Welcome Dr. Dennis Hartung!

BlogIcons_MeetStaffWe are so thrilled to introduce you to the newest member of our team: Dr. Dennis Hartung. Dr. Hartung joined our practice in January 2015. Many consider Dr. Hartung a legend in the Twin Cities birth community. He has a reputation not only for being a stellar OB/GYN, but also for being very supportive of natural birth and very empowering of the women and families under his care. He is appreciated by many of his patients for his remarkable calm, caring, approachable, attentive, and down-to-earth bedside manner and incredible skill. Welcome Dr. Hartung.

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What is your role at Health Foundations?

I am an OB/GYN physician. I see patients that need care for their birth at the hospital, but who would like to be seen at Health Foundations. I also offer well woman and gynecologic care, including managing surgery for those who need that as part of their GYN care.

What is your educational background/training?

I received my B.A in Biology at Boston University in Massachusetts. I later earned my Medical Degree at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. I received further OB/GYN training at the Walter Reed Army Medical Center.

Where were you born?

I was born in Billings, Montana in June 1958. I was born in a hospital and don’t know a great deal of detail about my own birth. I heard that my mom did not have a name picked out for me and that she named me after her OB.

Has anyone ever named a child you’ve helped deliver after you?

Not to my knowledge!

Where have you lived beside Minnesota?

I have lived all over the place! Growing up, my dad’s work took us from Billings and Bozeman, Montana to Yuma, Arizona. After my parent’s divorce, we moved west to Salem, Oregon. After that I moved around a lot with the Army to Clarksville, Tennessee; Hampton and Little Creek, Virginia; Brookline and Brighton Massachusetts; North Pole, Alaska (seriously); Ft Campbell, Kentucky; Fort Bragg, North Carolina; Fort Benning, Georgia; and San Antonia, Texas.

My favorite place I’ve lived has to be North Pole, Alaska. I worked for the Army as a medical doctor up there and our family just loved it there. It was colder, but my wife and I always say that Minnesota/Wisconsin feels colder much of the time in the winter. North Pole was a great place to raise our kids—we had a tightknit and very supportive community. We loved that wilderness was everywhere, all around you. Living in Alaska, you really have to adjust to the rhythms in a place where it is virtually dark 24 hours a day for a few months a year and then light for 24 hours a day for months. You could be out washing your car and realize it was 1am in the morning! But it was just a really cool place to live.

Where do you live now?

Hartung family in Hudson

Hartung family in Hudson

I live in Hudson, Wisconsin. We’ve lived here for 9 years. My wife’s parents live on the east coast and my parents on the West, but neither of their home states really attracted us—they are not particularly doctor-friendly from malpractice and other standpoints. So knowing we wouldn’t live on either coast freed us to look around. We looked in the northern US—we wanted the 4 seasons and a place that didn’t get too hot and humid. I was eligible to retire from the army at this point…so we interviewed for a job here and fell in love with Hudson. We loved the small town feel with proximity to the Twin Cities. It has been a great place for our kids—good schools and after-school activities.

Can you say a little about your family?

I have been married to Linda for 33 years, and we have three kids: Rebekah (28), John (25) and Aaron (21). My wife and I have two cats named Rue and Sega. I have a younger sister named Jani who lives in Turner, Oregon, just outside of Salem.

Dennis and wife Linda, Dominican Republic

Dennis and wife Linda, Dominican Republic

What led you to the Army?

When I was finishing up with high school, I didn’t have the financial means to go to college. My music teacher recommended I audition for the Army band as a flutist and get military college benefits. I was accepted and played flute for 6 years in the army. I received an army scholarship for my education with the expectation that I would serve the army as a doctor when I was done. I spent about 12 years as a student/resident and then about 11 years post-residency as an active duty army physician in OB/GYN care.

Dr. Hartung at military trauma course in medical school

Dr. Hartung at military trauma course in medical school

What is one of your favorite things to do when you are not at Health Foundations?

I am a flutist and still play regularly at church and other times/places that I can. I love gardening, hiking, and canoeing.

Linda and Dennis, annual fundraising gala at church

Linda and Dennis, annual fundraising gala at church

What is one of your favorite restaurants in Saint Paul?

