Water birth arrives in Columbus

Beginning in December of last year, a select group of Columbus mothers-to-be began delivering in the water after Doctors Hospital acquired an inflatable birth pool. I wrote a story for the May issue of her magazine about the water birth experience in Columbus – as seen through the eyes of the certified nurse-midwives at Obstetric & Gynecologic Associates of Columbus who began offering the option and one mother who highly recommends water birth after delivering her third daughter in the Doctors Hospital birth pool.

For more information on water birth, go to

Waterbirth.org and American Pregnancy.org

Thanks to her editor Jennifer Sillitto for allowing me to run the text of the story in this post. Please pick up the May issue of her to view the photos that accompany the story and to read other stories about mothering – the focus of this month’s issue.

Water Birth Arrives in Columbus
By Annie Addington
Photos by Seth Grant

On December 18, 2008, Rachel Rach of Phenix City brought her now 4-month-old daughter, Erin, into the world in the 101-degree warmth of a birth pool.

Erin’s birth marked the first in-water delivery at Doctors Hospital since the hospital acquired an inflatable birth pool in November 2008.

The opportunity to have a water birth in a hospital gives local mothers like Rachel, who are interested in having a natural but gentle birth, a powerful option for pain management.

After an increasing number of patients began expressing an interest in water birth, certified nurse-midwives Melissa Terry Flynn and Courtney Heynen, and obstetrician and gynecologist Dr. Joseph Eikelberry – all of Obstetric & Gynecologic Associates of Columbus – attended a water birth credentialing course in Atlanta. Five nurses from Doctors Hospital also attended the course. They worked with the staff at Doctors Hospital to get water birth protocol established and to acquire a hospital grade Birth Pool in a Box, which holds water at a depth of 23 inches and can easily be stored between uses.

When Rachel, a 25-year-old former Air Force airborne operations technician who swam competitively throughout high school, learned water birthing was being offered at Doctors Hospital, she was immediately interested. Rachel had a friend who experienced four water births at home and recommended it highly, and Rachel herself has always enjoyed being in water.

“It’s a comfortable element for me,” she says.

Courtney was Rachel’s primary midwife and recalls even in transition – the most intense stage of labor – Rachel seemed remarkably relaxed.

“When she was about 7 to 8 centimeters dilated, she just had a smile on her face,” Courtney remarks. “She did so well that no one could really believe she was in the transition part of labor. She said the water was just helping her so much. She definitely handled the pain very well. She was laughing and cracking jokes, and you could hardly even tell that she was in labor.”

Rachel admits she was in no laughing mood during her four final contractions, but she was able to move around in the water to help her newborn daughter emerge relatively quickly. She says she felt much more mentally present than when she was enduring that last bit of pushing with her first two children; in fact, Rachel was able to reach down to help welcome Erin to the world.

“I basically helped deliver my own baby,” Rachel remembers. “I grabbed her and helped pull her out to the surface.”

Rachel was the first of several women who have already enjoyed water births at Doctors Hospital. Between December 2008 and early-April 2009, six women delivered in the hospital’s birth pool and four women used the pool during a portion of their labor but then got out of the water to deliver their babies.

Melissa, who also attended Rachel’s birth and has been present for most of the water births at Doctors Hospital since the program was implemented, notes women laboring in water tend to know instinctively how to change position and make their bodies work for them.

And labor and delivery nurses, who have been watching births for years, are struck by how peaceful a water birth can be. Melissa recounts one particularly gentle birth in which the patient largely guided herself through the delivery of a 10-pound baby with some quiet coaching from her midwives. Three veteran labor and delivery nurses looked on with tears in their eyes, she recalls.

“They said they’d never seen anything like it,” Melissa says. “It’s just a really interesting take on the whole birth process because nobody’s really messing with anything. The baby’s just coming out on its own time and we just reach in and pull it up out of the water.”

But water births are not an option for everyone. The midwives and doctors at Obstetric & Gynecologic Associates of Columbus are only willing to provide the service to women who meet some fairly stringent criteria, including a history of uncomplicated prior deliveries and an uncomplicated current pregnancy. Even if a woman meets the criteria and plans a water birth, she may be removed from the water if complications arise.

Water birth candidates have to fill out extra paperwork, buy a disposable pool liner for $35 and meet with both midwives to discuss the risks and benefits of water birth along with potential reasons why the client may not be able to have a water birth. The midwives emphasize to their clients that the birth pool is just another tool for labor. In the end, the goal is not to have a water birth but to keep mom and baby healthy.

