Midwifery and Postpartum Care From Generation to Generation – From Mexico to the United States

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Sarah and Her Mother Martha: The Cuarantena – From Mexico to the United States, by Imeinu doula and midwife in training Cristina Urista, was published by Squat Journal in the Winter 2012 edition. Please find the article here: Cuarantena Squat Journal Urista Postpartum Mexican

My mother Esperanza (right), a former Mexican partera, her mother Eufracia (pic) who taught my mother the importance of the Cuarentena care was also a Mexican partera, and me (left), currently training as a nurse-midwife at UCSF. -- Cristina Urista

My mother Esperanza (right), a former Mexican partera, her mother Eufracia (pic) who taught my mother the importance of the Cuarentena care was also a Mexican partera, and me (left), currently training as a nurse-midwife at UCSF. — Cristina Urista

Sarah Miranda had discussed the special postpartum care she received from her mother with her Imeinu doula Wendy Kenin after her third pregnancy. They had hoped to document it, to share the important traditions in supporting maternal health. Cristina Urista encountered Wendy the next year.

Cristina herself was beginning her journey into birth work at the time she interviewed the Miranda – Moreno family about the Cuarantena. Doing this research gave her an opportunity to begin to approach her own mother for a deeper understanding of her background as a midwife (partera) in Mexico.

“I am grateful that Imeinu encouraged me to further connect with my mother’s past as a Mexican partera, allowing me to discover that my maternal grandmother was also a partera,” Cristina says. “Imeinu opened a space where I could explore and reclaim my traditional and intergenerational Mexican birthing customs.”

Sarah Miranda (left) and her mother Martha (right.) Martha cared for Sarah according to the traditional cuarantena customs of their heritage after the birth of Sarah's third child, as was documented by Cristina Urista.

Sarah Miranda (left) and her mother Martha Moreno (right.) Martha cared for Sarah according to the traditional cuarantena customs of their heritage after the birth of Sarah’s third child, as was documented by Cristina Urista.

Cristina did an awesome job applying her ethnic studies background to document the postpartum care that Sarah’s mother Martha Moreno provided beginning immediately after delivery of her third child. We were thrilled that Squat Journal published Cristina’s concise and rich article to help share the wisdom of these special traditions for women’s and babies’ health.

After, Cristina joined Imeinu at a home birth and several hospital births. She wrote the story of her own birth, published by instructor Samsarah Morgan, founder of Bay Area Birthkeeper, where Cristina dove deeper into birth work, and you can read it here.

“Imeinu opened a space where I could explore and reclaim my traditional and intergenerational Mexican birthing customs.”

Cristina has been accepted this year into the nurse-midwifery program at UCSF after working for three years as a doula, which followed after the publication of this article in 2011.

It was very special to have Cristina document this practice that a grandmother brought with her from Mexico to Napa Valley in caring for her daughter, our beloved Imeinu client. Imeinu thanks Cristina for her tremendous contributions and looks forward to continued collaboration as she embarks on her midwifery studies.

Mazel tov!