Pizza Luce

If you could get on a plane tomorrow and travel anywhere in the world for free, where would you go?

Ireland. My wife and I went there for our 25th wedding anniversary and were delighted by it. We want to go back sometime.

What inspired you to get into your field?

Being present for the birth of my daughter—our first baby. Our daughter was born while I was in college. We had a hospital birth with midwives and our care was much like what is offered at Health Foundations. Watching my wife go through labor (and later holding my newborn girl skin to skin) had a profound impact on me and really influenced my later decision to become an OB/GYN. At first, when I started college, I thought I wanted to become a dentist because I was fascinated by dental instruments. However, I spoke with some dentists during my college years and they really discouraged me from pursuing dentistry. Then I thought I wanted to go into surgery but I didn’t enjoy my surgery rotation during residency at all. When I had my OB rotation—by this time we had also had our middle son—I just knew that this was a good fit for me and that I wanted to serve women and families as an OB/GYN. 

Hartung family, Dominican Republic

Hartung family, Dominican Republic

 

What is your philosophy on birth?

A woman’s body can do it. Let’s approach it allowing normal physiology to take place without fussing. Then if there are difficulties, begin a stepwise intervention to facilitate a healthy birth, for mom and babe.

What do you wish all Health Foundations families knew? 

THEY CAN DO IT!

What piece of advice or wisdom can you share with pregnant or new mama readers?

In our culture, unsolicited advice and “birth stories” are often told to moms-to-be. People don’t mean to be rude, they often just don’t know what else to say. Humor them, thank them and then let your body do what it was designed to do. Surround yourself with the support you need to get through it.

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Birth Story: “Intense. But incredible.”

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Baby Hamilton’s birth story, as told by mama

I feel very blessed to have had a wonderful pregnancy, birth, and start to life together as a new family of three–and have to thank Health Foundations for providing the support to make it happen. When I became pregnant, I thought how and where I was going to give birth would be a no-brainer–I assumed I would do what all of my friends did: a hospital birth, with my OB, and definitely an epidural (you’d be crazy not to, right?!).

My first trimester was going so smoothly that I became a bit paranoid that I wasn’t really pregnant. So Fran and I kept our pregnancy a secret from everyone until we made it to the second trimester. During that first trimester it felt like a mini honeymoon with Fran because we found ourselves staying in to avoid the questions around why I wasn’t drinking, etc. One night we searched Netflix for anything “baby” and came across “The Business of Being Born.” This documentary opened our eyes to a whole new concept around birth, and spoke to me in a way that really excited me. Fran and I had spent the prior 2.5 years completely changing our approach to health. Essentially we committed to putting health first, starting with our approach to fitness (we joined a Crossfit gym) and then diet (we did a lot of research around the pitfalls of the “standard American diet” and starting to cut out grains and sugars that were inflaming our system and keeping our bodies from burning fat for energy).

We had such a positive experience with this “alternative” approach to health, that I found myself very receptive to an “alternative” approach to childbirth. I have never had a need to go to a hospital before in my life, so I really started to wonder why I should need to be in a hospital now, with all these potential intervention measures, when I was the healthiest I’d ever been in my life and knew that women have been delivering babies naturally for thousands of years? After watching that documentary and a few others, we started doing a lot of reading and research, we toured birth centers and hospitals, and spoke to midwives and my OB about our options. After a lot of debate and consideration, we followed our gut instinct and decided to transfer to Health Foundations when I was 20 weeks in to my pregnancy. The remaining fears I had around being out of the hospital quickly went away as I had my prenatal appointments with the midwives and started taking the child birth education classes.

Okay– now on to my birth story!

When I was 34 weeks along, I got this strong feeling that my baby was going to come early. I don’t know what it was, but I was convinced. So imagine my disappointed when my “due date” came and went, and no sign of baby! I chalked it up to my first lesson in motherhood–I’m on someone else’s schedule now. He calls the shots! So time to temper my expectations and go with the flow. Easier said than done, especially when my biggest fear was getting to 42 weeks and having to go to a hospital to deliver the baby.

