps because it is invisible, versus vaccines, for example, whose levels of mercury we can quantitatively measure, though I don’t think we can ignore their side effects any longer, either.

            While we employ nannies, baby sitters, and daycare we not only raise the expenditures in our budgets, we also create more non-bonding time for ourselves. Convenience? We have more time to create more ‘important’ (and costly) things to do. No wonder our standard of living in the U.S. in particular, and the Western World in general is so high. We think we must have a two-income household to survive, but in reality, we often create that level of need ourselves.

The French have an old saying that goes something like this: every baby is born with a loaf of bread under each arm. ~ as quoted by Dorothy Day

            When we were having our babies, we lived below the poverty line intentionally, not because we knew about the importance of bonding, but because we didn’t want to pay taxes that would be funneled into the military and the (then) Vietnam War. We home schooled, gardened, ate locally and seasonally, canned a good portion of our food using a pressure canner on our wood stove, raised a pig named ‘Bacon’, made our own clothes or shopped second hand, and created our own ‘organic’ entertainment. I didn’t work outside the home (a log cabin at the time). Our children were amazingly independent very early, which surprised us. We did not realize that by having one or both of us present all the time – they didn’t have a baby sitter once during those years – they felt completely secure and chose their own time to branch out into other levels of relationships. We called them our ‘free-range’ children. I didn’t feel like some camp's activity director, either. I was too busy. If I was kneading bread, they each got a little lump to destroy on their own. Theirs fell on the floor, adding a few cat hairs along the way, got over-kneaded, tasted, licked, and poked, and then went into the oven along with my loaves. They ate theirs for lunch, slathered with homemade jam. If I was cleaning one of the cabins with a baby tied on my back, (we maintained a retreat on 70 acres of virgin oak forest in Wisconsin back then, receiving an average of 600 guests a year) they all came along, inspecting bugs along the paths through the woods, eating wild black berries, having mock weddings in which they threw acorns in lieu of rice at the conclusion, the boys having peeing contests, seeing who could hit the farthest tree.  Ruth tried but never scored.

            They met people from all over the world: a pianist who played for them on our old upright (that I had bartered for a handmade quilt), a cleric from England whom they introduced to Dr. Seuss and employed him to read to them every night during his stay; artists, priests, nuns, writers, storytellers, monks, hermits, travelers – they all came for shorter or longer stays in the cabins. Our children observed all of them and gravitated toward the more well-adjusted folks among them; believe me, we got all kinds. This was the world our fifth child, Hannah was born into, (while I hung onto the rung on the front of the wood stove, while squatting and pushing.)

            The year was 1987. She was our 5^th child, born just under 3 years after Rachel who was born 2 years short of 5 weeks after our twins, Isaac and Ruth who were born on the Farm* with Ina May Gaskin and the Farm midwives in 1982. The twins were born 2 years minus four days after our eldest, Abraham. I had breastfed all of them well into their second year, using breastfeeding alone to space our babies. (Breastfeeding and Natural Child Spacing: How Ecological Breastfeeding Spaces Babies, by Sheila Kippley). Hannah, like her sister Rachel before her cost us all of $25.

They identified with Laura and Mary as we read every single Little House on the Prairie book to them by kerosene lamp, stopping to make Almanzo’s pancakes, or Pa’s button lamp, or dolly quilts from scraps like Mary’s. (Yes, Abe and Isaac also learned to sew by hand.)

Hannah was the easiest baby yet as all her siblings adored her and entertained her constantly. I did not realize the level of bonding that was happening between them as siblings but it has remained with them to this day. They are all grown up now and we are grandparents. The time really does fly by. We did not always find the right way with each child as this or that one tried to find their own independence and looking back we see things we could have done differently, but we are proud of each one and who they have become.

Note: By the way, the $25. Hannah cost us bought 1 box of maternity sanitary pads, 1 box of Chux for the bed afterwards, and Slippery Elm tea which I used to prevent bleeding after her precipitous birth. The others had all come very quickly which can cause hemorrhage sometimes, so I wanted to be prepared. The receipts are in her baby book. There isn't much else there, though. It never became an item on my list of priorities.

*see 2^nd edition Spiritual Midwifery, by Ina May Gaskin, p. 169, and A Natural Delivery of Vertex Twin Birth DVD, c2005 Birth Gazette Video.

To leave comments at this blog, please email me at: ssskimchee@gmail.com

Instinct or Social Norms?

Follows is an excerpt from my next book, Stone Age Babies in a Space Age World: Babies and Bonding in the 21st Century, pending publication.

Where have our instincts gone? And why do we deny them? We aren’t completely bereft when it comes to sex, though our bedrooms seldom come under public scrutiny, however this age of psychotherapy finds us feeling guilty and puzzling over conflicting feelings about ourselves and our urges. And our parenting skills. Why?