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Miriam Danced Through Labor

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The Birth of Emanuel 6/12/07 4:53 born 8 lb 11 oz A beautiful day it was June 11, 2007 bright sunshine and blue sky. I spent the morning working with the plants and soil, cleaning and organizing the house and making phone calls (work related.) I was overcome with a feeling of frustration and fear of the unknown ahead of me. How would I support my baby? What work will I find? Who will take care of my son? What will happen with my partner?? I decided nature would cure my feelings of despair so I went and took a hike with my mother in Tilden which felt very healing and definitely got things moving inside me. I released my fears and prayed for guidance. My mom then nourished me with a good chicken meal and I left to go to Melita’s birthday party. The house was filled with beautiful people, women either pregnant, with baby or toddler. The energy was so supportive and everyone gave me their blessings for my easy labor and that it should be soon. Jessica Ezra worked on my shoulders and my acupressure points on my feet and ankles and hands. I felt a little wet in my underwear, but figured it was nothing. I went home and ate dinner and got ready for bed. Just after my shower as I was about to get into bed my waters broke and began to flow at 11:45 pm. My body shook with great excitement as I knew that was it. I was in labor – a process that would be long, beautiful, intense, painful and bring Emani into my arms. I emptied my bowel and lots more water into the toilet. I then laid down remembering that I should try and rest to conserve my energy for active labor. I laid down in my bed, surrounded myself with candles and beautiful music. I entered a place of deep peace and rested a couple of hours. Into the night my contractions began to come on, so sweet and mellow energy every 3-6 minutes. I could breath through them and focus into the music and I was fine. Amir laid beside me in and out of sleep, but I was mostly alone, through the night warmed by the sounds of the Native American flute, Hariprasad, Indian Raga, and soundtracks of rivers flowing. Between contractions I prayed from my prayer book (comprised of prayers for all of my friends and community) and prayed for myself and Emani to have a peaceful union in this world. Through the night, each time I went to pee my mucus plus released and I bled into the toilet and into my pads. As the morning approached the contractions became a little more intense and regular and I knew it was time to start waking people up. My first call was to Wendy and she showed up at around 6 am. She timed my contractions and helped me find comfortable positions to work with. She called Jeri Zukoski my midwife, and we gave her a heads up that I was in labor. Then we called Jen Miriam who came quickly and then my mom who already had lost a night’s sleep knowing that I was in labor. My mom brought a siddur to pray, lots of food for my friends, and a bunch of jasmine that smelled amazing. I drank coconut juice throughout my labor which really gave me strength since I could not eat anything. Ice water was also great. Already by 6 am my contractions were one minute apart which made me need to completely focus on my labor with no real rest time to do anything but deep relaxing cleansing breaths. Jen Miriam was so amazing. She got me through each contraction by totally tuning her energy into my body either by putting deep pressure on my sacrum and lower back, or squeezing my hips together, squeezing my foot and sometimes my leg. Since my rushes were so intense, having intense counterpressure really helped.

Since my rushes were so intense, having intense counterpressure really helped.

The other way I got through my rushes was to be either on all fours or leaning over on a piece of furniture and swaying my hips side to side, doing large flat hip circles and flat figure eights. I relaxed my face muscles, moaned and made deep sounds from my gut. It sounded very sexual and I felt totally primal, uninhibited and deeply in trance. The water sounds really helped me flow through my rushes and I visualized my cervix opening each time. Jen had this amazing way of melting her body into mine in whatever strange position I was in and totally working through it with me. When she tells me the story of my labor she tells me that I danced through my labor which is so moving for me.

When she tells me the story of my labor she tells me that I danced through my labor which is so moving for me.

Another movement was sometimes at the climax and end of a rush. I would shoot a hand out with fingers spread wide out as if grabbing for something. It was like I was releasing these electric pulses of energy out through my hands and fingers. At about 10 am I went into the shower which was great. I either leaned forward with my hands on the bathtub and continued my hip dance or I squatted on a low stool and wailed out. Jen came into the bathroom and she played my frame drum and sang a Sufi chant to me over and over… for over an hour. It was so high. I will never forget her gorgeous silhouette figure with the large drum through the shower curtain. My rushes were constant and I used my low moan in rhythm and harmony with Jen’s song. I pray to never forget this moment of my labor. When I got out of the shower I must have been in transition since my voice changed and got louder and I was less able to communicate. I was so happy and thankful to be laboring at home and was really weary of going to the hospital. I really wanted to wait until the last minute, and in the back of my mind I thought maybe the baby would be born at home (by accident.) I threw up pretty violently and again emptied my stomach. By 1 pm my contractions were so intense I said, “I don’t think you can transport me to the hospital. If we have to go we better go now.” So I got in the back of Wendy’s van so that I could remain on all fours and not have to sit down. I felt like a wild dog, ready to escape a cage, but thank God the ride was short to Alta Bates. My mom followed in her car and Nuria followed in hers. Arriving at the hospital was intense. I continued to have rushes walking into the building. We had to keep stopping so I could lean over and have Nuria do the hip squeeze. In labor and delivery they told me to go to triage but when they saw my state they said just go to your room, room 22. It was really nice and spacious for a hospital room and even had a jacuzzi (although I was told to avoid it to avoid infection since my waters broke.) The shower was great, it was sort of broken but somehow Nuria got the showerhead to work and she had it on my abdomen consistently and someone else (my mom or Jen) poured water over my back. The nurse came in to check my dilation and I was 8 cm dilated!! It was such an exciting moment for all of us, and staying at home had been such a blessing. So we arrived at Alta Bates at 2 pm and I had 2 hours of really intense labor. The midwife showed up while I was in the shower, Nuria spraying me and my mom and Jen were singing to me two beautiful songs.

