Sunday, February 28, 2010

Birth Story - Rahma

rain's romantic pour #316 by ashley rose

This birth story comes to us from a lovely mother of two. This is the story of her first home birth.

How did I subconsciously soak in the meaning of her name ever since she rested in my womb? Rahma. My whole pregnancy was spent in the type of inner turmoil that comes only with self discovery. She taught me to finally have some true compassion for myself. Rahma. She continued to teach me to overcome my fears, to reclaim myself, to strive for my dreams and to stand strong for what I truly believed in. Rahma.

I had no idea that in the last trimester of my pregnancy, she would teach me that a beautiful birth means an empowered mother. That the only way she wanted to enter this world was if I felt ‘at home’ enough to submit myself to one of the greatest tests of perseverance, birth. And that in return, I would experience spiritual ecstasy. Ahmad, my husband, realized the value of my personal choice and despite his doubt and fears, supportively agreed to have a home birth. Soon, I even heard him convincing family members of its success rate!

We hooked up with ‘Birth Awakenings’, the midwifery group that a couple of friends swore by. Dana, Deborah and Julie became a part of our lives when we most needed them. The cold, stark, specimen-like ‘pre-natal appointment’ as I had known with my first daughter’s pregnancy became an afternoon cup of tea at home. They carried out the heart beat and urine checks, discussed my fears, played with my oldest daughter and let her listen to the baby’s heart beat with their Doppler. Their prescriptions were nettle tea and protein shakes. They helped me to realize that the weight of inner turmoil might tip the scales against the success of a home birth; they urged me to establish harmony within prior to the birth.

Ramadan came and shone forth with its beauty as we sighted the moon with a few families. I fasted. In the evenings we took turns with our oldest while praying taraweeh.Then the surprise came that Ammi and Abba were flying in. Yet again, I was forced to stand strong yet maintain gentleness. I really wanted to have the baby before they arrived as we weren’t sure if they were comfortable with our plans to birth at home. I prayed and prayed to have the baby prior to their arrival date and took castor oil in the hopes of stimulating my labor - despite the caution of my midwives. We were a week away from their arrival and two days from the due date. I woke up every midnight interrupted by the stormy rain and whistling wind outside coupled with the false contractions within. As much as I hoped tonight would be the night, the contractions were as calm as the bright sunny day the next morning.

Now two days from my due date, we found ourselves greeting Ammi and Abba at the door. It was not as I expected. All that tension which I had dreaded was replaced with easy, light hearted warmth, and time spent together at home. There was almost no discussion regarding the birth except a motherly concern about whether the check lists were implemented and support for the big day. How Merciful is Allah? I slept that night and woke up as usual around midnight, but this time the contractions were slightly stronger and then the instinct that this was it. I woke Ahmad up to give him a warning and he reminded me that Dana, our midwife, had said to go back to sleep to conserve energy for when the real thing begins. I bore the slightly uncomfortable intermittent pain as he hugged me snug. Before I knew it I had fallen asleep. A few hours later I woke up again and told him that they’re getting stronger. He got busy getting the pool ready. The sound of the gushing water reminded me about the contractions coming full force now. He lit our favorite incense to welcome the angels as they awaited the coming of our baby. He timed the contractions and realized that they were getting close so I called the midwife.

Dana told me to hang in there and that she would be there shortly. I went to stand under the hot shower since that had really helped me with my first birth. Ahmad played my labor cd and went to inform Ammi. As I quietly sought some strength from listening about my Prophet (peace be upon him), my mother entered the room. She hadn’t been there at this stage with Aisha’s birth and I realized for the first time how much it meant to have a line of support from her. She said in a broken voice “Be patient, it’ll all come together soon”. It meant so much to have my mother’s duas and to know that she had just finished reading Surah Baqarah prior to coming in to meet me.

My labor cd continued as I sat on the chair making dua for everyone that I could think of. Dana sat at eye level with me as the intensity of the contractions peaked and then Ahmad brought in Aisha. My gaze fell upon her and I wept. There she was, my big girl, who I had nourished in my womb just yesterday. I recalled the gratitude I had felt at her birth. And here I was welcoming another. Of course you can do this, I thought. Don’t you remember what it felt like when Aisha made her way out? It helped me move along and soon I was close enough to pushing. Dana signaled for me to gain some relief from soaking in the pool. The relieving power of water, what an immense blessing! Ahmad pulled out the Wird al-Latif and sat at eye level in front of me as our lips moved together in the chanting of those empowering duas, interrupted every now and then by the intensity of the contractions - a reminder about the need for intense submission to my Lord. After hardship surely comes ease! Indeed, hardship is surely followed by ease! I reminded myself about these ayahs which a friend had recommended to read during the labor.

Recharged a bit by the relief in the water, I was now up-right on the birthing stool requesting help from gravity. I never remembered feeling the urge to push with Aisha’s birth so this was all new to me. The contractions were peaking without any breaks now and I just wanted to get this baby out. But the midwives kept insisting to push when the body signals for it, not when I wanted to. And I’m thinking, what?! What’s the difference? Then Deborah, the other midwife, said, “Lubna, just submit to the will of Allah! Listen hard, work with your body! We don’t want you to tear.” That’s all it took. I realized that I had to stop focusing on the pain of the contractions, but rather just completely give up my body to its natural course as designated by Allah. I understood, that I had to know my limits, and with perseverance, to go beyond them. Feeling completely overwhelmed by the intensity, I kept telling myself to focus on the baby that wants to make its way out. Tempted to push even when it wasn’t the right time, Dana knew right away and said, “Just a little big longer, honey”.