          We are the only mammals who have devised an alternative feeding method from what we were born with or what Nature intended. We are also the only mammals who dress ourselves, and our baby mammals, as soon as possible after birth. Why have we so de-valued our instincts? Are we so afraid of them? When a baby is born we hurry to dress him, put clothes back on ourselves, cover up and remain like that for the rest of our lives, unless we challenge society and question our own nakedness phobias. Primitive cultures did not, over the past centuries, and still do not fret over phobias or dress their babies so soon, if at all. Carolyn Flint*, my favorite midwife in all of Britain, advocates that after birth we go home, if we are not there already, take all our clothes and our baby’s clothes off and go to bed with our little mammal for at least the next ten days and properly bond, not to mention mom getting enough rest and establishing a good milk supply. (Nappies or diapers allowed). How many readers cringe at that thought? Why? 

          Why has Western culture dictated which instincts are socially acceptable and which are not, and why have we not rebelled? How has it gone on for so long? Why have we succumbed to letting so-called experts -- who often propose only theories and hypotheses and not even hard evidence -- dictate how we treat our babies? When did we begin to doubt our instincts? Why do others have so much collective sway over us? And why have we relinquished our rightful places as protective, nurturing mothers and fathers? Is this progress? Is this what evolution teaches?

          Why would it? Logic tells me otherwise. Logic suggests that instinct would be preserved over and above transient ideas that individuals invent. When did we begin valuing un-tested, structured, formal education over natural instincts? Are we so afraid of being blamed or appearing different from a newly conceived norm that others are enamored with, that we rush en masse into nonsensical behaviors? When did this irrational behavior begin? Why have we not seen our error, perhaps moved on to learn from it, and corrected it? Why not? 

          Do we see this in other mammals? I think not. Bears build dens in the fall just like they have been doing for hundreds of centuries; eat what they will need to sustain themselves through the winter, just as they have been doing for millions of years, deliver their young before spring, nurse them even while half asleep, then eventually fully wake up to go out and forage, returning to their dens at just the right intervals to feed their cubs. Their milk contains high levels of fat so that their cubs will be fine for several hours at a time until they return. Human milk does not contain such high levels of fat. Human babies know this, but we have ignored them (and their insistent cries) in the past and instead nurse them on a schedule, often making them wait to feed for up to 3 or 4 hours, though they actually need to nurse by two, and did try to tell you that.

          Why do we doubt ourselves in favor of contradictory information? In retrospect I marvel at my own passivity. Before I had my own babies it never occurred to me that babies didn’t need processed baby food. I never wondered what happened before corporations made millions of dollars producing miniature jars of over-cooked, tasteless (and often far too starchy) baby foods. Taste it – go ahead and try some! I did and I was amazed that it sold in the markets at all. I didn’t even wonder what infants ate in China or Africa or New Guinea in my lifetime or thousands of years ago, for that matter. It never occurred to me that mothers in other countries had already figured out how to feed their babies after breastfeeding without buying strained food. I assumed we were so very much smarter in the Western World. There is enough evidence around me that proves we aren’t the only race to have survived in spite of the possible deprivation of not having access to Gerber foods. What did the rest of the world do, anyway? Would instinct serve me here too? Could Nature really have answers that we have discredited all these millennia? When did we stop listening? Why?

          One hunch is that we stifled many of our instincts around the same time that modern man became more mobile, and the intact family unit with its generations of wisdom, care and continuity became threatened. What happened when we no longer had grandparents, parents, and aunts and uncles all sharing their two cents over everything the youngest members of the group did, or didn’t do? Perhaps we turned to ‘experts’ in all the various disciplines who happily offered ‘wisdom’ to us in their place. We have reinforced their position of authority by returning to and honoring their advice. In turn we have increasingly doubted ourselves. We have perpetuated a farce, and our newborns, who are not yet polluted by these errors and know better, cannot tell us we are wrong. They try: they cry, fret, fuss, some refuse to thrive. Others develop colic, learning disorders, attention disorders, and a gamut of disturbing physical and emotional problems – I doubt we will ever realize the enormity of the entire scope of avoidable disasters that our errors have and are continuing to cause.

          When I first began observing groups of people who have been able to retain their extended family system, I also saw very primitive bonding behaviors. Perhaps I was seeing this because the child that was raised in this way, was being prepared to become the healthy adult who in turn would choose to perpetuate the extended family with its continuum of bonding still intact.

          The Age of Enlightenment may be at least one other player in the demise of our instincts. This was an intellectual movement in Europe that may have begun as early as the 1600s and developed throughout the 1700s. Intelligence became based on ‘enlightened’ rationality. The goal was to establish an authoritative elite body of knowledgeable ‘experts’ who would lead the world toward Progress. The masses were viewed as poor souls wallowing in irrationality, superstition, and tyranny which were what this new school now called the Dark Ages. This so-called ‘Enlightened’ era set the stage for the American and French Revolutions. It also resulted in the rise of capitalism, the invention of socialism, and a new renaissance in music and art.

