Birthing That Baby

Ashley Clark posted a take on writing based upon the painful experiences of the labor process during the birth of her son. http://feedproxy.google.com/~r/TheWritersAlley/~3/_8YVR7A04K4/surviving-labor-of-writing.html?utm_source=feedburner&utm_medium=email

 I am not experienced in that side of the deal, but I’ve been around a few births. I have been exposed to the process by which nurses and OB GYN staff determine the quality of health of the baby during the process known as Electronic Fetal Monitoring (EFM). So, with the idea churning around in my brain, I thought I’d birth it for you here. If you are interested in learning more about the technical side of this and you have a smart phone, find an app called EFM Guide. It will explain the terms and physiology of what’s occurring at any given time on the fetal monitor.

            The first thing to learn concerns the process of EFM. No one has x-ray vision. No one can see your creation, your story. It will only come to fruition if you let it out. However, with the proper monitoring, one can tell the overall health of it. So, the first step is to apply the belly band around the mother. This device connects to the fetal monitor and shows patterns that can be understood through observation. And, since birth is as much about the mother’s health as it is the child’s, we will also connect the mother to a heart monitor that will also take her blood pressure, pulse rate and breathing rate. By discerning the increase in stress of the mother, we’ll know to look for like stress in the baby and whether or not the baby, like the mother, can recuperate from periods of stress.

            Although there are millions of people attempting to birth books, the ones that I see becoming successful are the ones plugged into a venue that exposes their efforts to ones of greater knowledge and skill. This is the importance of writers’ conferences. Get plugged in. Dare to put your efforts up for observation. Let the pros discern your status. It’s for your own health and that of your creation.

            Now that you are attached, so to speak, we’ll look at a few of the terms and what they mean to the baby. Fetal heart rate (FHR) refers to the predominant average rate displayed on the graph. The issue is that a baby in the womb experiences many influences that will change their pulse rate. For instance, the baby may not like mom’s diet and the rate goes up. Mom may bend over and apply pressure to the baby and the rate goes down. There are any numbers of things that will change the rate. That rate is likely to be anywhere from 90 to 200 beats per minute (bpm). Contractions put immense pressure on the baby. What we’re looking for is the average baseline rate, generally expected to be around 140, ranging from 130 to 150, during rest or normal times.

            Think of it this way. You experience any number of things throughout your day. Some of you may even have an hour by hour calendar so you know exactly when to write, when to do chores, when to go to the store, etc. If you don’t write during the proposed time, your baby suffers. If the cat plops on your computer key board, the baby suffers. If the older child falls off the porch rail, everything goes haywire until the emergency is under control.

            Accelerations is a term applied to the FHR. When the baby is excited, its heart rate increases. If the increase is over twenty bpm, it shows on the graph as an upward swing of the FHR. Accelerations are expected to decelerate as evenly as they accelerate. What you see is activity measureable by rate and time. An increase of fifteen bpm over a period of twenty seconds will show the peak at ten seconds and a return to baseline FHR at twenty seconds.

All babies experience accelerations during the birthing process. Yours will, too. One day you’ll zoom through pages of text, moving right along on the plot and character development, and then it’s back to the grind. But that’s good! Realizing that writing comes in spurts allows you to go with the flow and realize that there will also be the work associated with normal activity.

In the same vein, decelerations occur. This pattern on the chart is the obverse of accelerations. This time the monitor shows a depression of the FHR. It is always a sign of stress. Whereas an acceleration can happen from fun things, like receiving Brussels sprouts for lunch, decelerations occur from stressful things, like contractions mentioned previously. Again, stress is a part of labor, but the key is how well the baby recovers. We look at how low the FHR drops, how long it takes to get to its lowest rate, and whether or not it recovers to baseline FHR in the same time span. This pattern, equal time going into the depression and equal time coming out of it, is normal for babies.

Most of you know that writer’s block will slow you down. Most of you have overcome the illness. One way or the other you have taken steps to recover, whether it’s writing something else (like a blog) or brain-storming with cohorts, the issue is that when your story is depressed, you don’t let it stay that way. You get on with it. That’s normal life to a writer, so I’m told…

Accelerations and decelerations generally occur in association with the mother’s health. If mom’s heart rate goes up, chances are there will be a response from the baby and it will chart accordingly. If mom’s blood pressure changes significantly due to an event, the baby will be stressed, too. However, the OB folks also have terms like Early and Late Accels and Decels. These events occur, generally, because of events that are not obvious. These events are watched with a closer eye on the chart to determine if they are a) regular, b) predictable (able to tie the pattern to a cause and it repeats), c) whether or not they can be relieved.

Sometimes when we write, stuff happens. Stuff outside of normal or the occasional emergency discussed earlier. Most of you have had these experiences: bad health reports relating to significant diseases, loss of a loved one, hard economic times. Each of these will have an effect on your writing. That’s why Hemingway always wrote in the morning. He knew that he’d be drunk by early afternoon and that all writing ceased at that time. I’m not advocating you plan that well for early decelerations, but you get it.

The last thing I think is important for you to know about this FHR monitoring is a major problem when the actual birth is occurring and it’s known as Shoulder Dystocia. The term dystocia simply means something abnormal. There are many causes for this, but the inclusion of the word “Shoulder” gives us a clue here. When the baby starts down the birth canal, the preferred position is with the head preceding everything else. The baby also rotates so that the shoulders end up with one toward the belly and one toward the spine with the baby facing either the left or the right side of the mother. This is the best position, considering the shape of the pelvic bone girdle through which the baby will pass. On the top of that pelvic girdle is the pelvic arch bone.

The problem comes when the baby’s shoulder closest to the mom’s belly catches, or hangs up on, the pelvic arch. Here’s the mom in heated battle with contractions going on, breathing heavily labored, she’s pushing to expel the baby and WHAM. The shoulder dystocia thing happens. The external sign observed by the OB folks is that the head “crowns” (the top of the baby’s head is exposed through the vagina and is usually a sign of imminent delivery), but then it gets sucked back up into the birth canal (turtling—like a turtle pulling in its head). Holy smokes! Emergency! The birthing staff starts doing many things at this point. The FHR monitor is removed. The mother is placed in a number of positions to assist in relieving the pressure and to assist the baby in acquiring a better position for delivery. Someone will usually start by applying full body pressure on the pubic arch to try to effect a change in the girdle shape. Often the mother is placed on her hands and knees to change the pressure points. All of these efforts are done to ensure that the baby comes out as quickly as possible at the right time.

What we know about writers is that unless they are being carefully tended by observant staff, they will experience shoulder dystocia of an incomplete or unpublishable work. I’ve experienced this. I wrote my first novel about twenty years ago, but didn’t really have the interest in continuing with the writers’ conference route. Life changes, work experience, the economy and any number of other excuses kept me from pursuing the dream of publication. Then one day someone offered to publish it for three hundred dollars. What a pittance to pay for a book I could hold in my hand instead of looking at the manuscript in a box in the closet. I jumped.

It was the wrong thing to do. Yes, I have a book to hold. Yes, I had friends buy it. Yes, I gave many away and some even said they liked it and want to read the next one. It was premature and should have hung up on the way out! Now I know better. Now you do, too. Don’t get anxious. I have since learned that God has my best interest at heart and He directs my path, if only I will follow him instead of getting in front of him. Thanks to many, I know I’m on the right path to publication, but it’s likely to be nine months from now.