Then I heard it, the rain outside. “Open the windows!” I declared in my weakened voice. They opened the one right in front of me. I became teary and bathed in the tranquility that the sound of the rain evoked. This rain that has just been with Allah, brings with it such mercy as it brings to life the earth.

Just like my Rahma. “Ok, the head is out, pussshhhhhhh!!” Dana announced. I grunted with all my strength, and gave one hard push that sent a sharp burning sensation through me. And then that same relief I had felt with the coming of Aisha, followed. After hardship surely comes ease! Indeed, hardship is surely followed by ease! “Ya Allah, protect my baby from shaytan,” I begged. Then she made a slight whimper as they announced, “A beautiful girl with a full head of hair!” I wept and declared, “My baby! My baby! My Rahma!” Ahmad, my companion in life, shared the joy, teary eyed.

Soon I realized that Ammi and Aisha had come in and were leaning over the baby. “Daikha Aisha tumharee chohtee behan!” Ammi cried and told her, “Baby Rahma’s hair is wet, Ammu!” Aisha smiled in amazement and approval. Then Abba ran in weeping and hugged me tight and gave me a bunch of kisses out of relief saying, “Shukr hay, sub kuch teekh ho gaya!!” Then it was just time to sit back as I nursed and enjoyed all the immense blessings that stood right before me. Aisha Aapi, Babajaan Baju, Ammi, Abba and now, my Rahma. How Merciful can Allah be?

Tuesday, February 23, 2010

Second Trimester - The Budding

Ija Maternity Sideshot by SHOfrE3zE.
Ija's Maternity Sideshot by SHOfrE3zE

"...then We made the drop a clot, then We made the clot a lump of flesh, then We made the flesh bones, then We clothed the bones with flesh, and then We produced another creature from it. So blessed is God, the best of creators."
Qur'an (23:14)

The glories of the second trimester! The foundation for your baby's rapidly growing body has been laid, and now as Allah miraculously details above, it is time for building upon that structure. Bones begin to ossify, fat forms, rapid eye movements begin, and the baby grows in length. As for mom, the nausea has for the most part passed, and you can feel the fluttering affirmations of life within. Your energy has likely returned. That little bump is starting to grow and you are starting to glow! Your appetite is increasing in proportion to your baby's needs. Blood volume is continuing to expand now and you may notice some of its signs; swelling, distended veins, shortness of breath. The increasing weight of the baby may also begin to show up in backaches. After taking a back seat in the first trimester nutrition and exercise, now reappear. Each subject deserves its own post, but I'd like to briefly discuss each below.

As the blood volume is expanding nutrition plays an increasingly important role. The quantity and quality of our dietary intake now can help to keep the placenta perfused for the entire pregnancy, allowing baby optimal nutrient intake and preventing complications of pregnancy down the line such as pre-eclampsia and intrauterine growth restriction. I would like to just offer a few basic principles, more on the quality of food rather than the quantity. Divvying up the food into vitamins and minerals is important, but that is too detailed of a subject for this post.

  • Nutrient dense foods such as whole grains, fruits, nuts, and vegetables, offer the maximum benefit per bite. Say you have the choice between a donut, or even four saltine crackers, and an apple or a cup of carrot slices. The donut and crackers probably have more calories, but the nutrient dense choice would be the apple or carrot. The latter choices also have more fiber and will be more filling. Fiber is important in pregnancy to keep you from becoming constipated or acquiring hemorrhoids.
  • I really like broths. They are easy to make and so nourishing. For busy moms on the go, broth is a life saver! Just heat up a cup at a time and you have a cup full of protein, vitamins and minerals! Here are some easy ways to prepare broth.
  • Getting lots of good fats in pregnancy is essential to your baby's brain growth and development. You also need fats to help you absorb the fat soluble Vitamins A, K, E, and D. It is also important to avoid trans fats and maintain a good balance of Omega 3's 6's and 9's. I like this fish oil, it is cheap, pure and tasteless! Salmon is another great way to get in Omega 3's, just limit your consumption to once a week.
  • Iron deficiency, or anemia, can occur in pregnancy. The blood volume expansion that occurs, occurs mostly in the plasma part of the blood. This essentially 'waters down' the red blood cells. Some women can tolerate this better than others. For all women it is a good idea to add a little extra iron into the diet. Good iron sources are lamb, beef, greens, dried fruits, and oysters. If you find yourself anemic, Floridex is an easy to digest iron supplement. Iron is always better absorbed when taken with Vitamin C and should not be taken with Calcium.

Exercise has many benefits in pregnancy...contrary to what your aunties may tell you! It has been proven to make for a more comfortable pregnancy, shorten labor and reduce interventions in labor It can also make for a quicker postpartum recovery. In pregnancy our bodies undergo vast physical changes in order to accommodate the baby; muscles stretch, ligaments soften, and joints loosen. In order to keep up with those changes and to recover from these changes, exercise is necessary. Here are some recommendations for moving your budding body!

  • Get your heart rate up at least three times a week for half an hour. Stationary bikes, swimming, and hiking are good ways to do this. Walking is good exercise, but your heart rate has to be accelerated while walking.
  • Yoga is a fine exercise and feels good while pregnant. Attend a pre-natal yoga class or find a good DVD to follow at home. It's best if you have some experience with yoga before becoming pregnant in order to safely practice whilst pregnant.
  • Avoid laying in the supine position, raising your temperature above 102F, and any contact sports. It's best not to begin new exercises while pregnant, but continue with what you have done in the past. Be sure to hydrate well and to add 150-300 extra calories on the days you work out.
  • Kegel exercises should be done throughout the pregnancy. They prevent urinary incontinence, can help avoid tears, can speed recovery postpartum, and maintain sexual function.
  • Dancing is a joyous expression and quite suited to pregnancy. Turning on some music and moving your body to it for half an hour is an easy and satisfying way to get some exercise in. Belly dancing is particularly suited to pregnancy and a great tool in labor. Please check this website for more details and stay tuned for an upcoming interview with the founder.