          Men decided they had finally woken up to The Age of Reason and appointed themselves the designated leaders of Progress. They assumed that, quite suddenly, they knew better as enlightened humans than the animal kingdom. They believed they had somehow woken up that morning instantly brilliant and insightful and intuitive, when in fact they had just thrown out all the intuition they ever had. The churches also jumped in to do their part. They taught the unfortunate masses that they must now rise above their animal natures (think instinct) and renounce sin (now equated with instinct).

          In this light, using their newly acquired, enlightened thinking, they viewed marriage as an inevitable sin, and as a result, the great age of monasticism soon reached its climax, flourishing with tens of thousands of men and women literally arriving in droves at the monasteries and convents, convinced that they would gain God’s favor by renouncing their instincts, and being ‘good’. (Good = holy). I do not believe this was the Creator’s intention.

          Scripture tells us, “And God saw everything that he had made, and, behold, it was very good. And the evening and the morning were the sixth day.” (Genesis: 1:31) It still amazes me that God tells man and womankind to “be fruitful and multiply” (Genesis 9:7) and then might change his mind 360 degrees. Permanently. Why?

          We have also seen in the past century where renegade individuals have rebelled on behalf of their children, against the norm, though far too few to make a world-wide impact. In Japan, just during the past decade, a small group of families dared to defy the status quo and blew the whistle on a country-wide system that is virtually destroying their children. They began the homeschool movement there for the first time in 2003 after a decade of school violence and a rise in teen suicides directly related to the pressures of the educational system. South Korea now has a never-been-seen-before epidemic of suicides among young people and recent studies are telling them that most happen around high school and college finals week. This is completely unacceptable. Is this what we call Progress? So, are we enlightened, finally? Are we? Where does this lemming-like behavior come from? Shall we also dive head first in the same fashion? Will our own country have to look like this before we wake up? Why? Not surprisingly, as parents grapple with the evidence there is also a resurgent interest in baby-friendly activities, numerous classes for new parents, and the baby carriers their grandparents and great-grandparents used. We see today in these Asian countries, and countries around the globe that slings, amauti, wraps, rebozo, parraje, cradle boards, manta, and numerous other age-old baby carriers are replacing the American-made strollers they worked so hard to purchase in the past. Breastfeeding, baby wearing and even homebirth are making a comeback in Korea, Japan, Mexico, and China – and the list goes on and on. Finally some courageous people are becoming truly enlightened. Finally some families are insisting on bonding with their babies and risking the ire of entire countries full of skeptics. But at what cost. Why?        

"Women today not only possess genetic memory of birth from a thousand generations of women, but they are also assailed from every direction by information and misinformation about birth." ~ Valerie El Halta

*see Carolyn Flint: http://www.youtube.com/watch?v=5bsVi4Mccac (with permission)

To leave comments at this blog, please email me at: ssskimchee@gmail.com

How much is a birth worth? (published without permission from my author-friend Meg.)

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HOW MUCH IS A BIRTH WORTH?

POSTED ON DECEMBER 24, 2018 BY MEG CORRIGAN

Today in the town of David a Savior has been born to you; He is the Messiah, the Lord. This will be a sign to you: You will find a baby wrapped in cloths and lying in a manger. Luke 2:1

 Parents Magazine recently reported on a few of the more luxurious birthing options in the US. Ronald Reagan UCLA Medical Center delivery suites are designed to look and feel like the out of doors. Tiny VIP’s born at Rose Medical Center in Denver may join their parents in one of six luxury suites, which include the services of a private chef. The “deluxe maternity package” at Cedars-Sinai in Los Angeles (a mere $3784 per day) includes a personal doula. In-suite manicure, pedicure, massage or haircut are extra. When Beyonce and hubby Jay-Z planned the birth of daughter Blue Ivy, they commissioned the custom remodeling of several birthing suites at Lenox Hill Hospital in New York City. Amenities included four flat-screen TV’s, a kitchenette, both a couch and a bed for Jay-Z, marble floors, Italian linens and elaborate meals prepared by five-star chefs. Silver spoons for the babies’ mouths were extra.

 Author Walter Wangerin Jr., in The Book of God: The Bible As A Novel, details how frightened a young man named Joseph was when his young wife Mary was about to give birth on the straw of a forgotten stable. “I am not a midwife!” Wangerin imagines Joseph saying. And yet, with his vivid memory of an angel’s visit and with the strength of his faith in God, Joseph tended to Mary in her labor. He held her, let her push against him, offered his hands for her to grip. He heard her cry and watched in terrified wonder as the Child was released from her body. Then he cleansed the Child and watched as Mary tied the cord and severed it. And the stable animals watched in silence.

