Last night I watched the British PBS TV series’ 2013 Holiday
Special “Call The Midwife!”* At one point we see the drama being played out
between one young couple as the mother goes into labor while our dad-to-be is
suffering symptoms of what was referred to back then as ‘shell-shock’ which we
now recognize as PTSD after his stint in the Korean War. As soon as their baby
girl is born, the wise midwife hands the baby not to the mother, but to the
father. He sees blood, one of the ‘triggers’ that has been setting him off
since the war, but this time it is “good blood” as the midwife tells him. He is
healed as he holds his tiny miracle. His wife has been through the worst with
him and now he is no longer the victim and not only supports her but shares
this amazing gift of life with her. It is a very moving moment. (Below: your doula says, "Please remove your shirt, your Highness")
It struck me as quite a coincidence as I watched it since I
had been thinking very much about two recent births I had attended as a doula
in the past 3 weeks. Under two very different circumstances both mothers were
not able to hold their newborns immediately after birth and their babies, in
both cases had been brought and left alone on warmers at the other end of the
room. Only a month ago I had the privilege of meeting and spending time with
Dr. Nils Bergman, a researcher from South Africa, at a summit in Minneapolis.
He speaks all over the world about his findings concerning skin-to-skin
contact, especially the benefits to premature infants. He goes so far as to say
that preemies will actually do better if ‘kangaroo care’ is introduced
immediately at birth and we do away with incubators all together. My own
research into bonding or maternal-infant-maternal** attachment (see my book Stone Age Babies in a Space Age World:
Babies and Bonding in the 21st Century© – publication pending) also points to Zero
Separation at all births and is now being scientifically confirmed by Dr.
Bergman’s studies and others.***
In the first of these two births a couple from Spain who are
living in Minneapolis asked me to be there doula toward the end of their
pregnancy. We were able to squeeze in two visits before her labor began. It was
their first birth. The mom had been dealing with multiple chronic health issues
and was quite successful in controlling many of them with natural methods. They
had really done their homework and were determined to have a natural birth. We
put together a birth plan listing all of their wishes and all of the things
they hoped to avoid, though they were very realistic about the possibility of
interventions in their case in particular.
They called in the middle of a snowstorm a week later. I met
them at the hospital as the nurse was hooking up a monitor on her belly. Baby
sounded fine. We had been put into a triage room. This particular hospital felt
that so very many couples were coming to the hospital far too early and were
being sent home to labor until contractions were closer to 5 minutes apart which
would ensure that they were indeed in active labor. This way only the exam
rooms would need to be ‘broken down’ and sanitized and not an entire birthing
suite had they been immediately roomed there. So her midwife was called and
luckily she was in the hospital and walked right over to check the mom’s
dilation. We were breathing through each contraction which were very regular. I
thought Conchetta
was handling this stage very well and expected to hear she was two, or
maybe 3 or 4 centimeters along at this point, being a first baby. When the
midwife announced that she was 8 already and, all in one breath indicated that
we were moving into a regular room, like IMMEDIATELY, I was surprised. This
lady should have written the book about dealing with first stage labor!
With a flock of nurses now setting up the room and the
midwife gowning up I continued to breathe with Conchetta. With the next
contraction she instinctively pushed for all she was worth. I knew she didn’t
need to be checked again, but the midwife wanted to be sure she was fully
dilated, which of course she was. Two more mega pushes and the head was born.
Another contraction and their beautiful baby girl slid out followed by a rather
impressive river of blood. It looked like a lot to me, so I waited to see how I
should help and back up the midwife’s next move. The nurses also saw that there
would be something other than the regular plop-baby-on-mom’s-tummy program
happening next and brought the baby to the warmer after hastily clamping the
mother’s end of the cord and cutting baby loose.
The dad had never seen a birth so he thought this was all
very normal and routine. He would be OK for a few minutes I figured, so I went
over to the warmer. Their baby was doing beautifully with a #10 Apgar score and
the midwife was talking to Conchetta while the nurses were hooking up an IV
with Pitocin and fluids. I was mainly concerned that baby not be left alone.