The second trimester is a joyous time for most women. It can be an intense time full of fruitful dreams and creativity. Relish in it. It's also a time where the realities of becoming parents, whether for the first time or fifth, can lead to some tension between husband and wife. Keep the lines of communication open and be honest about any fears or expectations you have. It is a time for immense closeness between partners as well. Many blessings on your growth and your baby's!

Saturday, February 20, 2010

Poem - Woman to Child

Young mother by CharlesFred.
Young Mother by Charles Fred

Woman to Child

You who were darkness warmed my flesh
where out of darkness rose the seed.
Then all a world I made in me;
all the world you hear and see
hung upon my dreaming blood.

There moved the multitudinous stars,
and colored birds and fishes moved.
There swarm the sliding continents.
All time lay rolled in me, and sense,
and love that knew not its beloved.

O node and focus of the world;
I hold you deep within that well
you shall escape and not escape -
that mirrors your still sleeping shape;
that nurtures still your crescent cell.

I wither and you break from me;
yet though you dance in living light
I am the earth, I am the root,
I am the stem that fed the fruit,
the link that joins you to the night.

- Judith Wright (1915-2000)

I love how this poem illustrates the beginning of the lifelong mother - child bond. It does start with the mystery of conception and pregnancy doesn't it?

Here are a couple of audio links for your listening pleasure:

  • A new book on the history of childbirth has just come out entitled,"Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank" by Randi Hunter Epstein MD. You can listen to an interview with the author here. Many of the callers have had home births. The author presents compelling historical evidence for change in maternity care brought about through women themselves. Something to ponder!

  • And to illustrate the above author's point, we have an interview from a Portland, Oregon radio station KBOO with two birth advocates from South Dakota. South Dakota is in the midst of a grassroots movement to legalize midwifery care and home birth in their state. They discuss midwifery and the politics of birth. The issue is framed and presented as a reproductive choice, similar to the abortion debate. It's fascinating!

Wednesday, February 17, 2010

Sayyida Fatima az-Zahra

inside of Blue Mosque by Atilla1000 (come back soon!).

The following is an inspiring and rare account of the birth of Sayyida Fatima az-Zahra (May Allah be pleased with her). I'm not sure of it's authenticity, but still, from it there are a couple of wisdoms which can be distilled. You can read the entire account here.

When the time of the delivery of Sayyidah Khadijah (Radhi Allahu Ta’ala ‘Anha) was near at hand, she sent for several of her relatives to aid her on that occasion; but as she incurred their displeasure by marrying the Holy Nabi (Sall Allahu alaihi wa Aalihi wa Sallim), they would not comply with her request, so that she was much distressed. Nevertheless, four women, resembling those of the tribe of Bani Hashim, suddenly made their appearance, and Khadijah was afraid of them. One of them, however said: "Fear not, for Allah the Most High has sent us to you. We are your visitors. I am Sarah; this is Maryam, the daughter of Imran; the third is Kalthum, the sister of Musa; and the fourth is Asiyah, the wife of Pharaoh. They will be your companions in Paradise" Then one of these women sat down on the right and another on the left of Sayyidah Khadijah (Radhi Allahu Ta’ala ‘Anha), the third in her front, and the fourth in her rear until Sayyidatina Fatimah (Radhi Allahu Ta’ala ‘Anha) was born. When this took place a light shone from that infant of laudable end, which encircled the houses of Makkah from the east and west, so that there was no spot in any house which was not illuminated by that light.

It's striking how Khadija (May Allah be content with her), in this story, had the desire to have companions during her birth. A natural, human instinct, and perhaps one we have lost. In parts of the Muslim world, birth is still a female, communal event. Women come together to read sacred poetry and Qur'an for the laboring mother and her child. They support her with their hearts and their physical presence. I wonder what kind of community we would have here in the West, if we were to draw near to one another and our Creator in that spirit? Women here largely birth alone, with just their husbands, and often with strangers. It would be nice to see Muslims bring back humanity to the birthing process.

Similar to how we might imagine that the contraction is a wave we are riding, or a mountain climbed, I think that the image in this story, of being surrounded by righteous women can also be a powerful visualization for labor. Imagine their purity, righteousness and faith surrounding you as you labor, not leaving your side until the baby is born. When the contractions begins to crest, imagine yourself surrounded by the strength of Sarah, Maryam, Kulthum, and Assiya (May Allah's mercy be upon them all). What serenity there is in that image. May it bring you serenity!

Tuesday, February 16, 2010

Vitamin D in Pregnancy and Breastfeeding

Heavenly Sunshine by mommamia.
Heavenly Sunshine by mammamia

"And have we not built over you the seven firmaments, and placed therein a Light of Splendour?"
(Qur'an 78:12-13)

Besides the warmth, light, and joy that the sun provides, researchers are now discovering even more benefits to sunshine. Vitamin D. Once thought of as a vitamin in the traditional sense, is now beginning to be thought of as much more than that. It is believed that Vitamin D is actually a group of fat soluble prohormones, really pre-cursors to hormones. These hormones are influential in many of the body's functions, building bones, regulating mood, quelling inflammation and more. Recently, Vitamin D has been touted as a prevention and possible cure, to everything from schizophrenia to the swine flu. Vitamin D can be consumed in our diet, and obtained from the sun. In the past it was believed that we only needed a little for bone health and to prevent rickets, but now it is being looked at in a new light, so to speak.

