A chapter from the next book: Раиса Рождение - Raïssa’s Birth

I received a call very early one morning from one of the midwives that I had occasionally worked with. She asked if I was still doing postpartum jobs and I said that yes, absolutely I am. She went on to explain the situation she was in. One of her clients had delivered the day before and was ready to discharge from the hospital but was having some pretty hard issues to deal with and she had recommended that they hire a postpartum doula to help at home while they resolve what was going on.

She explained that Raïssa had been adopted from Russia as a toddler. Her adoptive parents lived nearby in Minnesota but were older and couldn’t move in to help her because of their own health problems. Apparently while she was little, sometime before she the adoption, she had been treated with what they figure was too large of a dose of antibiotics for a minor complaint. An entire course of meds at the elevated levels had affected the nerve endings in her mucus tissues, making them hypersensitive and painful. As an adult it made intercourse virtually impossible, without first numbing the area with xylocaine jelly. At times even that was not effective enough.

When they married Raïssa and Serge agreed that they would find a way that they were both happy with. Both graduate students at the University of Minnesota, they were looking at three to four more years of research and study before graduating. They had agreed to talk about starting a family after that, so when Raïssa discovered she was pregnant, it changed all their plans. Though she continued going to school right up to the end of her ninth month, she decided to take six months off to be with their baby at home after the birth. She could always make up the classes later, but babies just don’t stay little forever.

She was extremely suspicious of any medications since that one course of antibiotics had wrecked such havoc with her system so long ago, so when they started talking about birth with their midwife, Raïssa was determined to have her baby naturally, no matter how painful that might prove to be.

Some facts about vulvodynia:

Recent studies place the occurrence of vulvodynia somewhere between 9.2 % - 16% of women in the U.S. The term is also used to refer to vestibulitis or Vulvar Vestibulitis Syndrome (VVS), which is an inflammation of the vestibule, or opening into the vagina and the tissues immediately around the vaginal opening. This condition is sometimes also called 'vestibular adenitis'. Often the edges of the inner vaginal lips are very sensitive and the pain so severe that it makes walking difficult. Some cases of vulvodynia (pronounced vul-vo-DY-nia) may be due to compression or disease of the pudendal nerve, one of the main nerves that relays sensation to and from the genitals. Symptoms can range in severity from mild to severe. Burning, itching and pain are experienced in the skin of the vaginal entryway and sometimes the labia or clitoris.

Dr. St. Amand, MD, specializing in fibromyalgia and author of What Your Doctor May Not Tell You About Fibromyalgia believes that all women with chronic vulvodynia have a form of fibromyalgia. He discovered that at least 11% of his female patients with fibromyalgia also have vulvodynia (painful genitals). The guaifenesin therapy for chronic fatigue enhances oxalate crystal excretion which has been shown to be beneficial in vulvodynia also. Reducing the amount of oxalate in your diet may be helpful. Things to avoid include tea, spinach, beer, berry juices, baked beans in tomato sauce, peanuts, peanut butter creams, pecans, soybean curd, Concord grapes. In addition, do not take more than 250 mg of vitamin C per day as it may contribute to oxalate formation. Restrict or limit milk or dairy products to reduce the amount of calcium oxalate in the body. Calcium citrate may prescribed to neutralize high blood or urine levels of oxalate.

Soothing relief may be obtained by applying warm soaked tea bags to the area. This can be done by placing the tea bags on menstrual pads to hold them in place or you can take a sitz bath in which tea bags have been soaked. To relieve pressure on thevulvar area when sitting you may use a pressure relief cushion, sometimes called a “donut” pillow. Biofeedback and pelvic muscle exercises involving relaxation and muscle strengthening may be helpful. Surgical treatment may include removal of painful areas such as the vulvar (Bartholin's) glands, decompression surgery of the pudendal nerve to free the nerve and its branches (from compressions due to blood vessels and veins, damaged tissue, and ligamental grip), and/or laser therapy to destroy underlying vulvar blood vessels.