My mom and Jen were singing to me two beautiful songs.

She stood there with the nurse, they must have been so moved. The nurse was so sad to leave but her shift was over. One amazing miracle that happened was that the computer died so the nurses were totally unable to do any tracking of fetal monitoring. They just checked the baby’s heart rate with a hand held monitor (like a doppler used in homebirth.) I went back and forth from shower to bed where I was on all fours and using intense vocalizations. Jeri the midwife checked me at around 4 pm and said I was completely dilated (10 cm) but the baby was posterior and could not come out in that position, that may take him a while to rotate or she could manually rotate him. So I told her to go ahead. It hurt but I knew it was worth it and she so skillfully stuck her fingers up into my cervix and rotated the baby into the perfect position. It was amazing. She then told anytime I wanted, to to start pushing. This was intense and I started to try different positions for pushing. I tried all fours, I tried standing squat, the squatting bar. In each position it felt like the baby was going to burst through me too quickly so I decided to sit up in squat and use the bar to hold the sides and press my feet into. At first I just breathed the baby down with each contraction and the midwife said she could see a tiny patch of black hair and that if I start really pushing he was on his way out. They brought a mirror so I could see the top of his head – it was so emotional so I told them to move it. Then I really started to push as Jen encouraged me. It was scary, I felt like I was going to explode and I kept saying that and Nuria reassured me. I can do it, she kept giving me strength through each moment. Wendy also gave me strength. I knew that if I pushed with all my strength he would come flying out of me and I would tear bad so I had to learn to push hard with strength, but also hold back a tiny bit. In between contractions I had those peaceful moments of rest longer than I had throughout my entire labor. I used these moments to let myself relax and totally go limp, and it was nice to have the back of the bed to rest on. One moment I almost slept for a few moments and everyone was super quiet.

In between contractions I had those peaceful moments of rest longer than I had throughout my entire labor.

The last stages of pushing and as I crowned was so intense. I prayed to God for help and really used my voice. As he crowned I must have yelled out so loud. I have never heard my voice get so loud. It burned like crazy, but thank God Wendy came to the rescue and poured tons of olive oil down my perineum which really cooled the burn. When his head came through Jeri told me not to push but to pant and hold back. I stretched beautifully as his head emerged and then his elbow came tip first which ripped me, but not too bad at all. Jeri saw that the cord was wrapped around the baby’s head once and she slipped it over his head and said, “Okay, you gotta push him out now,” in a scary voice and I knew she was concerned. So I gave it my all and pushed him out which felt so good! What a high moment. I felt like I was flying and God was carrying me on to another world. No drug has ever made me feel so high.

What a high moment. I felt like I was flying and God was carrying me on to another world.

Everyone cried and Jeri placed him on my belly as he screamed out and turned bright pink. What a healthy baby he was, so beautiful and perfect. He only cried a few minutes and then he opened his eyes and stared deeply into my eyes. I was in tears of joy at meeting my little Emani. He was wide awake and we spent the next two hours in blissful bonding and falling in love. I was so high and felt so empowered by my birth. I wasn’t even the last bit exhausted but felt such amazing spiritual energy. I have never at any moment felt so close to God and so in love While I was crowning and pushing Emani out my mother lead two songs. One was, “I am opening up in sweet surrender to the luminous love light of the one.” The other was a psalm. As I write this birth story my heart aches with longing to experience birth again. With all of the intensity and pain and beauty, and empowerment. I can’t wait for my next birth… please God let me be blessed. I also pray that all women can be so blessed to have such beautiful births.

I also pray that all women can be so blessed to have such beautiful births.