Vitamin D deficiency in pregnancy has some surprising results. Dr. Anne Merewood discovered that women with low Vitamin D levels were four times as likely to have a cesarean section. Pre-eclampsia, a metabolic disorder of pregnancy characterized by protein in the urine and high blood pressure, is also affected by Vitamin D levels. It can lead to problems in utero for the fetus and life threatening seizures in the mother. Dr Lisa Boden found that in women with low levels of Vitamin D, their risk for developing this disorder was five times higher than women with normal levels of Vitamin D. Gestational diabetes, a form of diabetes specific to pregnancy, can also be prevented by adequate amounts of Vitamin D. One researcher found that inadequate amounts of Vitamin D in early pregnancy resulted in three times the risk of developing gestational diabetes.

And if that's not enough to have you running for the sun, there's more. Women who are low in Vitamin D deliver babies who are as low or lower in their own stores of Vitamin D. This can have a wide and dizzying range of effects on the baby. It can cause or contribute to low birth weight, an increased incidence of asthma, small for gestation age babies, weak bones, autoimmune disease and may even contribute to schizophrenia. Unfortunately, Vitamin D is not transferred through breast milk very well. The American Academy of Pediatrics and others now recommend supplementing exclusively breastfed infants with 400 IU of Vitamin D per day. Generally, however, babies exposed to a little sun each day should have sufficient Vitamin D levels. If a woman's intake during pregnancy was less than ideal, she should consider supplementing both for herself and her baby while exclusively breastfeeding.

Muslim women who cover and women of dark skin are at more at risk of deficient Vitamin D levels. They require longer periods of sunlight exposure and often due to either modern lifestyles, which limit outdoor time, or to cultural considerations, or both, they are not likely to get it. Researchers in Australia found that 80% of veiled or dark skinned women had clinically low levels of Vitamin D. It is difficult to say how much sun exposure is adequate to raise Vitamin D levels as there are many factors, cloud cover, smog, season, that affect how much actually gets absorbed into our skin. Under ideal conditions it has been recommended that just 5-30 minutes of sun exposure on back, face, hands, legs during 10a.m. - 3 p.m. twice a week would be sufficient.

Here are my recommendations for pregnant and breastfeeding mothers:

  • Pregnant and breastfeeding mothers supplement with 1000-2000 IU of Vitamin D.
  • I recommend Biotics Research Bio-D-Mulsion.
  • Eat salmon, other oily fish, eggs, fortified milk, mushrooms
  • Sun exposure for babies of 20 min per day, this is with clothes on. With just a diaper, five minutes per day is enough.
  • You could supplement breastfed babies as the AAP recommends with the same supplement mentioned above, but in the 400 IU dosage
  • Cod liver oil contains an immense amount of Vitamin D, one teaspoon a day per 50 pounds of body weight is the recommendation. So, for an infant that weighs 20 pounds that is half a teaspoon. This is a great supplement for breastfeeding mothers.
  • Daily sunlight exposure for adults.
  • Supplementation should be looked at in balance with the day's total sun exposure. On sunny days where you and your family were outside for awhile , or you ate salmon for dinner, think of skipping the supplement, or diminishing the dosage.

Visit these links to learn more about Vitamin D and Muslim women, or Vitamin D in general. Vitamin D levels can be tested. The above links will give you information on this and much more.

Sunday, February 14, 2010

Birth Story - Baby Khadija

Birth Night by Onur YILDIRIM (Shadov).
Birth Night by Onur YILDIRUM

The following is a birth story from a mother who had had two previous hospital births, this was her first home birth. Sara is a new mother with a full home schooling schedule,which doesn't leave her much time to write out her story! Therefore, we have decided to collaborate on this birth story, which is written from my perspective with encouragement and permission from Sara. Sara’s impressions about the differences between her hospital birth and her home birth are below in italics.

Having a home birth was such a beautiful experience for me. Before my home birth I had two hospital births. Having a home birth for me was relaxing. I didn’t have to deal with all the needle poking that you do in a hospital. I was able to have everything natural, no drug interferences. Being at home I can be free to do what I want, to be comfortable. In labor, I was able to get into any position that was comfortable for me. There is a special bond that you feel with your baby when you have it at home. This bond I didn’t feel with my other two. I feel this extreme attachment to my baby. My husband experienced the same feeling as well. I felt secure in my house, not having any disturbances, being able to eat my own food and to have my family with me.

On Thursday night Sara called. She said her contractions were every 15 minutes continually throughout the day. This was her third baby, first home birth. And of course, this labor was shaping up to be completely unlike the first two.

“Take a nice, warm bath. Relax, unwind, and then try to get some rest,” I told her. “You could have your baby on jummah” I said, “or on Sunday. It’s best to just ignore these types of contractions. They often happen the more babies a woman has. They could go on for days, or you could have your baby tonight. We never know, but it’s wise to conserve your energy for whenever the hard labor arises.” Sara sounded reassured and so we hung up. I slept a full eight hours. In the morning I called Sara to check in.

“I had the best nights’ sleep I’ve had in months!” she exclaimed. I asked her if it was the shower. Sara explained that after her shower she laid down on the bed, not expecting to sleep. Her husband was reading the burda and she lay quietly, turning inward, and listening. Soon, it’s notes and cadences lulled her into a blissful, uninterrupted sleep. She didn’t even wake to readjust her pillows, something she had been doing for months! What baraka our Prophet (peace be upon him) has!

A sunny Friday came and went, and that night I called to check back in with Sara. She sounded discouraged, not like her normal cheerful presence. When I enquired about her state, she said she was frustrated and had had the same on again off again contractions all day. She just didn’t know what this was, it was so different than her other labors. We talked at length about never being in control of the process of labor, and that each labor is different just like each child is different. Although I think that the most reassuring advice to Sara was that, all of this was not for naught. That something was happening with every contraction or cramp she was feeling. It was maybe not measurable progress, but a sign that her hormones and their receptors were working just fine and that her uterus certainly knew how to contract, a sure reminder of the perfection of the process.

