Category Archives: birth pause

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Mother-led Skin to Skin: The First Minutes

Open Letter to Dr. Nils Bergman                                                                                     By Mary Esther Malloy

Your research has shown the world

a baby belongs on its mother,                                                                                                                     skin to skin.

You argue:

a baby on its mother,                                                                                                                                      it is where we lay the foundation for healthy people and healthy societies.

You say:

Skin to skin must start at birth,                                                                                                                     Skin to skin must be continuous.

Kangaroo Mother Care is not yet the bedrock of maternity care you’d have it be, but the world is listening. We are reconsidering one of the 20th Century’s grand experiments: the practice of separating mothers and babies at birth.

Now, when it is possible, a baby is delivered to its mother’s chest.

Immediate skin to skin.

But, what if we were to trust birth and women even further? What if, instead of delivering a baby immediately to her mother’s chest at the moment of birth, what if the midwife or doctor simply guides the baby down where she is born? …what if everyone pauses… and leaves the mother to initiate the skin to skin, on her time frame?

What might this look like? Continue reading

Delayed Cord Clamping: An all of human history practice (20th century exempted)

By Mary Esther Malloy, MA

Asthma-PlanThere are many things that help our children to be as healthy as possible during their first minutes, hours, days, months and years. If the findings of some new research are correct, then ensuring that our babies get their full volume of blood as they are born might be one of the more important steps we can take for the well-being of our children.

Here is the problem: while studies are showing us that there appears to be no good justification for the routine clamping and cutting of a baby’s umbilical cord seconds after the baby is born, survey after survey shows most obstetricians and many midwives still clamping and cutting cords very soon after delivery, with some rates as high as 95% (Downey and Bewley 2012; van Rheenen, 2011).  Dr. Jose Tolosa and colleagues write, “Although without clear benefit and no rationale to support it, early cord clamping remains the most common practice among obstetricians and midwives in the western hemisphere” (Tolosa et al., 2010).

What can we do about the disparity between evidence that strongly supports delayed cord clamping and widespread habits of practice that we know are not benefiting our children? We can educate ourselves. We can share research with our doctors and midwives. We can advocate for a change in business as usual. I’ve written this article to share an emerging perspective (that many have long held) and to make some of the research easily available to expectant parents. At the close of the piece I’ve included an except from a recent editorial in the American College of Obstetricians and Gyncologist’s journal that you might share with your doctor.

Don’t leave your child behind in the 20th century

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The Story of Your Birth

For Silas Wendell – Born at home on November 18th, 9 lbs, 10 oz

1-SilasWendell-natalie-and-aaron-belly-199x300The four days following your due date were long days. I wanted you to come, to be birthed into my arms. I was anxious to see you and hold you. I wondered, as the days wore on, if there was something holding me back from your birth. Kristen, our midwife, asked directly if I was afraid of labor or if there was something that was inhibiting me from going into labor. We talked through what might be in the way. On Saturday, the day before you were born, I was anxious to clear a space for you. I decided that I wasn’t going to work the following week. Your dad, brother and I went to Central Park to try to “walk you out.” We walked fast and hard and nothing happened. I was discouraged.

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Laura and Neil’s Story

1-LauraandNeilI first observed this pause at a home birth in the Bronx, where I helped Laura and Neil work through a rather zippy labor. Neil’s eight brothers and sisters had all been born at home in Ireland, and home birth had made immediate sense to Laura when I raised it as a possibility months earlier as she mapped out elaborate plans to arrive at the hospital as late as humanly possible.

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Mary Esther’s Story: I am not sure that I have ever been so present to another human being

1-Mary Esther seeing her daughterOn November 4th, 2010, I met my third child in what I can only describe as the most ecstatic of ways. After an unexpectedly long first stage and a shockingly speedy second stage, I birthed my baby on my bed in the all fours position. As my midwife guided my baby down below me, I was thrilled to finish a labor that had seemed to last an eternity. But it is the next moments that are forever seared in my memory. As I saw my daughter below me… as I touched her meaty little arms and legs, took in her strawberry hair, watched her first breaths, felt her cord pulsing with the life force we had shared for so long, and finally – when I had really SEEN her- picked her up, the experience was nothing less than euphoric. I knew from watching others that not hurrying a baby onto its mother’s chest left the moment open to be what it needed to be. But I had no idea that being upright for this precious first meeting … with my daughter below me… no one hurrying her or me … would feel so powerful. I don’t think I have ever looked so hard at another human. I feel that I now understand in a visceral way what we mean when we talk about the imprinting that takes place at birth. It was an extraordinary gift to be able to truly see and take in this brand new person in the moments in which she arrived.

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