Jeri stitched me up really well, which hurt a little bit but since Emani was at my breast nothing really mattered. He even latched on and started to suck which helped the placenta come out. Jeri waited for the cord to stop pulsing before cutting it which was really nice. The 2 hours following the birth were great. Noone bothered me and Emani just laid on my breast in total peace. Then the nurse came back, wiped him off with warm wash cloths, put drops in his eyes and weighed him. 8 pounds 11 ounces! Wow, that’s a lot! No wonder I felt like I was going to explode when he came out. When the women parted from my birth I cried in thanks and love as each one left the delivery room and they all hugged me as well. I never could have done it without them.

I never could have done it without them.

The nurse gave him the vitamin K shot while I nursed him. The nurse cleaned me up and put me into a wheelchair to got to my recovery room. I felt like I was on some crazy psychedelic going down the corridor of the hospital. The recovery room was fine and the nurses treated me so well. So I was happy to stay two nights. My mom slept the first night with me and Amir the second. Rachel, Wendy, Nuria, Jessica, Steve and Elan all visited me there in the hospital. The nurses really pampered me and helped me learn some breastfeeding and diaper changing skills. I was very grateful for their attention. Those first two nights of Emani’s life were so blissful, even though my stitches really hurt and so did my butt. I was so happy and high off of my love. Emani slept at my breast all day and night and when he was awake he was so quiet and peaceful and never seemed to cry. I called him my Buddah baby. My high of my love made my pain feel so insignificant.

My high of my love made my pain feel so insignificant.

Going home was intense. It was like entering reality. I was now a mother on my own. It was great to have so much support from my mom and all of my girlfriends (especially since Amir was so not up to the part.) Each day someone brought me a meal and some love. What a beautiful community and blessing. I never minded being woken every two hours with a poop or hungry belly. Emani is so precious, my little king. The first couple days at home he had a little jaundice which was upsetting and he didn’t nurse very often but by day four he was fine. He simply woke up!! I tell my birth story over and over which is almost satisfying but never really captures the magic for me since that magic is so beyond words of this world and I must just be grateful.

~

Miriam is an internationally acclaimed performing artist and instructor, with great inspiration to find ways the arts can help build bridges and create respect, love and unity among people of different backgrounds and spiritual traditions.

Noah’s Birth Story (written by Janie)

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janie riley and noah halbright 2010

He arrived at 6:05pm on December 13, 2010. I felt him come out of me.  I felt his head and his face slowly emerging from my body.  I needed to keep pushing until I felt the full release.  I kept bearing down even though the contraction felt like it had ceased.  I pushed down with my whole upper body and torso with the strength of the universe, since I had none of my own left.  I felt the release and I heard them say, “We have a baby!”  The pain vanished and my heart leapt with joy.  Our sweet little baby has arrived.  Hi baby boy.  Hello and welcome!

How it started

Just two days before on a Saturday night, Rudi and I were relaxing on the couch watching the movie “Babies” on Netflix. What a time to feel a strange sensation arise in my abdomen.  I wondered if it could be a contraction.  Our son’s due date still eight days away, I assured both Rudi and myself that even if it was a contraction, it was probably “false” labor. 

But they kept coming.  We both went to bed, wisely believing that at this point, sleep was paramount.  But the sensations woke me each time so sleep was elusive.  I knew my baby was coming.  By early morning, I was getting the hang of managing the rise and fall of the sensations through breath.  In the wee morning hours, I finally woke Rudi to be with me.  I had began to realize that nature and my body was taking over, and there was no getting off this new and exciting train, which seemed to be moving faster and faster.  I was wide eyed with anticipation and wanted to stay present to the strange and mysterious process unfolding.  It was hard to believe that the intense pressure in my abdomen was going to produce my son’s birth, as it felt more like a hindrance to opening my body rather than supportive of the process.

Sunrise came and the contractions spread out as the morning passed, to the point that I again had to wonder about the possibility of false labor.  I was able to do normal things throughout the day between them.  But by afternoon they seemed to increase again.  Rudi began wrapping up his school commitments and Isobel dropped off the changing table just in the knick of time.  Our friend Alissa came over to be with us, bringing food, support, love, and her healing touch.  In the afternoon, Rudi took a nap and Alissa and I took a walk.  Hugging a tree seemed incredibly important.  I could feel the strength of the tree penetrate my whole being and I felt at one with the tree and with the Tao of life.  We walked on for a while, stopping for each contraction.