Now, I had the best night’s sleep! The trilling of my phone did not punctuate my sleep! I was sure it would because I had something I really wanted to do the following day. We had planned a nice hike for the day. Alhamdulillah we were able to go and it was beautiful, long, and muddy.

At 7:56 Saturday night, my phone rang. Before I picked it up I knew that this was it. “Shannon, my water just broke!” Sara said. We celebrated over the phone. Now this was like her other labors, she was on seemingly familiar territory. Eat, sleep, and be happy I advised. Call when you need me or when something changes.

3:45 a.m. Sunday morning Sarah calls to tell me her contractions are now 4-5 minutes apart and that she is calling her doula over. She doesn’t need me yet she says. I listen through a contraction or two, she sounds like a professional, no tension or anxiety, just pure acceptance. It sounds like it’s on the early side of labor as well, so I stumble back to bed, proud, and reassured by Sara’s new calmness.

5:00 a.m. Sarah’s doula phones me. She sounds excited and explains that Sara’s contractions are now 2-3 minutes apart lasting for a minute! That was so fast. I throw on my birth clothes and jump in the car. It’s beginning to drizzle and Sara lives 20 miles down the highway from me. I don’t want to speed, but her labor has already flown through it’s ‘stages’, and the calls keep coming.

“She’s singing through her contractions now.”

“She’s feeling pushy at the peak”

“Drive careful, but are you almost here?”

It’s always better not to speed, to arrive in one piece, but it’s so hard when the adrenaline is rushing and you really, really don’t want to miss the birth. I had already phoned the midwife who is assisting me and told her to leave as soon as possible. I am making urgent du’a that it all goes well, and that I’m present for the birth. Sara’s exit had never looked so good to me.

I had her husband come and meet me. I brought up one bag which has an emergency delivery kit, just the basics you need to deliver a baby, which in reality, is not that much. What a contrast Sara’s birthing space was. It was an oasis of calm to my rushed frenetic pace. I took a deep breath and exhaled to attune myself to her birthing energy. I said hello, gave her a hug, and asked if she felt like pushing. She said that she did and so I told her to go for it… after I got my gloves on and listened to the baby's heart rate!

Alas, there was no need for the rush after all. The night became day. We opened the blinds, snacked on bagels and dates from Medina, and drank Zam Zam. Meanwhile, Sara went through second stage, all two and a half hours of it. For all of that pushing, not once did Sara utter a complaint, not once did she ask when it would be over, not once did she grumble even. She took each contraction as it came, she took our suggestions with grace and compliance, and when the miraculous moment of birth came, she was fully present to receive her little bundle. All of those days of contractions did make a difference after all, maybe not in the length or speed of the labor (or maybe so!), but in Sara’s willingness and preparation to take each contraction as it came, and not to anticipate anything. By the time the hard part of labor found her, she was ready.

It was a joyous birth, still and hopeful. Sara’s older daughters were milling about downstairs. And the rain was just beginning to pick up. Little Khadija had arrived and brought with her the rains. Which was just fine with her family, because all they wanted to do was stay indoors and adore her anyhow. Welcome little Khadija!!

Thursday, February 11, 2010


One way to describe the difference between hospital birth and out of hospital birth is high tech vs high touch. Working with my hands is one of the greatest joys of being a midwife. It's shocking to me to witness birth occur in situations where the one who delivers your precious baby, has little to no physical interaction with the mother other than to deliver the child. Sometimes all it takes is a light touch on the points of tension, shoulders, brow, fist, for a mother to realize where she is holding the tension with her contractions. From here she can work internally to dispel the tension and flow with her labor more fully. At other times a mother needs two strong hands applying counter-pressure to her sacrum with each contraction. This is hard, but essential work for her birth attendants. Mostly, laboring women just need to feel loved, supported, and understood and often the most effective way to communicate that is through touch. Naoli Vinaver is a Mexican midwife who has recently written an article in Midwifery Today about touch and midwifery care. Her description of the significance of touch in labor is poignant, "This is why touch and massage for pregnancy and birth can be especially important, as women in labor need to move a lot of energy through themselves, give themselves into a lot of energy, and allow a great many changes in their souls and bodies in order to open up to give birth." An excerpt of her article can be read here.

Wednesday, February 10, 2010

Your baby's DNA

Midwives, like hospitals and pediatricians, offer newborn screens to their clients. Typically, these state mandated tests are performed on the second postpartum visit in the family's home within the baby's first week of life. The procedure is to poke the baby's heel and fill five circles on a lab slip with the baby's blood. Now it appears as if more than just the blood is being scrutinized by the state as the above CNN report details.

It is not a fun test to perform. Often the baby is a little dehydrated as the mother's milk may not be in yet, or just coming in. This means less blood, and more squeezing and often re-poking the baby's little heel. The test is a screening test, not a diagnostic test, so if anything comes back positive, the baby requires further testing. Most of the fifty disorders tested for, if caught early enough can be prevented through various treatments, hormones, dietary changes, nutritional therapies, etc.. The March of Dimes provides a list of the diseases and disorders being screened.

Informed consent is a cornerstone of midwifery care. In this case, it means not only offering the newborn screen to our clients, but informing them of the risks and benefits of the test. We also must offer them the opportunity to decline the test. Each state offers a form for refusing the test. Everyone's circumstances and health history should be considered when making the decision about the newborn screen. But from now on, I hope that all care providers inform moms and dads what really happens to the baby's DNA in the decision making process. I know I will.