Would the Jewish leaders have believed that Jesus was a King if he had not had such a lowly birth? Why did God choose to send His only Son into our world without one shred of comfort or luxury as the Christ Child so richly deserved? The answer lies in the humility that Christ Himself portrayed.

 Star of Wonder, come to us this night, as the humble King of our earthly lives. Amen

 Meg Blaine Corrigan is the author of three books: Then I Am Strong: Moving From My Mother’s Daughter to God’s Child; Perils of a Polynesian Percussionist; and Saints With Slingshots: Daily Devotions for the Slightly Tarnished But Perpetually Forgiven Christian. She holds a Master’s Degree in Counseling from the University of New Mexico and has over thirty years’ experience working with survivors of domestic violence, sexual assault, war veterans, and other trauma survivors.  Her books may be purchased through her website, www.MegCorrigan.com or from www.amazon.com .

To leave comments at this blog, please email me at: ssskimchee@gmail.com

You are my hero!

Just when you think you've seen it all, the universe sends you a new one. And this one was a whopper!

It was exactly 10 days past her due date. I wasn't worried. Baby obviously wasn't worried. Our mama wasn't worried. She knew babies come when they are ready. But boy, were the midwives worried. They had already resorted to scare tactics by telling Zala the statistics on stillbirths and post-due babies. Right, I thought. Exactly what she needs just now. 

So now Zala was becoming less confident by the minute.  She considered using castor oil, tried long walks, and then agreed to let the midwife she was seeing strip her membranes--twice. That is done by sweeping a finger around the baby's head inside the cervix. The water isn't broken, it is just manipulated a bit, just enough to get things rolling, usually. It often sends a signal to the uterus to begin labor. It didn't do anything in this case. Another day went by.

Then on day 12, a gorgeous Saturday morning, I got a text at 10 a.m.: "Contractions 5 minutes apart. Meet us at the birth center."

I was so excited. Even after 30-plus years I still get excited. I texted back: "On the way! Happy birth day!" I was actually ecstatic because I thought my grandson's birth had been my last-ever birth two years earlier. I had retired due to health issues; paramount was my loss of over 90 decibels of hearing. I was diagnosed with Meniere's which not only destroys hearing but also affects one's balance and equilibrium. I could no longer only not hear my clients but could fall over at any time without warning besides. Broken ribs and a fractured leg proved my point.

On the way to the birth center I got another text: "Water broke. Birth center won't be open until 12:30." Since when do birth centers have hours? Really? I couldn't believe this.

When I got there I rang the doorbell over and over again. There really won't be anyone here until 12:30? That is over an hour from now. Are you kidding me? I went from being incredulous to being angry. What the f&#@! I still could not believe it.

Finally the door opened. The lady apologized, "I am so sorry. I am just the cleaning lady." I told her she isn't just the cleaning lady. We couldn't do this without her!

She let me in and I asked if there really would not be anyone in until 12:30. She confirmed that.

I could not wrap my brain around this one. What do I do now? Well, I do what I have always done when I find myself in hot water: I brainstorm all my options and all the possible scenarios.

I decided I would go to the couple's home and catch the baby there if I needed to. But I'd retired from midwifery close to 10 years ago now. I didn't have a birth kit with me. I didn't have anything.

I told the cleaning lady that I am thinking I should "borrow" some supplies from the center and go to the couple's house and hang out there until the center opened. She agreed (I would have stolen the goods even if she had disagreed,) so I went into the first birthing room along the hallway and ransacked the drawers. I opened up my shawl and started dumping things into it: sterile instrument pack, cord clamps, gloves, bulb syringe, etc. I wrapped it up and made a bee-line for my car parked out front. It crossed my mind that I might end up in jail by the end of this day, but I didn't care. It wouldn't be the first time. And that was not for delivering a baby.

It was back during the notorious 1960s when I was hitch hiking with friends along the West Coast.

We'd made it as far as Eugene, Oregon from San Francisco when we were arrested. Literally. Hitch hiking is illegal in Oregon. Who knew? We were put in jail, literally. Although I was only 16 at the time, they didn't buy my story. They laughed when I told them I was a minor. So I spent the night in jail. I chocked the experience up to "education." The other time I was arrested was a year before the hitch hiking fiasco while protesting the Vietnam War at Washington Square Park in Greenwich Village, New York City. I was allegedly defacing city property by painting peace signs on the cobblestones, even though it was water-based acrylic paint. Yes, the '60s were an exciting time.

But back to this birth which was close to fifty years after the arrests. (I have managed to avoid prison time since then.) So I raced to the couples' house 12 minutes away from the birth center with the loot wrapped up in my scarf on the passenger seat. I ran a red light, too, which I have never done before. A 65-year-old rogue. A miscreant grandma. What had I become? The thought crossed my mind, I wonder if they have a vegetarian option in prison these days? 