Sundown must have signaled to my body that it was time to get to work again.  The sensations got a little closer and more intense, and I began to feel more reliant on the presence of my loved ones.  I started to realize that there was no place comfortable to go, as I moved from the couch, to the birth ball, to the beautiful, carved, wooden South African birthing chair that my friend Moira had dropped off just a week or so earlier.  I danced a bit, walked a bit, and continued to seek comfort with different positions.  Alissa stayed on until 11pm or so, and then another dear friend of ours, Naomi arrived.  Rudi was being very loving and supportive and his very presence was one of my biggest comforts.  He went to bed to get some rejuvenating sleep when Naomi arrived.  Naomi’s presence was gentle and consistent.  I decided to take a bath.  The two of us moved through a couple of hours together until it was time to call my doula, Wendy Kenin.  She arrived in the middle of the night and just the sight of her brought more relief.  At this point, the contractions were five or so minutes apart and all of my energy, focus and concentration were on them.  I had left the normal world and I was in labor land.  Now I knew what the books meant.  Nothing else mattered to me, but to ride the contractions and find ways to work with them rather than against them.  I was my instinctual body in motion.  Any resistance from my mind was futile, though I did try to resist several times!  I kept looking up to see Wendy’s soft, focused face.  She was sitting beside me as I lay sideways on the couch, the only position that seemed sort of okay.  She coached me, but I don’t remember what she said.  I finally found my voice and began using it to move through the awesome and mind blowing pressure in my uterus and abdominal area.  With each contraction, I let out a yelp or a moan all the way through it, and this felt very powerful.

Rudi emerged from sleep in the early morning hours and I was relieved to see him again, but I couldn’t really communicate with him or anyone.  I could tell that he understood.  I just stayed deep within.  At some point, I wondered why we were not rushing me to the hospital.  I asked and was told that I was managing the contractions well at home, and that it was a good place for me to be.  This information thoroughly surprised me because I thought I had become a raving lunatic.  The confidence of my team seeped in and I recommitted to the process and let go of the oncoming desire for an epidural.  Plus, we had called Kaiser earlier in the night to let them know that my contractions were only minutes apart and they had said not to come in until there was no relief between contractions (turns out they were having a busy night themselves with many other births under way).  Sunrise came again, and Wendy had to leave, replacing herself with her partner, Lauren.  I was sad and distressed to see Wendy go, but some rational part of me knew that she had another job to go to.  I locked eyes with Lauren and we bonded quickly.  Her presence was very sweet and loving and her melodic voice and English accent gently soothed and energized me.

At 6:30am, we left for the hospital.  Rudi packed and readied the car and we left our cozy little home with our Mexican blanket wrapped around me.  I could not sit on the car seat but had to kneel on the floor and lean over the seat.  The five minute drive felt torturous!  Once at the hospital, two personnel tried to get me to sit in a wheelchair to get to labor and delivery, but I found it impossible to sit in the chair without feeling intolerable pain.  I insisted on walking into the hospital and up to the fourth floor, my birth team and the mexican blanket huddled around me, keeping me safe and warm.  I was just aware enough to reflect on the fact that I was walking into the same hospital entrance that Rudi had exited when he was released from his five week hospital stay in 2009, after he had a life threatening reaction to the H1N1 (swine flu) virus.  Now I was walking through Kaiser’s corridors birthing our baby, which was a miracle given Rudi’s brush with death in ’09.  Getting to the fourth floor felt like trying to climb up a tall building while enduring the iron weight of my pulsating uterus against my pelvic floor.  Once in triage, I was comforted by Rudi’s steady presence.  We were quickly told that I was already six centimeters dilated with only four more to go.  They quickly moved me to a room.  Lauren and I did some dancing once we were situated, which felt momentarily good. I met my nurse Marissa soon after and she kept referring to me as mama.  This helped.  I felt empowered, like I was being initiated into mama-hood and I had to show up for it.  She explained to me that giving birth would turn me into mama bear.  This did not seem corny, rather, it seemed right on.  I began to become more aware that my son was going to arrive and I became thrilled, awed and frightened.  I knew that my faith in myself as a mother would be tested during birth and here it was.  Could I do this?  If he came out, would I know what to do?  Everything will change.  Am I ready?