            Their midwife was ecstatic that the birth went so well, but she became concerned, afterwards when most moms feel like they could tackle the world, Raïssa’s pain level continued to go up, instead of down. They had tried everything they could think of including herbal baths, sizt baths, heat, ice, lidocaine injections, and xylocaine jelly applications, but nothing worked as the pain level continued to escalate. Raïssa finally agreed to try non-prescription muscle relaxants which took enough of an edge off the pain to let her sleep for an hour or so at a time, but then the pain came roaring back. Her midwife wanted her to return home where she hoped that her husband could support her and that I could somehow re-introduce her baby back into the picture.

            The ride home alone was torture. I started the tub as soon as we got there. It seemed to give Raïssa the most relief, though she couldn’t stay in the tub forever. I brewed up a gallon of our own postpartum bath herbs in a large soup pot to add to the water. It contained lavender comfrey, rose petals, calendula, plantain, yarrow, uva ursi, and sheperd’s purse. Other blends on the market also include sea salt, peppermint or red raspberry leaves and other ingredients. It is safe for babies, too, so often that will be baby’s first bath with mom even before they leave the birthing center to go home. I like to put the herbs in a large jelly bag before I brew them and then hang the bag over the pot to finish draining before I pour it in. I also poured a few tablespoons of the tea onto maternity size sanitary pads and put each one into its own new Ziplock freezer bag to apply during the night.

            Before Raïssa got out of the tub an hour later I asked if I could come into the bathroom. I scrubbed her arms and legs and back, and then massaged over each part again with warm olive oil. Then I helped her out and pat her dry. She still could not bend or walk without pain. I got her into bed and surrounded her with pillows, hoping to work on relaxing first. Then we got Baby arranged next to her where he could nurse. At least that didn’t hurt her. When he stopped sucking and fell asleep I moved him to a place I had made for him at the head of the bed so he was still nearby, but she could move if she needed to.

            I picked up around the bedroom and noted the time. I wasn’t going to let her sleep all night in one position, that wouldn’t help anyone. I suggested she try the bathroom about an hour later. She did not want to get up but I explained that she needed her bladder empty to help her uterus to continue to contract. She slowly got up. I tried to talk her through each step and reminded her to breathe. She was holding her breath with each step, anticipating the pain and barely moving anything, including her arms. Her shoulders were contracted, frozen, along with her arms and neck. I had her just stand by the bed and suggested we relax there before going any further. I took one hand and slowly massaged it while I talked to her: “Relax your jaw first. Good, that’s it… now your shoulders… yes, more….” Then we breathed slowly for a couple of minutes. Next I had her do a few Tai Chi arm sweeps. Now we could walk to the bathroom. I had made up another gallon of my postpartum brew and filled a pitcher with it for her to pour over herself as she peed. It worked wonderfully, minimizing the pain.

            During the night I helped her arrange herself and Damian so he could nurse. Then I would change and burb him, get her to the bathroom once more and help her back to bed. Serge manned the kitchen bringing in juices and snacks whenever Raïssa was awake. 
            On day two their midwife stopped by to see how everything was going. She felt that Damian seemed slightly jaundiced and suggested waking him up every two to three hours to nurse which would help clear out his liver and resolve the problem. She also suggested putting him near a sunny window throughout the day, preferably without any clothes on if the house was warm enough. Before she left she told me she thought Raïssa should try walking around and insisted that she not stay in bed all day, maybe getting up in a chair with the donut pillow in the living room for a while.

            Before breakfast I drew another bath with herbs for her. While she was in the bath, Serge spent time with Damian while I made us pancakes for breakfast. Later in the day her sister came by. She was amazing, helping Raïssa walk around the house, then washing her hair for her, doing laundry and changing the sheets. I think I managed to talk her into consider becoming a doula.

            We had a few setbacks as Raïssa tried to stop the medications she had finally agreed to back on day one, but we gained back that ground and more over the next few days. Our midwife called in to touch base once a day. When she called later in the day on day three I told her Raïssa was doing great. I said we were doing jumping jacks now! (We weren’t.) Her sister and I continued using massage and guided breathing before, during and after Raïssa got out of bed or transitioned from the chair. I never felt at any time that she was over-reacting or playing the drama queen. I was glad I could help her that first week. She is really one amazing mama!

  

 "Relax, nothing is under control" ~ Adi Da Samraj


Stay tuned for more chapters from the next book!