When I went in for my 40 week appointment Monica checked me, and she said I was still very posterior. So I spent the week going on lots of walks, got adjusted a couple times, and tried accupuncture. At my 41 week appointment (Tues), Monica swept my membranes, which made me pretty crampy for the next day or so. Through the baby stress test at 41 weeks the baby checked out as healthy and the machine showed that I was having contractions–that was a surprise because I wasn’t feeling them! Encouraging, my body was working away! I also went in for an ultrasound to check on amniotic fluid–all looked good.

On Friday of that week I had my next appt with Monica, and she thought maybe baby’s head was a bit tilted, preventing him from engaging my cervix. So she showed me how to do inversions at home to try to lift him up and off, and then go for walks to get him moving down. Along with that I did more acupuncture, took more walks. No contractions. Went in on Sunday (41 weeks and 5 days) and had the catheter put in and went for a walk. To our surprise, it fell out after 2 hours! I thought maybe I had done something wrong, because it came out but labor didn’t start. Amy had me come back in that evening to get checked and get the castor oil+herbs — which I was to take the next morning if I wasn’t in labor. She said my cervix was in a good spot, but didn’t share with me how dilated it was (we found out the next day that I was 4 cm at that point! I’m glad she didn’t tell me — would have messed with my head I’m sure).

Cramps started to get intense around 6pm on Sunday, after that appointment. We went for a walk and went grocery shopping. I took a bath at 8pm to ease the cramping, and to get ready to go to bed early to try to get some good rest. I was in bed at 9pm, and contractions started then. From 9pm-1am I was able to rest/sleep between the contractions (8-10 min apart). My back was really feeling it, so I put on a hot pack which really helped. Fran was great at telling me to relax, just as we practiced in class.

At 1am I couldn’t lay anymore — contractions were getting more intense, and about 6-8 minutes apart. I tried different positions but all I could handle was standing and leaning against the wall, and then between contractions I found myself pacing the bedroom (with all the adrenaline, I had a hard time relaxing). I had a few unpleasant trips to the bathroom, where I threw up everything in my system. We called the midwife page at 2am, when contractions were about 5-6 min apart. Amy was excited for me that I was going to be able to have this baby without castor oil (I’m pretty sure having that bottle stare me in the face was what started labor) and she listened to me breathe through a contraction. I could still talk through contractions and wasn’t yet vocalizing, so she told me to keep it up and said that next time I call I won’t be able to talk as much.

At that point we called our doula, Sarah, and she came over. She had me take a hot shower, which felt great on my back. And then encouraged me to try laboring on my hands and knees, and start to really focus on resting between contractions (head down on a pillow) and pay less attention to the contraction. This helped me get some much needed rest. Contractions were getting more intense, and I had to fight the urge to pace and lean against the wall like before. Sarah left the room to let me and Fran work through contractions together, and she listened from outside the door. My contractions weren’t following a consistent pattern so after a while in that position, Sarah suggested I pull one leg forward (like a deep runners lunge) and do juicy hip circles (Sarah is also a yoga instructor at Blooma, so she was using cues that she uses in the classes I would go to–which was nice and familiar). I thought she was nuts, because I thought that would be too much, too hard. Between contractions I told her that I was never going to think of those juicy hip circles the same way again! 🙂

But I gave it a whirl — for 2 contractions on each side. Well that seemed to adjust baby’s position, because I definitely started to feel something new, which I later confirmed was the urge to push! I just went with it, thinking I was still more than 3 minutes apart on contractions (I had mentally prepared for a very long labor)–and I didn’t really wrap my head around the fact that I was already through transition. I guess those juicy hip circles in the runners lunge helped me get through that. But apparently my vocalization changed and based on how I sounded, my doula suggested we make the move to the birth center. This was around 4:30am. Sarah got in touch with Amy, who heard me in the background and said “Oh, yep, I’ll be right there!”. We jumped in the car and the car ride was as promised — hard. Luckily there was no traffic and Fran drove very fast!