One of the primary fears surrounding water birth is the notion that the baby might inhale water, but Melissa and Courtney say the instinct to breathe is not triggered until an infant is exposed to air, so water aspiration is almost never a problem, especially if the baby is brought up out of the water quickly.

And for women with no contraindications for water birth, the process can improve outcomes for both mother and baby.

A comparative study of nearly 6,000 spontaneous births at a clinic in Switzerland, more than 2,000 of which were water births, concluded that water births “do not demonstrate higher birth risks for the mother or child than bedbirths if the same medical criteria are used in the monitoring as well as in the management of the birth.” The study, published in a 2000 issue of Fetal Diagnosis and Therapy, also found that mothers’ blood loss was lower in water births; mothers had fewer episiotomies and fewer severe perineal tears; and the babies’ Apgar scores after birth were significantly higher.

According to Waterbirth International, water births also speed up labor, reduce blood pressure and reduce Caesarean section rates. If women enter the pool too early in labor, however, it can adversely slow their progress. Providers at Obstetric & Gynecologic Associates of Columbus encourage patients to wait until they are 5 to 7 centimeters dilated before getting in the birth pool.

In her book, Gentle Birth Choices, Barbara Harper notes that women have been using water for thousands of years to ease labor and assist in birth – especially in areas of the world located near slightly warm water. But it wasn’t until the 1980s that water births began to gain acceptance at some birthing centers in the U.S., following documentation of successful water births in Russia and France in the two prior decades. Now the movement toward water birth is growing, although most hospitals do not yet offer the option.

Melissa says she’s only aware of one other Georgia hospital offering water birth: North Fulton Regional Hospital in Roswell, Georgia. That hospital’s protocols for water birth became the model for Doctors Hospital.

Melissa says the warmth and buoyancy of a birthing pool are very logical aids for a woman in labor.

“It makes sense that when your muscles are sore and tired, getting in the water kind of revitalizes you,” she explains. “The lack of gravity when you’re buoyant in the water makes the body less likely to secrete stress-related hormones and that allows women to produce their own endorphins and be more comfortable. Also, being in the water with endorphin releases keeps blood pressure lower.”

Melissa adds she’s been struck by how comparatively gently a baby born via water birth emerges into the world.

“They seem to come out more quietly, and they come up onto mom’s chest and don’t immediately start screaming or anything,” she says. “It tends to be a much more gradual and quiet kind of birth – and absolutely beautiful to watch.”

Rachel says she did plenty of online research before settling on water birth as a safe option. Her husband, Michael, a U.S. Army Ranger, was soon persuaded by the research, too. He says the water birth experience was more relaxing for him, as well, largely because his wife was so much more visibly calm than she had been during her two prior deliveries.

Rachel says with the birth of each of her children, she has come closer to finding comfort in natural childbirth. She says by having a midwife, moving a lot and using a birthing ball and squatting bar during the labor and delivery of her second daughter, she felt much more comfortable than when she was lying in a hospital bed, as she had been during the birth, three years ago, of her first daughter. Her third labor was the most manageable, she says, due to the buoyancy and warmth of the water and the ability it gave her to change positions easily and alleviate muscle fatigue.

“My first experience, I basically stayed in the bed because I was with a doctor, and transition was so hard – the pain was so great that it was hard to concentrate,” Rachel recalls. “The second delivery was a lot easier because I had a midwife and was able to move around and stand and use the squatting bar. With this (third) delivery, I was able to move as my body dictated. For me, since I’m a swimmer, when I would go through a contraction I would immediately start doing flutter kicks. I felt like I was more in control; I was able to move in order to compensate for the pain.”

The Rachs don’t yet know if they will have another child, but if they do they’ll have their birth plan ready.

“If I had another, I would definitely do a water birth again,” Rachel says. “And, I highly, highly recommend a water birth, especially to first-time moms.”

Friendy flies!

On Saturday night, about a month after Will captured his caterpillar “Friendy” and two and a half weeks after Friendy had spun a cocoon for himself, he finally emerged from his cocoon as a little grayish-brown moth. We’d begun to wonder if we’d have to give up on Friendy up as dead-in-cocoon after reading that it tent caterpillars generally stay two weeks in their cocoons. But due dates always vary and Friendy pulled through in the end.

When I asked Will if he noticed anything different about Friendy’s jar on Sunday morning, it took Will a minute to spot his new moth friend clinging to the screen at the top of the jar.

When he did he was ready to release Friendy on the spot:

“He’s ready to go out!” Will said. “I think he wanted to be in there a little longer so he could be into a bigger moth so all the other moths wouldn’t laugh at him.” And then Will addressed
Friendy through the jar: “Hey there, little friend.”