My contractions became more intense and eventually were unceasing, meaning that I was getting no break between them to catch my breath.  I longed for relief and wondered if I needed an epidural.  Part of me wished for it and part of me wanted to stay with my plan for a birth with minimal medical interventions.  Finally, I cried out for help, and my team suggested that instead of an epidural that I take a dose of pain medication instead.  This sounded like a good idea because the pain medication would have a temporary effect and not confine my movement as an epidural might (but not necessarily).  The medication, Fentynal, brought about a bit of relief and I was able to relax more and catch my breath.  Around this time, there was some confusion about whether or not I was transitioning to the final pushing stage.  Inwardly, I made a decision that I was going to steer in that direction by starting to push during each contraction, and by getting into a position on the table that would allow me to bear down.  I wanted to move forward with this birth.  I positioned myself on my back and sought the support of a bar and the stir-ups.

I got what I wanted.  I found that during the pushing stage, the contractions didn’t come as often but they came regularly, demanding that I bear down into the pain and not away from it.  They would come saying, “Bear down and push through, push all the way through.”  Sometimes I would resist, and I had to learn to let go of control because I just didn’t have it.  I learned that if I went beyond the pain, as Lauren suggested, that I could actually move through it, and use my strength to channel the energy into my pelvis to push the baby out.  But I wasn’t just pushing through pain.  I was pushing through fear.  Marissa was right that it was going to take courage.  Would I be able to take care of this baby?  Could I move forward, even more into the pain, where there is no turning back?  But this was all mind blabber as I learned later.  My body knew I could do it and so did everyone around me.  Even the Kaiser staff, whom I feared would not honor my birth plan.   I called on the female Buddha, Tara and felt strong again.  I could hear everyone around me occasionally say,  “ She is pushing again,” and they’d help me the best they could.   Everyone had something important to say to me.   Rudi made me mad to help me push.  Marissa kept calling me mama.  Naomi said I could do it and I believed her face.  They were all around me now, so many doctors and residents.  I became my animal body and everyone around me was my helper, my lover, my friend, and I trusted them.  The attending doctor comes to my bedside with her quiet, firm strength and told me it will only take one more push and this baby was coming out.  I believed her and I went for it.  I became fully committed to his release, and about two pushes later our precious baby came.  As I heard them say, “We have a baby,” I looked up to see his whole little body held in the air.  He was being rushed over to a small table due to the meconium (first baby poop) found in his amniotic fluid.  He looked perfect, and I exclaimed, “My baby, my baby!”  I was filled with joy.  I knew he’d be okay.  I heard his cry, the  first cry I had been hearing in my mind for months, and I knew that his Dad was with him at the table.  I relaxed and waited excitedly for my baby.  He came to me and he looked just perfectly beautiful.  I couldn’t believe the beauty of this little being placed in my arms.  He was quiet and surprisingly clean and smooth.  I guess they wiped him off a bit, but he really just came out that way.  Later, I learned that his little stomach had to be pumped because he swallowed some of the meconium.  But my sweet baby was okay and now we were skin-to-skin.  He was lying on my chest and my breast, peaceful after our birthing, our two-day journey in which we worked so hard.

Dear Noah,

I want you to know how you came into this world.  Cheering people surrounded you.  People committed to your safe arrival.  Your mama and daddy were right there ready to envelope you into our loving arms.  Lauren, Naomi, Marissa the nurse, and a few residents and doctors were there and love was in the air.  This was our vision for your birth.  Alissa and Wendy were there at the front and middle ends, and possibly hundreds of people were waiting to hear of your arrival.  You are our celebration.  You are life!  We promise to do our best to let you unfold into the human being that you are meant to be.  We love you Noah!

Janie Riley’s birth story was first published at The Brightlys.