We beat the birth team to Health Foundations, so I had a contraction or two on the ramp outside the door- -likely waked some neighbors (Sarah found my flip flops in the parking lot, I labored myself right out of my shoes!). Rachel got there first, and we got in the room and had a couple more contractions. I told her I felt my body pushing, so she checked me, and indeed I was 9 cm dilated- with just a lip remaining! She asked if I wanted a water birth, and I said I was open to it (I wanted to let my labor decide what would feel best when the time came). But I really wanted to labor in the tub for some relief. So she started filling the tub right away–though it felt like an eternity before it was full. While I waited, I labored on the bed on all fours, and put my head down on a pillow to rest in between. Fran got emotional at this point, as he was so relieved that we were at Health Foundations and in good hands–everything got so intense so fast! At one point I looked up between contractions and said “tub time?”… I was thinking, let’s do this! I wanted to get in there and be able to move forward with pushing.

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The tub was full, I got in, and the pushing urge was really there — Rachel said I could, but slowly like I had been outside the tub. All in all, I pushed for about an hour (the total time I was in labor at the birth center!) — and our baby arrived! I was on my hands and knees, so Rachel said that once he was born she would push him through my legs and he would swim up to me so I could catch him and bring him out of the water. It was completely amazing. He came swimming through with his eyes wide open–such an incredible feeling to be able to grab him and pull him on to me.

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The birth team was awesome –I was so impressed with all of them. Fran was a champ, definitely benefited from the child birth classes to help prepare. It was tough for him to see me laboring. I am SO glad we had a doula–Sarah was amazing, and really helped at home (where the majority of labor ended up happening). I was surprised that during labor I never questioned my decision to do a natural labor. I was expecting to have doubts and to have to mentally push those thoughts out, but they never came. Also I had been nervous about my umbilical cord being around baby’s neck (I had been told that this is pretty common, but it still freaked me out)–mine ended up being wrapped around his neck once, but it didn’t harm him at all and Rachel was able to easily unwrap it.

In total I’d say I was in labor for 12 hours (including pre-labor)– 6 of which was active labor+pushing. The birth team applauded my ability to control the pushing, and take it slow. I didn’t need any stitches, and both me and baby checked out as healthy and good to go. I will share that when the nurses had me get up for the first time to use the bathroom (after about 3 hours of laying and bonding with baby), I made it to the bathroom but passed out once I got there — I think at the sight of blood (first time I really saw any… and I have a weak stomach). The nurses took good care of me, got me lots of fluids, and back in bed without any issues.

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It was truly an amazing experience. Intense. But incredible. And everyone who has checked on our baby’s health have remarked on how awake, aware, calm, strong, and healthy he is — which was our goal in having a natural birth, and I think only made even better by going with a water birth. And my recovery was smooth and quick, I was excited I didn’t need to have any stitches (even after delivering a 9 lb, 3.5 oz. baby with a 15 cm head — which apparently is in the 99.8th%!).

Special thanks to….

Health Foundations — for providing personal attention and care throughout my pregnancy, and an unforgettable birth experience that helped our family get started in this new life together in a healthy, beautiful, and very special way.

My Husband, Fran — for being fully committed to being my partner through this journey, for being such a strong supporter, and a beautiful father.

My doula, Sarah Auna — for being a strong, calm, beautiful presence and providing support through this amazing process to both me and Fran.

Crossfit St. Paul — for helping me to put health as a top priority, and to learn that my body is stronger and more capable than my head likes to think it is and that I can push through and achieve great things.

Body Workers, Amber (chiropractor) and Adrienne (massage) — for helping me to feel amazing throughout my pregnancy, even at 41 weeks pregnant my body felt great! You helped me truly believe that my body was made to do this and it was all very achievable–and perhaps my swift labor was possible because my body was all good to go!

Blooma — for being a weekly reminder throughout my pregnancy that my body is completely capable of birthing this baby, and for making the journey towards motherhood a special and sacred time. And for introducing me to my amazing doula, Sarah.

My Parents — for raising me to be an intellectually curious, confident woman who feels empowered to make informed decisions

Birth Story: Meeting Finnlee

Finnlee Joan birth story

The birth of Finnlee Joan told by mama Nicole

Since she was 41weeks, I had been getting a little worried that she would never come out, so I requested to work a evening shift of Thursday so I would be on my feet. We had a check in with Monica who gave me a belly band and told me to have a good night at work. Sure enough I started having contractions. I didn’t know what they were (now I know!)– they stopped when I would rest, so I didn’t really concern myself. After three weeks of everyone at work asking me “when are you going to have that baby? I can’t believe you are still at work!?” I was excited to move the process along.