When I got to the house Zala was dealing well with the contractions (being called 'rushes' now,)

walking around the house, puffing away, holding up the wall when a rush built up again. I didn't think we were at transition just yet. Her breathing didn't sound like we were. You get used to that sound if you hear it enough times.

I asked if she felt 'pushy' yet, which she didn't, though I expected to hear that tell-tale sign sooner than later. I encouraged her to keep drinking juices and rest when she could.

Finally we got to 12:00 p.m. without a baby appearing so we all agreed to go to the birth center, where they quickly got Zala in a room and checked on her progress. 5 centimeters. YAY! 

Contractions slowed down, allowing her to rest and eat something. Then they all but petered out. The midwives started getting anxious. Walking didn't help. Nothing helped, so we waited, and waited...and waited. Finally, about supper time, they suggested that for some unknown reason, she just might need a bit of help getting things going, like with Pitocin, which they couldn't offer at the clinic but she could get at the hospital. The couple were pretty deflated by that, to say the least, but I explained that if it worked, got the rushes coming again, they could turn off the dose completely and we could proceed with a natural birth. I also told them that they could still have a midwife and we would also still honor their wishes as outlined in their birth plan. (And I had visions of a home birth only hours earlier.)

They liked that, though it was not what they had expected. I assured them that they would be respected and not be bullied into all sorts of interventions. This hospital had some great midwives that I'd worked with in the past and I told them that we all still wanted the best for them and their baby. 

We got settled in and the new midwife checked Zala. 4 centimeters. What is going on here? I thought to myself. I haven't seen anything like this in a very long time. I didn't want to alarm anyone, so I tried to stay positive and very patient. A major change during labor, like moving to a different place could definitely slow things down. Except 10 hours later, she was still at 4 centimeters. We had tried everything. Walking, resting with a peanut ball between her knees, more walking, lunges which often help baby engage in the pelvis. The midwives were concerned that the baby had not properly engaged in her pelvis. She remained so high and felt like she was in an asynclitic presentation. 

Below, everything you've always wanted to know about asynclitic presentation but were afraid to ask, from the Spinning Babies website, https://spinningbabies.com

Asynclitism refers to the position of a fetus in the uterus such that the head of the baby is presenting first and is tilted to the shoulder. Asynclitism means asymmetrical. It’s when a baby’s head is tipped towards one shoulder. The tipped head has a harder time passing through the narrow part of the pelvis, the ischial spines. Labor becomes longer, and sometimes baby doesn’t fit out the pelvis. Happily, we have techniques for this problem!

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The baby who is asynclitic after engagement is at a disadvantage. Soften and balance then get upright for stronger and more effective surges to bring baby down.

Early in labor, the baby’s head enters the brim of the pelvis in asynclitism, tipped, to get around the protruding base of the spine (sacral promontory). Early in labor, before 3 cm, asynclitism is normal and desired.

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Normal asynclitism helps baby engage by navigating the sacral promontory.

At 3 cm, when the nurse checks the cervix, she’ll notice that the baby’s head is closer to the mother’s front (usually). There is space between the baby’s head and the mother’s sacrum in back. We are reassured, as long as the forehead doesn’t overlap the pubic bone (in which case, we help the baby engage in labor).

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Normal posterior asynclitism – this just means baby’s head now tips below the sacral promontory.

By 4-5 cm, the head has usually filled in the space in the pelvis evenly.  There will be more room in the back, but the side to side angles of the head match. The head has become symmetrical inside the pelvic canal. The head is synclitic.

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Now baby is synclitic and about to rotate on the pelvic floor (not shown) See the “seam” or suture of baby’s skull bones in the transverse diameter. First time Zala is about 5 cm now.

Asynclitism becomes a problem when the head is still tipped at, and after, 5 cm dilation.

Discovering asynclitism in labor

The nurse, doctor, or midwife may notice the asynclitism during a vaginal exam.

The cervix will be thicker on one side and thinner on the other side (NOTE: thicker in front is normal, in my experience, and I don’t worry too much about that). The baby’s head will seem a little lower and closer to the bones on the thin side. The baby’s head will seem to angle away, deeper into the pelvis and less close to the mother’s bones on the thick side. The nurse will have to think about it, so ask her to check for this before or during the vaginal exam.

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The baby’s head is asynclitic. On one side there is more head coming down, and less cervix. On the other side there is more cervix but less head. I’m not talking front to back, but rather, side-to-side.

Labor with an asynclitic baby

If the bag of water releases suddenly with a strong contraction, there is a possibility that the baby’s head comes down to the mid-pelvis while still asynclitic. Asynclitism may be caused by a hand near the face, or if muscles are imbalanced a twist in the lower uterine segment, causing the baby to twist to fit the area. More typically, the pelvic floor is asymmetrical and so the head gets tipped as it is pressed down with strong contractions on the uneven edges of the opening to the pelvic floor.