We gathered Grammy and Grandpa and Owen and Rob in the backyard to release Friendy. He (or she – only Will has determined Friendy’s gender as male) immediately clung to the underside of a wax myrtle leaf and prepared to wait out the hot day before he would presumably go out on a nighttime mating flight. His out-of-cocoon lifespan should be about five days or so, according to our research.

In the meantime, Will’s assuming Friendy will be attending moth school -- and he’s informed me that moths are able to talk to one another.

“Friendy won’t worry about talking at first,” Will explained to me, “because he’ll probably be shy when he meets all his moth friends at moth school. Right now he’s probably four.”

The perfect moth friend for a four-year-old sometimes shy boy. Maybe Friendy and his progeny will wind up gobbling up all the tree leaves in our yard, but we definitely enjoyed watching him grow and change and generally work his magic during his month on our kitchen counter.

Inspiring reluctant readers

For those of you who live nearby, I wrote a brief story for Thursday's Ledger-Enquirer about a “Heroes Read” event on Saturday (May 2) targeted especially at reluctant readers in fourth through sixth grade, but open to children of all ages. (The link to the story's coming soon). At the Columbus Public Library, local real-life heroes will be on hand to show off their fire trucks and police cars and the like and to talk about why reading’s important to them. Each child will also get a free comic book – and organizers hope to give parents the message that children should be given access to whatever it is that inspires them to read – whether it’s comic books or cereal boxes (assuming it doesn’t contain inappropriate content) or books about whatever fascinates them.

Here are the details for Saturday’s event:

If you go:
What: Columbus Heroes Read
When: 11 a.m. to 2 p.m. Saturday (May 2)
Where: Columbus Public Library, 3000 Macon Road
Who: The event is targeted toward boys in grades 4 through 6, but children of all ages and gender are welcome.
Cost: Free. All children will receive a free comic book and lunch.

And a few links for finding high-interest and/or award-winning books

Go to the American Library Association for lists of award-winning books. Click on Caldecott Medal, Children’s Notables Lists, Newberry Medal and more…

Go to boysreading.com for help, including high-interest fiction book recommendations, inspiring reluctant male readers to start reading. The target age group here is 7th to 12 grade.

Go to this Reading is Fundamental web site for a “Top 25” list of books for infants through 9-year-olds. Go to this Reading is Fundamental web site for a “Top 25” list of books for kids ages 10 and up.

Leaving Disney

My parents flew in from Colorado this week, and yesterday I sent Will and Grammy off to Disney on Ice, while I taught at the preschool. Will lasted for about 2 minutes of the performance. Once he saw a car drive out with Minnie and Mickey, and listened to the audience erupt in cheers, he put his hands on his ears and told Grammy, “I don’t like it. I want to leave.”

Before she could argue the point, he was climbing the stairs toward the exit. So she suggested they talk about it outside. Grammy spent quite a while working to convince Will to give the show another try but Will remained determined to go – and he was too frightened or stubborn to say what it was that bothered him about the show. (Later, to me, he just announced: “That was not fun.”) He may have been the only kid among the hundreds in the audience who fled the show – but I’m certain he wouldn’t have stayed with me either.

We’re not quite sure why Will feels overwhelmed by so many performances, movies or even television shows with a slightly feisty character. (When he sees a mean dog barking on the benign PBS shows Martha Speaks he covers his ears and fetches me to turn the TV off.) I suppose I could expose Will to a bunch of Teenage Mutant Ninja Turtles or horror movies or something to try to desensitize him. But I’d rather wait and let him live in his world of books, imaginary play and gentle PBS children’s programming for as long as he needs to. And we’ll try again for Fantasy on Ice Next year (even Will admitted that he might like it by the time he’s “8 or 9 -- or 10 or 12.”)

For the next couple months at least, I think we’ll skip big spectacle performances and go to outdoor music performances (like the downtown concert series that starts up next Friday) instead. At an outdoor concert, Will and Owen are both in their element – frolicking and dancing and perfectly at ease.

The Butterfly Project

The Holocaust Museum of Houston is sponsoring the Butterfly Project , an exhibition planned for 2012 featuring 1,500,000 handmade butterflies in remembrance of the 1.5 million children who died in the Holocaust.

I’m planning to have Will -- as well as the students in my preschool class – make butterflies. At preschool we’d already constructed these butterflies for a spring poster using the old tried and true method of dabbing paint on one side of a butterfly cut-out, then folding the paper in half to create some mirror-image symmetry.