Friday 10/24

Evening comes along and I started to leak- best way I can describe it- my water was slowing breaking. I probably went to the bathroom like 50 time in 4 hours. I was having to convince my husband that my water broke but he was not so sure. We called Monica and she said just to sleep, eat, and the rest will take care of itself.

Saturday 10/25

Morning came and Nick was so excited the baby could be coming, he stayed up until 4am cleaning the house. When I wanted to take a hike at 9am, he was too tired. I called my sister-in-law and we went hiking up the sledding hill by our house, which did cause the contractions to increase but I was still able to talk through them. At this point, I had pulled out all my Health Foundations binders and was looking for all the stages of labor. Also it seemed like in every birth story in the Ina May book, the women went for a hike to keep labor going. I was fearful that the contractions would not ever come consistently because after the walk, they stopped again.

I had been seeing an acupuncturist to try to get the baby out earlier that week so I went to my 2:30pm appointment to get the show on the road. My husband drove to make sure I was safe and to ask the acupuncturist how this whole thing worked. He put the needles in me and he and my husband carried on talking and laughing meanwhile my contractions became much worse and I was not so easy going at this point. We left and I really wanted some ice cream before this labor thing got really intense so we stopped at Culvers. I ate a sundae and before I could get around the block, I had to get him to pull over so I could vomit. I guess it was Mother Nature’s way of making sure I didn’t eat any more bad food.

Recalling that the labor stages book said vomiting means things are moving, I was getting a little nervous. The book was right, I started having contractions every 5 min. But my husband would not let me go to the birthing center until they were 3-1-1, he must have been listening to Rochelle (our childbirth education instructor) during class. I begged him for two hours to leave the house, but it was not until Monica gave him the go-ahead to drive me in at 8:30 pm that he agreed.

We arrived to hear another mama laboring in the other room where another baby was being born. This was a little intimidating until I heard the baby cry, then I was jealous because she had a baby and I had a lot of work to do still. Monica checked and I was 5cm dilated. I asked her how far I was and she said ” you’re far enough you can stay.”  It had not occurred to me there was a chance I would be sent home. I was ready to meet my baby and did not plan on leaving! Thank goodness we stayed at home long enough.  The next 6 hours were a bit of a blur: shower-tub-vomit-repeat. At one point, Monica checked me and said I could start pushing. My husband wanted to catch her and the first thing he saw was her little face with her hand over it. Nick told Monica that the baby had her hand on her face and we were still in the tub. Monica calmly told me to get out of the tub and do a runners lunge (with a baby head half way out.) One more push and there she was! Nick got to catch her like he wanted.

We met Finnlee at 3:26am on Sunday October 26, 2014.  She was 7lbs 10oz and 20.5 cm long.

Birth Story: Women should be running the world!

ElenaJane

Birth Story of Elena Jane

As told by mama Emily

Elena Jane was born Sept. 7 at 12:45 a.m. She weighed 8 lbs, 1 oz and was 21.5″ long. Here’s how it went down:

T-minus 5 days until the 42- week mark. Monday, Sept. 8 was 42 weeks, this was Wednesday, Sept. 3. We met with Midwife Monica, she had me wear a belly band to make sure everything was lined up. A belly band sounds nice — oh it supports your back from your massive belly. But, actually it was kind of painful and I had to wear it over night. I kept coming up with excuses to take a shower so I could have a reprieve for 10 minutes.

T-minus 3 days until the 42-week mark — Friday, Sept. 5. We met with midwife Monica in the morning and she checked things out. She said things had progressed slightly since last time and my cervix was soft. I was dreading the herbal induction but by this point had succumbed to the fact that this is probably in my future. Monica suggested we do the Foley catheter–I would need to return that afternoon so Midwife Amy could insert the Foley. I was sent home with the herbal induction if, by Sunday morning, nothing happened I would need to start the herbal induction — which is ingesting something every 15 minutes followed by a lot of time in the bathroom (as I’ve heard).