Especially after my own work on bonding and the summit by Dr. Bergman I was
completely convinced that babies are born fully expecting a continuum of
contact and that there should be Zero Separation from now on. Not only are
human babies fully hard-wired with this expectation, but they will not thrive unless this is provided. We are the only
mammals that consciously defy Nature and dress and take our baby mammals away
from their maternal environment at birth. The consequences are dire.
Researchers are now even going so far as to suggest that many if not all of the
multitude of developmental disorders that are mysteriously proliferating in our
century in spite of all our advanced
science and medical knowledge may very well be caused by this unnecessary separation. And I would posit even
further that we are looking at what is called iotrogenic disease which is now resulting in a doctor-induced
diseased generation.
I thought now, “What do we do with baby?” No one was paying
much attention to her at this point. All of the drama was across the room while
everyone was trying to figure out where this hemorrhage was coming from. So I
loosely wrapped up baby, replacing her soggy little hat with a dry one while I
talked to her. I held her close and went and got her Dad where he was still
standing at the head of the bed by his wife. The midwife was trying to sound calm
and reassuring as she explained to them that she was poking around down there
trying to find the source of this bleeding. I walked back to the other side of
the room with Dad and motioned for him to sit down in the rocking chair by the
warmer. I suggested he take his shirt off and keep his baby nice and warm and
skin-to-skin until Conchetta could get her back. He did what I asked
immediately. I find that dads are especially compliant at this stage and will
do absolutely anything I ask them to. I could have just said, “strip” and he
would have, I am sure!
His baby girl had already started blowing bubbles and
rooting around while I picked her up. I told him she already knew him and his
voice and was smelling him as she got to know him. The look on his face said it
all. He was smitten. As she cuddled into his chest I could tell he had probably
never held an infant. Then she started throwing her head back and wiggling. I
told him just to hold her as I wrapped them both in blankets. When she reached
the point where her head was cradled in the crook of his arm and her cheek was
touching his furry chest, she stuck out her tongue and started licking his
nipple! I giggled, but Dad looked up at me with tears in his eyes. He
completely melted. I just repeated to him that she knows him and needs to stay
with her parents. In the meantime, the room had now filled up with a couple of
OB doctors and additional nurses.
They had found the source of the bleed. Its
apex was behind the cervix in the posterior or back vaginal wall that rides
above the rectum. One of the medical issues that Conchetta had been dealing
with was a problem with the clotting factor in her blood. Because her baby had
descended down the birth canal so very quickly, where most women would have
stretched slowly as the baby’s head molded, her ‘friable’ tissues had simply
parted and broke open. This was about the worst 4th degree tear I
had ever seen. They were tying off the bleeding veins and soon had the
situation under control.
Time passes outside of our usual frame of reference during
emergencies. It had only been 20 minutes or so but felt like hours from my
corner of the room. Dad did not really have an inkling of what was going on and
I was glad I could reassure him and get him and baby away from the electric
vibes on the other side of the room and actually create a safe or sacred space
for his baby during this time. I kept wondering what my friend Nils Bergman or
his ‘kangaroola’ wife Jill would have done in my place.
Within an hour we were able to get baby onto her mother’s
chest where she immediately raised her head and latched on the first try
without any direction from us. I visited this couple the next day in the
hospital and the day after that at home and both times found the Enriké still holding his baby
with his shirt off. I doubt very much he had put her down at all in the interim.
I marveled that this was indeed continuum bonding as I had rarely seen it since
becoming a doula. How could I do this more? How could this affect father-baby
bonding especially? I did not have long to wait to find out.
A week later I was at a birth at a different hospital with a
couple who were living in one of the highest crime-ridden neighborhoods in the
city. You can automatically add on social and economic poverty to the list of
things this family was dealing with. It was this mom’s third baby, though it
was his first. He was clueless. But it was
his baby and he was going to give it a shot. Unfortunately, the African
American community continues to struggle with the highest rates of absentee
fathers in the nation. According to 2011 U.S. Census Bureau data over 24
million children live apart from their biological fathers. That is 1 out of
every 3 (33%) children in America. Nearly 2 in 3 (64%) African American
children live in father-absent homes. One in three (34%) Hispanic children, and
1 in 4 (25%) white children live in father-absent homes. In 1960, only 11% of
children lived in father-absent homes.