Labor is often longer. Sometimes the labor pattern is a fast dilation to about 8 cm and then slow to get to 10 cm. Other times, when a hand is up, things may be slow throughout dilation. Pushing tends to go very slow – the baby can’t help get born in this position. The head is angled wide and the baby can’t wiggle down because the neck isn’t lined up with the spine. Zala has to do the work.

Dilation often takes longer and there can be a delay in progress at about 8-9 cm or 9 1/2 centimeters for many hours.

A mother may feel pain to one side. She may have significant pain in one hip. Hip pain may also be from one of the baby’s arms being up along the head or a spasm in the muscles within the broad ligament.

Contractions are often strong throughout, unlike the ebb and surge of a posterior labor (though that can happen, too).

Longer second stages

It not unusual for second stage to last 3-6 hours when the head is tipped. I’ve also attended first-time mothers with second stages 2 and 3 times longer than this.

The baby can develop a caput. This doesn’t necessarily mean that the baby won’t fit. Often, the baby requires the mother to change position frequently (maternal positioning) to open the pelvis. Spinning Babies pays attention to the “soft tissue” anatomy (muscles, fascia, ligaments) in the midpelvis and muscles to the pelvis.

What should I do for Asynclitism?

·       Do the Pelvic Floor Release (Side lying Release)

·       Follow with the lunge (the lunge will work better after the pelvic floor/sidelying release)

·       Doing the Dangle should follow the Pelvic Floor Release and the lunge.

·       Sometimes resting and not pushing at all through 2-5 contractions helps molding. Rest in a Rest Smart position.

·       Vertical positions, such as standing and slightly bending the knees during a surge

·       Stand with one foot on a stool

·       Sit on the toilet with one foot on a stool and the other foot on the floor

·       Pulling on a towel or rebozo during pushing contractions

·       “Shake the apple tree” by shaking the mother’s buttocks in the same speed you would shake a branch to make a ripe apple fall

·       Keep moving during a contraction (it’s ok to rest, but don’t “freeze” your body with tension)

Eating small amounts and drinking warm honey tea helps keep labor contractions strong enough to keep moving the baby.

Lying down in one position is not likely to allow the baby to descend further downward. Very specific and persistent techniques are often necessary.

As long as we are talking about what to do, please look into craniosacral therapy and pediatric chiropractic for baby after birth. They should know the special techniques for babies. This can be very helpful with the breastfeeding latch.

 Asynclitism means asymmetrical. It’s when a baby’s head is tipped towards one shoulder. The tipped head has a harder time passing through the narrow part of the pelvis, the ischial spines. Labor becomes longer, and sometimes baby doesn’t fit out the pelvis. Happily, we have techniques for this problem!

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The baby who is asynclitic after engagement is at a disadvantage. Soften and balance then get upright for stronger and more effective surges to bring baby down.

Early in labor, the baby’s head enters the brim of the pelvis in asynclitism, tipped, to get around the protruding base of the spine (sacral promontory). Early in labor, before 3 cm, asynclitism is normal and desired.

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Normal asynclitism helps baby engage by navigating the sacral promontory.

At 3 cm, when the nurse checks the cervix, she’ll notice that the baby’s head is closer to the mother’s front (usually). There is space between the baby’s head and the mother’s sacrum in back. We are reassured, as long as the forehead doesn’t overlap the pubic bone (in which case, we help the baby engage in labor).

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Normal posterior asynclitism – this just means baby’s head now tips below the sacral promontory.

By 4-5 cm, the head has usually filled in the space in the pelvis evenly.  There will be more room in the back, but the side to side angles of the head match. The head has become symmetrical inside the pelvic canal. The head is synclitic.

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Now baby is synclitic and about to rotate on the pelvic floor (not shown) See the “seam” or suture of baby’s skull bones in the transverse diameter. First time Zala is about 5 cm now.

Asynclitism becomes a problem when the head is still tipped at, and after, 5 cm dilation.

Discovering asynclitism in labor

The nurse, doctor, or midwife may notice the asynclitism during a vaginal exam.

The cervix will be thicker on one side and thinner on the other side (NOTE: thicker in front is normal, in my experience, and I don’t worry too much about that). The baby’s head will seem a little lower and closer to the bones on the thin side. The baby’s head will seem to angle away, deeper into the pelvis and less close to the mother’s bones on the thick side. The nurse will have to think about it, so ask her to check for this before or during the vaginal exam.

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The baby’s head is asynclitic. On one side there is more head coming down, and less cervix. On the other side there is more cervix but less head. I’m not talking front to back, but rather, side-to-side.

Labor with an asynclitic baby

If the bag of water releases suddenly with a strong contraction, there is a possibility that the baby’s head comes down to the mid-pelvis while still asynclitic. Asynclitism may be caused by a hand near the face, or if muscles are imbalanced,  a twist in the lower uterine segment, causing the baby to twist to fit the area. More typically, the pelvic floor is asymmetrical and so the head gets tipped as it is pressed down with strong contractions on the uneven edges of the opening to the pelvic floor.