My husband, Geoff, and I left with my bag of “goodies”. We decided to go to Mickey’s diner in St. Paul to load up on a greasy meal (figured it was similar to an herbal induction, right!?) and then went to Como zoo to walk around. Luckily, I took a 2-hour nap before going back to the birth center to get the Foley.

I know we learned about the Foley in childbirth ed class or at the Health Foundations complications class, but until I actually had to have it, I don’t think I filed it in my brain as something to recall. The Foley catheter is a thing that is inserted into your cervix and then two small balloons are filled up with saline solution on each side of the cervix. This is meant to aid dilation. It falls out on its own around 4 cm, otherwise you have to have it taken out. I was scheduled to have it removed on Saturday at 4 p.m.

As soon as midwife Amy filled the balloons, I got instant cramps all over. By the time I came home, the pain was so bad, I called the midwife line to see if there was anything I should do — I couldn’t imagine having this constant pain until 4 p.m. the next day. I will remember Monica’s words forever, “Well, Emily, it sounds like it’s doing what we want it to do, which is put you into labor…so wrap your head around that!” I laughed and thought, OMG — no kidding, I can start doing my relaxation and breathing (for some reason that didn’t occur to me until she told me that). Monica said to focus on if contractions were coming and going and to call if they got close together or especially if the catheter fell out.

Once I had that to focus on, the contractions were more manageable. I could barely eat anything for supper (rice and cream of mushroom soup) and then I went to bed. The contractions lasted all night but by the morning, they had lightened quite a bit so I could eat a solid breakfast (thank goodness or I don’t know if I would have had the energy). After breakfast we went for a walk which picked things back up quickly — we didn’t make it for a long walk and we had to stop every 5 – 7 minutes to work through a contraction.

I got back and called the midwife Amy to check in and let her know where we were at. She said she’d see me at 4pm but to rest and eat some oatmeal. Geoff went and got me some oatmeal of which I could eat half — and then in less then an hour the contractions were so bad, the oatmeal came back up. Geoff called again to let Amy know the contractions were consistently 5 minutes apart ( I was also concerned b/c I needed to get to the birth center for antibiotics b/c I tested positive for group B strep — and they said I should go in about 5 min apart). Amy said to really try to get some sleep and she’d see me still at 4pm.

I went to bed to try to get some good shut eye but within 15 minutes I had to pee and out came the catheter — those balloons were WAY bigger than I had thought…Not quite a raquet ball but I’d say maybe two ping pong balls on each side. As it was coming out I thought, what good practice for birth — HA (not the case). This was at 1:45pm on Saturday.

We ended up meeting Amy at the birth center at 3:30pm. She wasn’t quite there when we arrived so I had some lovely heaving and ho-ing out on the deck until she arrived. As soon as she opened the door, I went into the birth room (the one on the left), knelt on the ground with my head on the sofa and dealt with a few more contractions while I got my antibiotics. I heard my husband ask Amy, “Do you think we’ll need to go home or is she far enough along to stay?” Amy said based on the noises I was making, I was staying (I was relieved).

My doula, Kim, arrived shortly after. I started working through contractions in the shower on a birth ball, which was nice and then Amy had me get up and walk up and down the steps and around the studio upstairs. I don’t know what we would have done without our doula there, it was nice for Geoff to be able to take a break or stay with me when I wanted. I was so out of it, I didn’t notice any lapse in having someone there to help me. And I later found out that he had eaten dinner at some point…who knew!?!

Around 6 or 7pm, Dr. Amber (chiropractor) came to adjust me. Her three cute kids walked in and I was again heaving and ho-ing in the waiting room. They were so cute but I couldn’t say a word to Amber!  After the adjustment, Dr. Amber had me go to the bed and hang one leg over the bed ( I think we watched a video of this in class) and labor there for a bit. After several of these on each side, Amy checked to see where I was at.

With Amy’s check, my water broke because it was right there and she said I was fully dilated and ready to push! I couldn’t believe it! It didn’t even seem possible, I kind of just assumed at that point that the baby would be in me forever and I would have contractions the rest of my life. She said once I stood up, I’d probably feel a lot less pressure and an urge to push.