Tuesday, February 9, 2010

Poem - To a Ten Months Child

Still Pregnant After All These Weeks by hexodus....
Still Pregnant After all These Weeks by Hexodus

This is for all of you mothers who have had the distinct pleasure of going past your due date. Enjoy!

To a Ten Months Child

Late arrival, no
One would think of blaming you
For hesitating so.

Who, setting his hand to knock
At a door so strange as this one,
Might not draw back?

Certainly, once admitted,
You will be made to feel
Like one of the invited.

Still, because you come
From so remote a kingdom,
You may feel out of place,

Tongue-tied and shy among
So many strangers, all
Babbling with a strange tongue.

Well, that's no disgrace.
So might any person
So recently displaced,

Remembering the ocean,
So calm, so lately crossed.

-Donald Justice (1925- )

Also please head over to Rickshaw Diaries to read her post on her upcoming labor. She is extending a lovely gesture.

Monday, February 8, 2010

1st Trimester - The Seedling

First Trimester - Tulip by Creativity+ Timothy K Hamilton.
First Trimester Tulip by Creativity+ Timothy K Hamilton

O humanity, if you are in doubt about the resurrection, remember that We created you from dust, then from a drop, then from a clot, then from a lump of flesh, formed and unformed, in order to edify you. And We keep in the womb those We wish, up to a designated term; then We bring you out as infants, and enable you to reach your maturity: but some of you will pass away, and some of you will be kept here until the age of senility, such that they know nothing of what they knew before. And you see the earth lifeless, but then We shower water on it, and it stirs and swells and produces every beautiful species."
(Qu'ran 22:5)

That sums it up doesn't it? What a beautiful verse. The first trimester is an exciting time. The promise of a new life, a change, can be both exhilarating and overwhelming. A meeting of the sperm and the egg, traveling deep and burrowing into the muscle layers of the uterine wall, begin a cascade of hormonal changes in the mother's body. This is the beginning of placentation, and a foundational moment for the rest of the pregnancy. From here it is a continuous miracle of cell division and organ formation, forming the "lump of flesh, formed and unformed" which Allah refers to in the verse above. In this entry I want to talk briefly and generally, about some of the physical and emotional symptoms that these changes can bring and offer a holistic approach to alleviating any discomfort they might provoke. Please comment on what has helped for you during these precious first three months.

The most notorious symptom of these hormonal changes is the dreaded nausea! Women experience nausea in varying shades and degrees. Some have nary a flip of the stomach to others who vomit so intensely that they must replace the lost fluids with an IV. Most women fall somewhere in the middle. One of my teachers insisted that the more out of touch a woman is with her body, the worse the nausea is. Here is what I recommend.

  • I love red raspberry leaf tea. It is a nutritive herb, providing minerals in an easily absorb able form. I recommend buying the herb in bulk. You can make a tea pot of the herbs and drink from it throughout the day. Steep for at least twenty minutes. Strain and enjoy. You can let it steep for as long as you like, the longer it steeps the more medicinal it is. It does taste a bit like hay, so it can be sweetened with honey or lemon. Drink throughout the pregnancy.
  • Some nausea can be attributed to low blood sugar. I find that a lot of women, when not pregnant, don't eat consistently throughout the day. It is hard to adjust to the body's increased caloric demands during pregnancy. Eating small, frequent meals throughout the day can help alleviate any nausea due to low blood sugar. Carry food with you at all times!
  • Get plenty of fresh air, exercise, and breathe deeply. The increased intake of oxygen can help to increase circulation which can help to decrease the greater levels of acids and carbon dioxides now accumulating in the blood.
  • Homeopathic remedies can be phenomenal in their abilities to turn nausea around. Each remedy has different indications, so please read more into their unique properties. The ones which I've seen work most consistently for nausea are Nux Vomica, Sepia and Pulsatilla.
  • Ginger tea, peppermint tea, and/or anise with fennel teas are all soothing to the digestive tract.
  • Aromatherapy also helps if you have nausea worsened by smells. Try a warm bath with lavender, sweet orange, or sandalwood essential oils. Also try a couple of drops on a cloth and sniffing it throughout the day.

Cramping and/or bleeding can be a frightening experience during pregnancy. In some cases though, it is a reassuring sign of pregnancy. As the uterus rapidly expands in size and weight it goes through toning contractions. The ligaments which suspend the uterus in the body have to stretch along with the pregnancy. This can cause round ligament pains which can often be quite sharp and crampy. Bleeding, usually spotting, can occur with implantation of they embryo, it may also occur around the time you would expect your period, and after sex. If you experience heavy bleeding and cramping contact your midwife or doctor.

  • Use a hot water bottle or take a warm bath to alleviate round ligament pains
  • Stretching and/or massage can also alleviate these crampy sensations.
  • Make sure you are hydrated as dehydration can also cause cramping.
  • Make sure you are emptying your bladder as a full bladder can also cause cramping!
  • Turn inwards and locate a place of deep knowing and trusting. Remember Allah’s words above, “And we keep in the womb those We wish, up to a designated term”. Remind yourself of the power, bounty, and generosity of our Creator. Submit to the mystery of the process.

Your baby’s liver, kidneys, heart, lungs and much more are rapidly developing during the first weeks of gestation. As you can imagine this is a very sensitive, yet crucial window of time. It is affected by everything around us, and everything we put in our bodies. Here are some suggestions to get their organs off to the best start:

  • Stick to organic, high quality foods. If you can’t afford to buy organic everything, here is a link to the dirty dozen, the foods most contaminated from pesticides.
  • Clean your air. Open a window to air out any indoor air pollutants that may have accumulated in your house and/or car.
  • Check with your midwife or doctor regarding any herbs, or medicines before you take them.
  • Stay away from parabens. These are mostly found in lotions and cosmetics. They are carcinogenic.
  • Try to switch to natural cleaning products. Chemicals from standard cleaning products can be harmful to fetuses and adults alike. Vinegar and baking soda do wonders around the house!