But our butterflies are too big (the guidelines on the museum website call for butterflies 8-by-10 inches or smaller), so I’ll hunt around for a different butterfly craft. Here’s one web page with a bunch of them.

With three-year-olds, I will talk only vaguely about the tragedy of the Holocaust, but they will understand quite clearly the importance of treating all children with love and respect and of honoring other who aren’t as lucky as us. I like the idea of encouraging kids to make art for a larger audience as an expression of love and remembrance and as part of a collaborative project with children around the world.

Thanks to Grace, a friend from Atlanta and a home-schooling mom who’s much craftier than me, for clueing me into this one. Check out her daughter Ella’s butterflies and the poem that inspired the project on Grace’s blog.

Flirting with the potty

Twice this week, Owen has announced, “I pee pee” from the changing table after I’d stripped him of his nighttime diaper and so I’ve whisked him off to his potty seat in the bathroom and left him for a moment, only to return and discover that he’s both pooped and peed on the potty.

The fact that there’s already a potty in our bathroom is Owen’s doing too. About a month ago, he became so desperate to pee like Will before bathtime that we brought down the plastic potty out of the attic. We never push Owen to sit on it, but we’ll ask him if needs to go potty before getting in the bathtub. A couple times he’s produced a pre-bath pee on the potty.

So we are flirting with potty training only because Owen’s leading us that way.

And I’ve learned that it’s bad to ignore a 21-month-old’s pottying instincts. Owen’s potty-using attempts this week began one evening after a bath. Owen said “I pee pee” as I was drying him off. I thought he’d spotted the toilet and was just playing with the concept, so I told him as soon as I dried him off a bit, he could go.

Seconds later he was peeing on his towel and me and the bathroom floor. Now when a bare naked Owen says “I pee pee,” I will heed the call immediately.

Still I think I’ll stick with a very low key approach to potty training until Owen’s at least 2. 21 months seems early, and with the boy in daycare a few mornings a week we can’t get much accomplished anyway.

Wouldn’t it be nice, though, to get out of diapers? I long ago gave up using cloth on Owen and I’d like to stop sending several diapers a day to the landfill.

If Owen still seems interested this summer, I may try several days of running around naked in the backyard or wearing heavy-duty training pants. I know from experience that this time I don’t want to bother with sticker charts or bribery, and I’m not spending a penny on pull-ups.

Fortunately Owen’s teacher for next year agrees that pull-ups are just glorified diapers and when a kid’s ready, they need some heavy duty cotton underpants to help them learn the value of staying dry. I don’t want to pressure, shame or bribe Owen into potty training too early, but once he seems ready I’m going to go at the thing armed with lots of laundry detergent and patience -- and a dozen or so super-absorbent cotton training pants.

In the end, Owen will probably wait to get himself fully potty trained until 3 or later. But a mother can dream…

Here is a potty training readiness checklist if you’re facing similar questions about when to get started with your own kids.

And if you’ve got experience in the matter please weigh in: Have you had any luck potty training boys (or girls) under 2 without using scare tactics or other psychologically questionable methods?

Field trips to the farm

The ultimate preschool field trip is a visit to a farm, I think. And this week was a little farm field trip fiesta for me, as I accompanied Will and his pre-K class to Butts Mill Farm, near Pine Mountain, one day, and then the next day brought Owen along on a field trip with the three- and four-year-olds I teach to Marengo Creek Farms in Alabama.

At Butts Mill Farm Will rode a horse for the first time in his life (nervously clutching the saddle so tightly that his knuckles turned white), and he fed some peacocks, goats and pigs. But the highlight of trip for him was playing on the various oversized play equipment. Butts Mill Farm is really more amusement park than farm -- it’s like a petting zoo and pony ride venue crossed with an outdoor Monkey Joe’s-style play environment. Not so bucolic perhaps, but a kid’s paradise. Here I share a couple photos with the animals, but Will’s favorite Butts Mill feature was some big slide.

At Marengo Creek Farms, Owen enjoyed petting baby ducks and baby goats. He found himself a four-year-old female tour guide, who told him about the various chickens, roosters, bunny rabbits, ponies, cows and pigs as they viewed them together. And we enjoyed watching a border collie herding sheep, a white dove release, and took a hayride around the farm, which is now a working sheep farm and a show farm, run by the grandson of a man who once raised pigs and cattle there. If he’d followed strictly in his grandfather’s footsteps, owner Stewart Harvard said, he’d be bankrupt by now.