I did feel less pressure but never really had the urge to push — just pushed when I had a contraction as they told me. This was 9:30pm. I started pushing on the birth stool — not really a fan. I felt kind of like the gorilla I saw at the zoo that morning — just sort of sitting there with my big belly while everyone watched me from every angle. Then we did squats in the shower — these were my least favorite as they were the most painful, I think I thought the baby would accidentally fall out on the hard shower floor (I’m an idiot) and I didn’t like that I couldn’t rest in between pushes — just stand. Then we labored on the bed in the normal legs raised position — and a little with the birth ball on the bed..by far my favorite because I liked that I could rest in between. However, Geoff and our Doula sure had to be strong to basically be my make-shift stirrups!

We rotated between all of these positions maybe three times. Every time Amy suggested the shower squat thing I gave her a bit of a stink-eye (she later told me!) but complied because I knew the pain meant it was working. Throughout I thought I would not have enough energy to get through it. A few spoons of honey I think pushed me through.

Finally, we got to the point where I could feel things happen and Amy told Geoff to get ready to catch the baby. She had one of the nurses (Monica – a nurse in training and her first birth) take his place to hold my leg. That was exciting for me because I knew it was close. I asked if I could push even if there wasn’t a contraction, I was ready for the finish line. I pushed and felt her head come out. Amy told everyone to wait (while she moved the umbilical cord from around the neck). I remember just being super still and then she said, “ok” and I was still. That felt like 10 minutes of waiting for — I didnt realize she was saying ok for me to finish pushing. I just watched her and it felt like silence. Then she looked at me and said, “ok, push” and that was super easy! Elena’s slippery squirmy body went from Geoff’s hands to my stomach — It was awesome!

I remember saying something along the lines of, “Holy @#$&, I cannot believe women have done this for so long. We deserve a huge amount of money and women should be running the world!”

The rest is a blur — I had to get that darn placenta out. I had to cough a bunch which was hard because I was sore everywhere and my throat hurt from groaning for 12 hours. Ok, it wasn’t anywhere as close as hard as birth but I was just tired and wanted to cuddle my baby. Geoff was nervous because there was bleeding and clotting that the nurse was concerned about but they all calmly did what they said would happen in the complications course (super helpful). I was on cloud 9 and didn’t really have any concerns.

We packed up and headed home at 5:30 a.m. It felt a little weird to be driving home with an infant after having no sleep at all and going through that but it was nice to be home. All things said and done: Labor for 33-ish hours, active labor for 12-ish hours, pushing for 3 hours, 0 drugs (well accept for the antibiotics and ibuprofen afterwards), 0 herbal inductions :), 1 cutie pie and 1 happy family!!

I can’t say enough about how amazed I am with the nurses and midwives at Health Foundations. What an amazing profession they have been called to do. I could never do it but I am so grateful for them!

Emily, Geoff, Elena & Ella bean (the dog isn’t too jealous!)

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Endorphins in Childbirth: Body’s Natural Painkillers

Mother and babyIt is simply amazing what our bodies are capable of doing.  And at no time is this more obvious than with pregnancy, birth and breastfeeding.  It is incredible how well built the female body is for giving birth.  We have everything we need built into our very chemistry to be able to go through labor and give birth!

In the 1970s scientists discovered what laboring women have witnessed and understood for ages: that the body produces what it needs to temper the physical stress and pain of natural childbirth.  Science put a name to the body’s natural pain killers—endorphins—and discovered exactly how they work in the body before, during, and after birth.  What they found is remarkable. ***

What are endorphins?

Endorphins, specifically beta-endorphins, are hormones secreted within the brain and nervous system in situations of stress or pain.  They are the internal (endogenous) equivalent to our pharmaceutical painkillers, such as morphine (though without the many undesirable effects of the external, or exogenous, drugs).

 Ten cool facts about endorphins in childbirth

1  Endorphin levels increase toward the end of pregnancy.  During labor, endorphin levels rise during each contraction, most noticeably in the second stage of labor. Endorphin levels are highest just after birth.  It takes two weeks after birth for endorphin levels in the body to return to normal.