Children who live absent their biological fathers are, on
average, at least two to three times more likely to be poor, to use drugs, to
experience educational, health, emotional and behavioral problems, to be
victims of child abuse, and to engage in criminal behavior than their peers who
live with their married, biological (or adoptive) parents.
I knew all this already, but wondered if there wasn’t a
possibility of perhaps connecting some of the dots here by finding a way for
dads, especially ones who didn’t have a mutual agreement of commitment yet in
place, as in being married to the mother of their child, and if by better,
earlier bonding these statistics might be reversed. While I was busy pondering
this, I was referred to this particular family.
I was able to meet with Sh’neice four times in the weeks
before her guess date, (formerly called the due date.) I collected baby clothes
from friends for her and made sure she was connected to WIC and any other
services that they could use. She was taking very good care of herself and her
other kids and we had enjoyed getting to know each other.
I went to her last
prenatal clinic visit with her at her request. She had hoped to have a chance
to have a VBAC but her OB wasn’t budging. In the end the doctor convinced her
that after 2 C-sections already, this was the best choice for her. At this
point as a doula this is not my call. As much as I would love to support her
having a VBAC, it would only undermine her physician’s relationship with her,
and also be outside of my current scope of practice. I bit my tongue. Hard.
I met her at the hospital on the appointed day at 7 a.m.
When she was finally wheeled down to the OR at 11:00 her boyfriend and I put on
our scrubs that the nurse had handed us. They wanted us to wait while they did
the epidural and prepped her for surgery. Then someone would come and get us.
He looked at himself in the mirror and I could just barely hear under his
breath, “I will not faint… I will not faint.…” I then realized that this was
his first-ever birth. Was there any way I could involve him and have him feel
intimately a part of this birth? It was easy when a dad is at an all-night
birth and I can have him rubbing her back, fetching juices, wiping her face with
cold rags and walking the halls for hours on end, but this was all going
according to protocol and I didn’t know what I could do to fit him into this
picture. I did all the usual things I did at C-sections like having him take
pictures as his baby is brought to the warmer and hold his baby’s hand or foot
as they assess her. I also direct him when he is finally holding his baby back
to mom and help her also hold her baby. Sh’neice was still quite uncomfortable
and the doctors had a lot to do to repair not only this incision but also deal
with extensive scar tissue from 2 previous Cesareans, so she was not ready to
hold her baby when he did return.
Dad was happy to just sit there holding his
fat bundle where she could see him. I checked in with him periodically to make
sure he was OK. He did really well, which I made sure to let him know I
thought. It was finally time to move into the recovery room so we all
followed the bed out of the OR and down the hall, Dad proudly carrying his very
own baby now. As soon as we got there Sh’neice began vomiting, which is not all
that unusual after surgery. She still was not ready to hold her baby and I
didn’t think I should push her at this point but rather thought to let her take
her time to recover.
I am definitely going to keep this in mind for my next
births. I think we are on to something very significant here. Stay tuned!
This and other stories will be appearing in my forthcoming
book, Call The Doula! a diary©
pending publication.
*a true story re-enactment of a diary written by a novice
midwife sent to the notorious East End of London to practice in the 1950s.
**I now insist on using the term ‘maternal-infant-maternal’ attachment, instead of the former,
‘maternal-infant attachment’ to exemplify the fact that the infant is also
displaying cues and instincts that he expects will be reciprocated, despite the
persistent thinking by some doctors even into the 21st Century that
bonding is only ‘one-way’ or that the majority of bonding is from mother to baby if not exclusively initiated by
her. Dr. Bergman and many other researchers are now proving unequivocally it is
indeed otherwise.
***See: http://www.skintoskincontact.com/dr-bergman.aspx
for Dr. Bergman’s mission statement.