The prospect of becoming a mother, whether it’s your first or fifth time can bring a flurry of emotion. One can feel anxious about the added responsibility, shy about the noticeable changes in ones body, as well as excited at the prospect of a baby. It’s good to be honest with yourself and your family about these feelings. They are normal. As our bodies make way for a new life, so must our psyches. Sometimes there is more of a struggle than others. Be kind to yourself, soon you will feel the fluttering of new life within, bringing with it a new slew of feelings and excitement.

Lastly, it is also a time of soul development! The baby’s sustenance, deeds and ultimate destiny before Allah will be decided sometime around the end of the first trimester, beginning of the second. It is recommended to keep our internal houses clean as well. Mothers should try to stay in a state of wudu, read Qur’an, be in a state of dhikr, and generally prepare for the arrival of angels. They are bringing gifts from the heavens insha’Allah. May this time be a reminder to us as well, for as Allah states in the verse above, “…if you are in doubt about the resurrection…” , and then He advises us to reflect on this miracle occurring right inside of us! What an awesome way to draw near to Allah.

Please leave your advice and best solutions to any of the above in the comment section.

Friday, February 5, 2010

Birth Story - Muhammad Idris Cong Tu

Our first birth story comes from a dear friend. It's an excellent story. I like how she clearly experiences the sensations of the contractions and really opens herself up to them. Not to say that contractions don't hurt, but resisting them only increases the pain. This story is a good example of surrendering to the contractions as they are. You can read more about her here. Stay tuned for an upcoming interview about her work entitled, "Sunna of Birth. Enjoy!

Peace & Blessings,

I was blessed to have a beautiful home/water birth on September 18, 2009.
This was a very special day for my family because it was the last Friday in our holy month, Ramadaan, and just two days before our day of celebration, Eid ul-Fitr. The last 10 days of Ramadaan are very sacred for us and Fridays are also special because they are the holy day of the week when we attend the Mosque and pray with our community. My friend Shoshanna baked Challah bread for us on that day also, on the day of my daughter's birth in 2007 she brought me fresh squeezed grapefruit juice while I was in labor, and on our son's birthday she brought us the special bread and shared that it was also the Jewish holiday, Rosh Hoshanna, which is the day of the "Birth of the World" and the bread symbolized the world. Praise our Creator, what a blessed and perfect day to give birth and to be born!

On Thursday evening a bit of my mucous plug released when I used the restroom. I texted Racha & Maura to give them a heads up...and than my Husband, Daughter, and I went on a short evening walk. I didn't necessarily expect too much, as I've learned as a Doula and Midwife Apprentice never to expect anything in birth, except the unexpected. When we returned I took a shower, relaxed, and put my daughter down to sleep. Because it was Ramadaan, and my husband was fasting during the days, he had a lot of energy at night, and we used this time to bond and do extra praying and reading of our spiritual text, the Qu'ran. That night we were up at 4am when I began feeling contractions. I joined my husband for the pre-fast meal and we waited until 5:30 to pray the dawn prayer. I was anxious to get some rest realizing that my contractions were only going to get stronger, especially because in the one-and-a-half hour I was up I had at least 5 to 7 strong contractions.

When we finally went to bed after 5:30am, I lay down, only to realize within 30minutes that I wouldn't be able to sleep because the contractions were already pretty strong. Between 6am and 8am I labored alone in our family room so I wouldn't wake my husband and toddler. By 8am I realized I should call Racha and let her know that my labor was pretty intense already. As a Doula & Midwife Apprentice I never wanted to call my midwives in the middle of the night, which is usually how we are called, I guess its a little courtesy, but by 8am I couldn't really wait any longer! I'm glad I called Racha because she suggested I wake up my husband and have him set up the birthtub. I really wanted to let him sleep until 10am because I knew once he woke we would be in full labor mode, good thing I listened to Racha, because by 10:12 am our baby boy was already born!

When I woke up my husband, my daughter also woke up, and when I told her the baby was coming she replied grumpily, "Don't come out baby, stay in there!," because she still wanted to sleep. Daoud went straight to work setting up the tub in the corner of our kitchen, it was really beautiful because we have some nice house plants and spiritual art in that corner of the kitchen, he also made a tent by staple-gunning some pretty sheets into the ceiling around the tent creating walls and a little room for me. I decided he was the best husband in the world and I tried to tell him, but was having a contraction and told him to "Go away, please," instead! During the hour or so it took my husband to set up my sacred birth space my contractions became very intense, lasting a minute-and-half to two minutes and coming on at least every 2-3 minutes. I labored on my hands and knees feeling a sharp opening of the last bit of dilating of my cervix and shaking with contractions, as Sumaiya, my two year old, played "horsey" on my back...

