|Sarah and Scott Mayer|
My views on pregnancy, childbirth, and child rearing have dramatically changed, especially during the last five years or so. During this time, I have gone through my clinical training in gynecology, obstetrics, and pediatrics first as a registered nurse, and then as a family nurse practitioner. During R.N. school, I actually had a great teacher for learning about childbearing who emphasized the idea that pregnancy and birth is a natural part of life with usually no intervention needed, instead of the idea that it is some sort of illness that requires a long panel of tests.
However, my brief six weeks (yes, just once a week for six weeks!) of time in Labor and Delivery at the hospital showed a different idea. I did not see one woman walking the halls, encouraging the natural descent of her baby, or in a tub, or using any other sort of labor assistant device. No, my first day there, my patient was on her back, with a Pitocin drip (a drug to supposedly speed up labor), and a fetal monitor strapped across her belly. I felt so awkward, and the only thing I could think to offer was a back rub, which I wasn’t even sure what I was doing there. All the things we learned in class, such as position changes, could not even be applied in this situation. I did not get to see the birth of this baby, as a more critical situation arose with another patient. At only about 20 weeks, her cervix was opening and there was nothing the doctors could do. She had no one with her, and I just could not leave her. I held her hand and talked to her as she delivered a stillborn little boy. I still remember the details of that day like it was yesterday, and it still makes me ache and cry when I think of it. That was my first and only birth I have ever seen.
Fast forward about two years, and I was in obstetrics clinical again, this time as a nurse practitioner student. I studied at a community health center. Prenatal visits had a routine sequence. Weight, urine check, lots of blood work, offers for amniocentesis and genetic testing, pelvic exams and ultrasounds, and brief teaching on taking vitamins, doing birth preparation classes, and warning signs to look out for. Nothing about encouraging breastfeeding, nutrition and exercise advice, or what to expect after the baby was born. Breastfeeding was basically approached as a question if the mother wanted to do it. Whether she said yes or no was just documented in the chart. And I sadly remember all this as thinking at the time that this was the normal way to experience pregnancy. This lack of encouragement for breastfeeding continued into my pediatric clinical, as the doctor just asked whether the mother was breastfeeding or not and left it at that.
The semester after all this happened, I started clinical work with Drs. Denise Punger and John Coquelet, with whom I am currently employed. And my view on pregnancy and birth and breastfeeding was turned upside down. After reading Dr. Punger's book, "Permission to Mother", as well as other recommended books by her, I was brought back to that original idea planted by my wonderful teacher in R.N. school. A woman’s body is meant to carry a child and birth it! And those two things on our chest actually have a purpose, a wonderful purpose that every woman who has a baby should be able to do! After assisting in several lactation consultations with Dr. Punger, I saw how truly wonderful it was to breastfeed, that there is lots of help out there if a woman is struggling. I knew that when the day came for me to have a baby, I would want it to be different than what I experienced in school.
All this change came none too soon as shortly after starting that semester, my sister, the writer of this blog, shared the amazing news that she was pregnant. And she wanted me to be present and assist her in the birth. I was definitely impressed and inspired as she shared her preparations for birth and child raising, and her dedication to a healthy diet and exercise during all this time. In preparation, I read her birth plan and learned about her methods of coping with the labor. I also read a great book on being a labor assistant or doula, the many different position changes, and massage, focus, and relaxation techniques. As her readers know, the birth did not go exactly as planned, but she did as best as the situation allowed, and Nolan got off to a great breastfeeding start. I am so grateful that I had the experience with the breastfeeding consults, as I was able to help out Jenn those first few days after delivery when she was getting frustrated with engorgement, latching, and Nolan spitting up. Even though our mom was there too, it had been over 25 years since she breastfed, and did not even do that but a few weeks. I see Jenn and Nolan frequently first hand, and he is an adorable, healthy, intelligent little boy (and I’m not just saying that because I am his aunt!), and the bond they share especially during breastfeeding is beautiful. Also, Jenn has taught me a lot about a more natural, healthy, and “green” way of caring for a child, such a making homemade baby food, reusable diapers, and really the unnecessary accumulation of so many “necessary” child care products out there. She has certainly been an inspiration to me and will be a great resource for questions.
I do not do the consults with Dr. Punger anymore as I am busy with my own patients, but whenever I do see a patient who is pregnant, or a patient who has a family member or friend who is pregnant, I always discuss her birth plan and plans for breastfeeding. If she is not sure, I reinforce the benefits of breastfeeding, and encourage her to meet with Dr. Punger or another lactation consultant both before and after the birth, attend La Leche League meetings, and read lots of books so things get off to a great start. And to all the women out there who are pregnant or plan to be someday: do not count on your doctor to provide you with all the information you need! More than likely he or she had minimal training in breastfeeding and other “normal” parts of being a mother. We are taught mostly what to check for and the illness side of things. Read books, talk with other mothers whom you admire, and seek out specialists like doulas and lactation consultants.
Sarah Mayer, ARNP, FNP-BC
You can contact Sarah with any questions at: 772-466-8884
Coquelet & Punger Family Medicine
4640 S. 25th Street
Ft. Pierce, Fl. 34981