Labor is often longer. Sometimes the labor pattern is a fast dilation to about 8 cm and then slow to get to 10 cm. Other times, when a hand is up, things may be slow throughout dilation. Pushing tends to go very slow – the baby can’t help get born in this position. The head is angled wide and the baby can’t wiggle down because the neck isn’t lined up with the spine. Zala has to do the work.

Dilation often takes longer and there can be a delay in progress at about 8-9 cm or 9 1/2 centimeters for many hours.

A mother may feel pain to one side. She may have significant pain in one hip. Hip pain may also be from one of the baby’s arms being up along the head or a spasm in the muscles within the broad ligament.

Contractions are often strong throughout, unlike the ebb and surge of a posterior labor (though that can happen, too).

Longer second stages

It not unusual for second stage to last 3-6 hours when the head is tipped. I’ve also attended first-time mothers with second stages 2 and 3 times longer than this.

The baby can develop a caput. This doesn’t necessarily mean that the baby won’t fit. Often, the baby requires the mother to change position frequently (maternal positioning) to open the pelvis. Spinning Babies pays attention to the “soft tissue” anatomy (muscles, fascia, ligaments) in the mid-pelvis and muscles to the pelvis.

What should I do for Asynclitism?

·       Do the Pelvic Floor Release (Side lying Release)

·       Follow with the lunge (the lunge will work better after the pelvic floor/side lying release)

·       Doing the Dangle should follow the Pelvic Floor Release and the lunge.

·       Sometimes resting and not pushing at all through 2-5 contractions helps molding. Rest in a Rest Smart position.

·       Vertical positions, such as standing and slightly bending the knees during a surge

·       Stand with one foot on a stool

·       Sit on the toilet with one foot on a stool and the other foot on the floor

·       Pulling on a towel or rebozo during pushing contractions

·       “Shake the apple tree” by shaking the mother’s buttocks in the same speed you would shake a branch to make a ripe apple fall

·       Keep moving during a contraction (it’s ok to rest, but don’t “freeze” your body with tension)

Eating small amounts and drinking warm honey tea helps keep labor contractions strong enough to keep moving the baby.

Lying down in one position is not likely to allow the baby to descend further downward. Very specific and persistent techniques are often necessary.

As long as we are talking about what to do, please look into craniosacral therapy and pediatric chiropractic for baby after birth. They should know the special techniques for babies. This can be very helpful with the breastfeeding latch.  End of quoted text.

Added on December 12th:

We tried many of the above maneuvers, though nothing worked for long.

Her midwife suggested an epidural at this point, her reasoning being that maybe labor wasn't progressing because Zala was so depleted. They had started an IV so they could re-hydrate her, which made Zala feel so much better, but didn't restore the rushes or encourage dilation. I suggested that the epidural be postponed which the midwife thought about for a moment and then agreed with. I suggested that perhaps a short term drug like Fentanol might give her the rest she needed without pulling out all the big guns, so to speak. After this, the midwives and nurses included me in all their conversations, asking for my advice or input along the way. As the couple's advocate I often turned to them, explaining what had been said and giving them full autonomy in the process. This was paramount to me.

One nurse in the room said that if she had known who I was she would have felt quite intimidated by me; (the midwife had actually trained under me in a birthing clinic in the city while she was still in school and knew about my book, Ma Doula: A Story Tour of Birth, and had obviously talked about it at the nurses' station.) This particular nurse however, had absolutely impressed me with her brilliant knowledge of how to correct mal-presentations. This was new to me. It was brilliant, groundbreaking stuff. I told her she should publish this. 

When she said that she would have been intimidated by me, I couldn't disagree more: what she was doing in this hospital and teaching new methods of correcting a mal-presentation actually blew me away. I was genuinely in awe of this lady and I told her so. I had never seen anything like it and had a lot to learn from her. Then I quoted something Ina May Gaskin once said, "If you meet someone who knows more than you do, you just shut up and listen." Exactly! I might never have an opportunity like this again. One thing that she addressed was the shape of Zala's pelvis. 50% of African women have an Android pelvis which could be what we were dealing with here. I had heard of this and had a bit of a guess that this was possible. So many women in Africa experience the horrific complications of this (when a C-section is not  available) that they not only loose the baby, but even if they themselves survive delivery, often their anatomy is compromised by a fistula and other damage and they are rendered incontinent. This becomes a permanent condition without surgery to correct it. see https://www.youtube.com/watch?v=93JdSmRqsNc

From another, reputable source:
The Android pelvis. It has a heart-shaped brim and is quite narrow in front. This type of pelvis is likely to occur in tall women with narrow hips and is also found in African women. The pelvic cavity and outlet is often narrow, straight and long. The ischial spines are prominent. Women with this shape pelvis may have babies that lie with their backs against their mothers’ backs and may experience longer labors. It is important that these women take an active role during their labor and need to squat and move around as much as possible. 

