Sunday Brunch with Christy Anderson, OB nurse extraordinaire - Part II

Christy Anderson and a really amazingly adorable baby
Ladies. I present to you... Christy Anderson. Yes, she was over for brunch last week. But her interview is our third-most-popular post of all time, so I thought y'all might enjoy hearing the rest of what she had to say.

Christy Anderson is an obstetrics nurse with over seven years of experience in assisting women deliver their babies. She will soon enter a midwifery training master's program and is going to be pretty much the sweetest, most compassionate and no-nonsense midwife you could have.

Over last week's Sunday Brunch, Christy shared with us her experiences working at St. Francis Medical Centre, a mother-oriented hospital in Minnesota. This week she discusses the need for patient advocacy and her daily, woman-to-woman work in counteracting society's misconceptions about birth and the female body.

Gero apetito!
– Svea Boyda-Vikander

SV: In the first part of this interview (click here to read) we talked about some of the amazing (well, they should be standard practice so maybe I should say, unusual?) policies your hospital implements. I'm wondering what proportion of women feel good about their births on leaving your hospital?

Water birth is amazing.
CA: When surveyed, most mothers, around 91%, would recommend our hospital to other women. I think most women have positive thoughts about their births with us though of course this is only a guess. I think introducing water births significantly increased the percentage of women who have positive experiences. If I had to estimate maybe something like 10-15% of women are disappointed in some way of their birth experience. Sometimes that has to do with having very rigid expectations of exactly how their birth will go, or not being open-minded about the fact that birth is unpredictable.

SV: Is the idea that it will go according to a plan the biggest misconception about birth that you've encountered?

CA: Not really. The biggest misconceptions are in regards to pain. Our society tells women that this is an extremely painful event and that it will be just horrible and that their bodies might not be able to do it. In reality, it is something that while intense and requiring a lot of concentration and effort, will not last long compared to the length of their life. Not to mention it can be one of the most empowering moments of their life. There are many ways to manage the intensity of pain through non-pharmacological and/or pharmacological options.

(ed. note: The book 'Water Babies' pictured above describes the work of Igor Tjarkovsky, a Soviet crazy-man who thought babies should spend most of their time in the water. Strange and all, but we have to give him props for bringing water birth to the West.)

Sims, the good doctor, is depicted
preparing to perform forced, unaesthetized
reproductive surgery on a female slave.
SV: I think Obstetrics medicine itself has a lot of these misconceptions embedded within it. Maybe this reflects its spotty history – for example, the man commonly credited as “the father of gynecology” performed forced unanasthetized hysterectomies on slaves in the American South. I wonder how this past has influenced the field today.

CA: It can change from patient to patient and hospital to hospital. In fact, patients have a lot more rights than they are familiar with and actually advocate for. I've seen patients work in partnership with a midwife a little more often than I have with a doctor. Perhaps this has something to do with the power dynamics from the history of medical care, as you said. Often patients with a doctor as provider will just do anything and everything the doctor says without any questions. This is very frustrating when the patients don’t even know how to advocate for themselves. Sometimes the patients don’t like or trust their provider but have no idea that they can transfer care to another provider or clinic.

SV: What are some of the most common mistakes women and their families make in preparing for birth?

CA: Over-preparing for birth, self-diagnosing via the internet, thinking that losing your mucus plug means you should rush to the hospital, and coming to the hospital too soon. An educated patient is better than an ignorant one but it’s important to remember that experiences written in books are just one of many paths or outcomes that can happen in labor. Sometimes, a woman will lose her mucus plug minutes/hours/or weeks before birth. This is normal. Most often it means just that: you lost your mucus plug and you will eventually have your baby! Whereas having your water break is a sign of imminent labor, this distinction is often lost on first time mothers. 
Lying on your side? Not if your bathtub is this bathtub.
But who owns this bathtub?
(I want this bathtub!)
 Often women are not well-educated on when to arrive at the hospital. They can stay home as long as they are comfortable. Our suggestion to patients is not to come to the hospital until their contractions are 3-5 minutes apart (timing from the beginning of one to the beginning of another), where each one lasts about 60 seconds, when this has been going on for over an hour and the mother has to stop and breathe through the contraction. If this is going on, it's good to get into the tub at home and get as much of your belly submerged as possible. This often involves lying on your side in a traditional tub. If the contractions get better and go away, this is just early labor. If they continue and get worse you are probably in active labor and ready to come to the hospital if you wish.

SV: Can you share a particularly heartwarming or funny anecdote from your work?

Crowded waiting room, 1950's style.
CA: I picked up an extra shift for a Friday night. I showed up at 11pm and they told me there was a patient waiting in the family lounge for a room to be cleaned. I checked and it was ready so I went to get her. Once I looked at her and then at her chart I realized that she was only 16 years old. Not only that, but the ENTIRE family lounge was full with her family and friends. I went to the room with her and we went through her admission. After that we had a long discussion on what her preferences for birth were. She preferred to only have her mother, sister, and father of the baby (fob as we call him) in the room with her. She preferred to have an un-medicated birth if at all possible.
 Upon hearing this I knew I needed to get these people involved in her birth process to help me support her because at this time she was only 4 cm dilated but in active labor. I was able to show her mother and the father of the baby how to massage her while she was on the birthing ball. After a while we changed positions and she walked the halls for a while, squatting when having contractions.
 I could tell she was progressing and now starting to work harder with her labor so I suggested we get her in the bathtub. She spent some significant time in the tub with the lights low, some flameless candles on, quiet music on, lavender essential oil on a cotton ball near her and her family next to the tub with her supporting her through each contraction. After a while she wanted to get out of the tub. At this point she was 8 cm dilated.
In case you were wondering what 4 and 8,
and 9.5cm dilated looks like!
She got into the bed and I showed her family how to push on her knees to help release some of the back pain she was having. She began to involuntary push at this point and had progressed to 9.5 cm dilated. The little bit of cervix that was left was on the anterior side so I had her flip to her hand and knees. In this position she started to get a bit nauseated, she vomited, her water broke and she was fully dilated.
She pushed about 20-30 minutes to deliver her baby boy over an intact perineum. She had complete control while pushing and listened so well to just breathe when her body was stretching. I have never been so proud of someone in my life. She delivered at about 3:30 in the morning so in only 4.5 hours she dilated 6 cm, and pushed her baby out. She did it just the way she wanted to, with her family all there and supporting her. It is amazing what a woman/teenager can do with the right support! I feel so good about being there for her and showing her she was able to do it.

SV: That's a great story. I have goosebumps. I feel this is the kind of birth experience we should all have access to – but when you're part of a marginalized population (being a young mother, for example), so much choice is taken away from you. To sum up, what has working in this field taught you?

Little children are so good at surrendering.
The average grown-up needs a little support.
CA: Patience, how to work well with others, the amazing power of the female body, that the mind might trick you while in labor. Just at the point when you feel as though you can’t go any further or any longer, this is when you need to continue as you are getting close to the end. Often, if I can get a patient to believe me when I tell them this, then surrender and go with the process, they will deliver quickly. It's a beautiful process and I feel honored to be a part of it.

SV: Thank you so much for sharing your education and experiences!

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