By 9:30am I managed to text Maura and Racha, "I think you should come soon", and I made my way to the tub getting in to the hot water. Daoud put on a recording of Surah Maryam, the chapter in the Qu'ran where Maryam gives birth to the Prophet Isa (Jesus). Its a beautiful Surah, my favorite in the Qu'ran, and I listen to it and read it often during my pregnancies because of the blessings it holds especially for Mothers and babies. As I relaxed in the tub, letting my body go to the support of the water as the last few contractions made powerful waves through me.
Racha and Maura arrived by 9:48am, and during the time my husband went to the front of our building to open the door and return with them, I followed my body in its urges to bear down with my contractions. When they came into our home I was already beginning to push. They came into my birth tent quietly, bringing some green water for me to sip on. I couldn't believe I was already pushing and didn't feel like I was ready since everything happened so fast! Racha had to help me get my underwear off because the baby was coming down pretty fast once the midwives got there and I felt I was just gonna go for it. With the next push Racha said she could see the head, it felt very close and I somehow communicated that she should let Daoud know that the baby would be here any minute. Daoud and Sumaiya came in, and Sumaiya really wanted to get in the tub with me when she saw that the baby was already coming out, she stripped off her clothes, but Daoud managed to keep her out of the water! With the next push the baby was crowning, Racha asked Daoud if he wanted to catch, and even though he did, I said no, because I wanted to catch him because I felt very relaxed and focused and in a really connected rhythm with the baby. I always feel that a mother should be able to be the first to receive her child when possible, to welcome her baby with her own hands! Within two contractions the baby crowned and his head was out, still in the water-bag, which midwives call being born in the Caul, and many say it is a very sacred event. I had to gather myself and blow because the energy and pressure was so strong and I didn't want to do it all at once. I grounded myself and gathered energy for the next contraction, blowing and breathing because I knew he would be fully into the world with the next contraction and push. I could feel his body fully rotate within me and followed the contraction and his bodies movement to push him out and kinda ride the last wave.

Our little Muhammad, named after our Prophet (Peace & Blessings be upon Him), was born at 10:12am, just 6 hours after I felt the first contractions of active labor. Most importantly, I thank Allah for the blessed gift of our new son, Muhammad, AllahuAkbar! AllahuAkbar! AllahuAkbar!

Wednesday, February 3, 2010

The Wife of Umar ibn al-Khattab

abaya mama by the Humanette.
Abaya Mama by the Humanette

I have always wondered about the women during the earliest generations of Muslims. How they dressed, how they cooked, how they educated their children. And, I have always wondered who took care of them during their pregnancies and deliveries. Coming across this paragraph below, I was fascinated to see that the wife of Umar ibn al-Khattab (May Allah's Mercy be upon them both) was a midwife! Can you imagine having her deliver your baby, perhaps with Umar patiently waiting outside? What a blessing that would be. I love the reminder of Umar's scrupulousness and love of the Prophet (peace be upon him) in the paragraph below. You can read the entire description here.

He was a very pious Muslim. His success lay in two things-fear of Allah and his love for the Holy Prophet (Sallallahu 'alaihi wa Sallam). He never used even oil from the Bait-ul-Mal (Public Treasury) to burn a lamp at night for his personal needs. Whenever he finished the official work he put off the lamp. He used to patrol in the city at night to find out the needs and requirements, and conditions of the people. He did not hesitate to take his wife to work as a midwife for a poor woman. The salary he got from the Bait-ul-Mal was so low that it was hardly enough for him and his family's needs. When some of the eminent Muslims requested him to increase the amount he, said, "The Holy Prophet (Sallallahu 'alaihi wa Sallam) has left a standard by his personal example. I must follow him".

Tuesday, February 2, 2010

Eating and Drinking in Labor

Dates, anyone? by jemasmith.
Fresh Dates by jemasmith

Then labor pains impelled her to the trunk of a palm tree. She said, "Would that I had died before this and been completely forgotten." Then he called to her from below, saying, "Do not grieve; your Lord has put a stream beneath you and shake the trunk of the palm toward you to let fresh ripe dates fall by you. Then eat and drink and be of good cheer: but if you see any man say, 'I have dedicated a fast to the Benevolent One so I shall not talk to any human being today.'"
(Qu'ran 19:23-26)

This is from the Qur'anic chapter entitled Maryam, and it is detailing the birth of 'Isa (peace be upon him). Allah is directing her to eat and drink during labor. A woman's first labor can be the caloric equivalent of swimming nine miles, why wouldn't one eat or drink to maintain their stamina? Allah is Wise.

In the majority of today's maternity wards however, women are not allowed to eat or drink during active labor. Ice chips are given out, but not much else. The logic behind this is to keep the stomach empty in case an emergency arises which may require the woman to undergo general anesthesia. Having any food in the stomach while undergoing general anesthesia can increase the risk of aspiration, a potentially life threatening situation.

In an out of hospital situation it is generally accepted that depriving a woman and her hardworking muscle, the uterus, of food and drink during labor can lead to a state of starvation, called ketosis, in the mother. This can prolong her labor, make her uterus ineffective, and possibly affect the reserves of her baby as well. In my practice, I give a list of beneficial and recommended food and drink to my clients during a prenatal visit in their last month. Broths, popsicles, honey, dates, yogurts, easy to digest foods are all encouraged. Labor is hard work and incredibly physical, we need to replenish our bodies as we labor.

And now it looks like modern obstetrics is concluding with the divine advice revealed to Maryam and with what midwives believe, that there is no justification for the restriction of fluids and food in labour for women at low risk of complication. A recent Cochrane review found no compelling reason to uphold the ban on food and drink in low risk women during labor. In a NYT article, summing up the study, one obstetrician illustrates the lack of logic behind the ban, “My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study.

While we don't need modern science to prove the Qur'an, it is always harmonious when it does. "Do not grieve" Allah says to Maryam before He tells her to eat and drink. I imagine her comfort at finding a gurgling, cool spring beneath her; of refreshing her mouth dry from breathing with her contractions. And, of her hearing the reassuring thud of dates falling on the ground as she shakes the palm tree towards her. Soon a great prophet is to be born, and Allah is telling her, 'eat, drink, and be of good cheer'. The world was forever changed. Gentle, encouraging words from the One who has designed perfectly how we birth our babies.