2  Endorphin levels are highest during vaginal deliveries in unmedicated mothers.  They are lower in women who have a cesarean section after laboring on their own for some time and even lower in women who have a cesarean without experiencing labor.

3  The use of exogenous pain medications (endorphin-like drugs) dramatically decreases the body’s natural production of endorphins.  Unlike narcotics, which are given in “surges” to some laboring women, endorphins are released in a more steady fashion, providing consistent pain relief without the crash that comes with big bursts of chemical pain relief.

4  Endorphins can actually help regulate the pace of labor—high levels produced in the body and slow labor by lowering oxytocin levels, which can serve to regulate the intensity of labor and our ability to manage it.

5  Endorphin levels protect and serve babies during childbirth as well.  Endorphins are elevated in newborns that experience distress during the birth process.

6  Endorphin production in the body is tied to our emotional states.  Stress hormones (i.e. catecholamines) counter endorphins in the body.  The more relaxed and calm a woman is through childbirth, the more endorphins she produces and the less stress hormones her body makes.  A relaxed laboring woman actually feels less pain than a woman who is scared or distressed.  Unresolved stress or anxiety should be processed prior to labor to prevent these from becoming obstacles to her labor experience.

7  Endorphins behave differently from woman to woman, which is perhaps one factor in why women have different perceptions of the pain of childbirth.

8  Endorphins stimulate the production of prolactin, the relaxing “mothering” hormone that aids in breastfeeding and mama-baby bonding after birth.

9  Endorphins are the cause of the “high” many women experience during labor and in the early days postpartum.  They assist in allowing a woman to be alert and attentive to her newborn despite sleep deficits.

10  Endorphins are present in breast milk, which may explain the natural high that babies can get after breastfeeding.

***Note: Natural hormones oxytocin and prolactin also play a major role in birth, though this article focuses primarily on endorphins.

The benefits of a doula

doulaIn our last post, we covered the basics about doulas—what a doula is, what she does, how she fits into the birth team, her training and how to find a doula.  Today, we talk about the many proven benefits of having a doula.

In 2011, an extensive study—the largest systematic review of continuous labor support—demonstrated the effects of having a doula for over 15,000 women who participated in 21 randomized controlled trials.  The study authors concluded from this extensive research that:

Having continuous labor support has clinically significant benefits for women and their babies and no known harm.  All women should have support through labor. 

Other experts have said that if the benefits of a doula could be bottled up in a jar and given to laboring women, it would be a crime not to use such a potent medicine.

Doulas mean better outcomes for mom

The best and most recent studies show that women with continuous labor support have:

  • shorter labors (by about 40 minutes on average)
  • a greater chance at spontaneous vaginal birth
  • fewer interventions, such as cesarean section or vacuum extraction with forceps
  • lower rates of epidural or analgesia to manage pain
  • lower rates of induction (via Pitocin)
  • more positive feelings toward their birth experiences, leading to a cascade of positive effects including
  • lower rates of postpartum depression

Specific studies have found that doulas help increase a laboring woman’s self esteem and actually can decrease her perception of physical pain during childbirth.

If we are just talking continuous labor support, wouldn’t a partner or a friend have the same effect?  Not necessarily.

The effects of continuous labor support are strongest when the person is not a member of the hospital staff or a person in the woman’s social network, and was present solely to provide one-on-one labor support (i.e. a professional doula).  With a doula, specifically, women were:

  • 34% less likely to view their birth experience negatively
  • 31% less likely to use synthetic oxytocin to speed up labor
  • 28% less likely to have a c-section
  • 12% more likely to have spontaneous vaginal birth
  • 9% less likely to use pain medication

Newborn in mother's handsDoulas mean better outcomes for babies

Research also shows improved outcomes for babies when doulas are present for a laboring woman.  These babies have:

  • better APGAR scores at birth
  • shorter hospital stays
  • fewer admissions to special care nurseries
  • have greater early breastfeeding success
  • have more affectionate mothers in the postpartum

In sum, the most important thing is for women to have continuous labor support from someone– a nurse, midwife, partner, or doula. However, with several birth outcomes, doulas have a stronger effect than other types of support persons.

For tips on how to find a doula, please see our post here.