The Gynaecoid or genuine female pelvis. It has an almost round brim and will permit the passage of an average-sized baby with the least amount of trauma to the mother and baby in normal circumstances. The pelvic cavity (the inside of the pelvis) is usually shallow, with straight side walls and with the ischial spines not so prominent as to cause a problem as the baby moves through. 

The Anthropoid pelvis. It has an oval brim and a slightly narrow pelvic cavity. The outlet is large, although some of the other diameters may be reduced. If the baby engages in the pelvis in an anterior position, labor would be expected to be straightforward in most cases. 

The Platypelloid pelvis. It has a kidney-shaped brim and the pelvic cavity is usually shallow and may be narrow in the antero-posterior (front to back) diameter. The outlet is usually roomy. During labor the baby may have difficulty entering the pelvis, but once in, there should be no further difficulty.

Many women are concerned that their pelvic capacity may be limited and that they will therefore have difficulty in giving birth. The true capacity of the pelvis will only be realised during labour. Only the forces created by mother and baby during birth will allow the pelvis to open to its full potential. This may take some time, but it is the only true way of exploring the “fit” between the mother and baby during birth. ~ end of quote on pelves (plural of pelvises.) 

******

And then Zala's temperature started creeping up. And after that her blood pressure crept up, though ever so slowly. And the baby's heart rate soon followed suit. What was going on here? Her urine was also pink at this point, though we knew she wasn't dehydrated. No one could put their finger on what was going on here. That's when Zala mentioned that she thought the amniotic fluid that continued to drip smelled funny to her. Smart lady.

Bingo! The next thing I knew, a special team showed up to both analyze the infection, now being called sepsis, determine what kind it was, and isolate it or confine it to this room only. This hospital is on the ball, I thought to myself. 

From some articles on sepsis explaining that the baby can get the infection from the mother before or during delivery: The following increase an infant's risk of early-onset bacterial sepsis: GBS colonization during pregnancy, infection of the placenta tissues and amniotic fluid; Neonatal sepsis can be caused by bacteria such as Escherichia coli (E coli), Listeria, and some strains of streptococcus. Group B streptococcus (GBS) has been a major cause of neonatal sepsis. However, this problem has become less common because women are screened during pregnancy. The herpes simplex virus (HSV) can also cause a severe infection in a newborn baby. This happens most often when the mother is newly infected. Early-onset neonatal sepsis most often appears within 24 to 48 hours of birth. The baby gets the infection from the mother before or during delivery. The following increase an infant's risk of early-onset bacterial sepsis: GBS colonization during pregnancy, preterm delivery, water breaking (rupture of membranes) longer than 18 hours before birth, infection of the placenta tissues and amniotic fluid (chorioamnionitis,) etc. ~ end of article.

Without having the luxury of an instant diagnosis--the blood work could take hours to get back--the midwives and now their consulting OB doctor laid out the options which continued to dwindle by the minute. What it all came down to was: A. we could wait for the labs to get back, but if they were positive, then baby would have to go to the NICU (neonatal intensive care unit) immediately upon delivery or, B. If baby was delivered now, s/he could stay with Zala and bond, most likely be treated in the room with Zala, and not have to be separated. The team would deal with the infection in the most appropriate way as the results of the labs came in. At this point the surgeon came in and explained all this to the couple. He did't rush and I must say I have never seen such respect from a doctor before. He could not have been kinder.

This was not a case of going to the hospital and having all the interventions domino into a C-section. This couple could not have done anything differently or better. The doctor explained that the uterus was fighting this freak infection and couldn't function normally by producing effective contractions or appropriate dilation. Now we knew what we had been dealing with all along. It dawned on me that if this couple were back in East Africa where they were born, the odds of Zala and baby surviving were not good at all. They were just as good as nil. They might have become a WHO (World Health Organization) statistic. 

Her doula, Isa, and Dad were given scrubs to put on and went into surgery with her. I could have gone in, though I would have bumped her doula who I knew needed as much experience as she could get and was only at the beginning of her career. I had seen dozens of Cesareans and as much as I wanted to see their baby being born, I didn't want to take this away from Isa. 

Within an hour Zala was in recovery. We all sighed a huge sigh of relief and said our prayers of thanksgiving. I got to see the new little family in recovery. Daddy had baby on his bare chest. He was on cloud 9, totally smitten with his new baby girl who was peacefully sleeping. After a couple more days they could go home and start their new lives as parents.

Zala, you are my hero and I love you so much. All that pure love and energy to birth your child. Thank you for sharing that with me.
I count my blessings.

To leave comments at this blog, please email me at: ssskimchee@gmail.com