Thursday, August 12, 2004

Births in the Caul

I went a long, long time before ever seeing a baby born in the caul (inside the amniotic sac). In hospitals, the membranes are ruptured (broken) somewhere along the way in every birth I have been to. Even in birth centers, Artificial Rupture of Membranes (AROM) is absolutely commonplace. At Casa, the students need to learn to rupture the membranes (and yes, "rupture" isn't the prettiest word... some say "release" which IS nicer, but absolutely contraindicated in AROM), so we routinely did so... sometimes with our fingers, fingernails (inside gloves), or with the AmniHook... a long crochet-needle looking thing with a beak on the end that snags the bag and breaks it, releasing the water.

(Rupturing membranes is a blogspot unto itself... another day... remind me!)

Then, a midwife at Casa thought it would be a grand idea to see how many babies we could have born in the caul and the game was on. I'd heard about an OB that was so disgusted with AROM that he offered a $50 bounty for every caul birth and shelled out thousands before calling the game... proving that it is possible and isn't dangerous and not AROMing did not slow labors down, but, in fact, helped women cope better.

The first caul birth I saw was so cool! I was doula-ing at UCSD at the Birth Center (on the 4th floor) and the CNM was terrific in wanting to leave things alone. As the baby was being born, it dawned on me that the mom's membranes were still intact; soooo cool! The baby was born with a tight sac on the face and shoulders before the midwife used forceps to break and lift the bag off the baby's face before the first breath.

Another I saw was at Casa. I spent a lot of time there in 2002... about 9 months total that year. There were times I was so exhausted, I could not get up to witness births. My first trip there in 1993, I went to every single birth I possibly could... 90 in 3 months, catching 30 myself. These long months of "getting numbers" in order to sit for the California exam, were exhausting and sometimes I just ignored the "Birth in the Bear Room!" call over the intercom.

But, when cool things happened, I was asked to come anyway to photograph. I always made sure the mom was asked if it was okay before I was awakened because I had shown up once with a camera and a mom was horrified. I left with camera in tow.

So, there was a birth happening and the membranes were still intact and someone knew the birth would be something to see. Groggily, I grabbed my camera and went to the birth, watching and taking picture after picture of the most amazing sight; the sac began protruding, water filling up the sac gradually... a slow, s l o w birth where the sac came long before a head did. I began seeing hair floating in the water behind the amazing amnion and chorion... flecks of vernix swirling around as the head began being able to be seen.

I have a picture here:

As the baby was born, the bag broke and water spilled onto the bed and the midwife lifted the bag over his face. I loved capturing it on film!

One birth here in San Diego, I was the first assist and was behind a kneeling mama with the midwife. It was cave-dark and we began watching the membranes bulge the perineum. This midwife had not seen a birth in the caul, so I gave whispering instructions about how to manage it so the baby can breathe.

When the head is born, it is important to watch for breathing motions because if those happen, it is important to remove the sac from the face. If s/he isn't making a motion to breathe, allowing the body to flow out inside the caul is perfectly fine. Once the chest is born, removing the sac is imperative since the first inhalation often comes from the release of chest compression from the vagina. I explained about lifting from the chin upwards because two midwives I know had babies aspirate their amniotic sac because it was pulled downwards from forehead to chin and as it came down, the baby inhaled. (Remember how I said we are a product of our experiences? This is a lesson I learned without it happening to me directly!)

So, as she is pushing, we see a darkness in the forward moving sac... vernix? meconium? I had the third assist grab the flashlight and we peered into the sac. Inbetween pushes, the floating stuff settled to the bottom of the "bag" and we had to wait for the next contraction to stir things up again. It was wild to watch! Once the contraction began, we saw that it was, indeed, meconium and pretty darn thick, too. The midwife asked mom's permission to break the water right before the head was born so she could suction with a DeLee (something we don't do anymore) and mama said, "okay," so we did. I often wonder what that would have looked like to let the baby keep coming in the floating mec pool. Probably safer.

As this baby came out, even though the midwife had broken the bag, the amniotic sac was still covering the baby's face. She, however, did not see it! I showed her how it looked like cellophane and that anytime there are late ROM, to check closely to get the face cleared. She was wide-eyed as I pulled a completely covering film of amniotic sac off the baby's face... chin to forehead. The baby inhaled as I lifted.

It is said that babies born in the caul are special or gifted. Various traditions around the world say that the baby will never drown... that the baby will be a midwife... that the baby will have a second sight (a view into the Other Side or psychic powers). I find, as time goes by, that I touch membranes less and less. I believe they are there for a reason... will break when ready... and serve a purpose we might never know.

But, can I tell you quick about how the gift of an amniotic sac helped my partner Sarah after her eye cancer surgery?

You see, in hospitals, placentas (with their amniotic sacs) are "donated" by the women. Cosmetic companies and, ever increasingly, medical supply places buy them for a variety of reasons. Many of us feel women should be paid for their placentas, but the hospital considers them donations (tax deductible? I don't think so). Hardly anyone knows about this donation, either.

So, many parts to the story that I will eventually blog, but Sarah had to have some lymphoma cut out of her eyeball (in the white, not over the part where she sees) and the surgeons were discussing the surgery and all that it entailed. They told us that they would graft it (cover it, actually) with one of two things: the foreskin of a circumcised penis or the amnion of an amniotic sac. I could NOT believe, first of all, that they really sold and USED foreskins from babies. She said she could not have that in her eye because then she would be cock-eyed. They didn't laugh. Really, truly, she told them ethically she could not do that. They said fine, amnion it is (there are two pieces to the amniotic sac... the amnion and the chorion... each has its role in the baby department and can be separated, but is very much like sticky cellophane pulling them apart). They were equally unamused when I offered to bring in swatches of amniotic sacs to see which one matched her eye color best. We thought it was hysterical.

After her surgery, we could see this precious gift from an unknowing mom and baby... a centimeter-wide circle that was covering where the cancer had been dug out and sutured with 40 stitches... teeny tiny stitches that she blinked on for several weeks. We both thought of and sent prayers of thanks to this mom and baby that they would give this gift so Sarah's eyeball cells could regrow together, using the amnion as a scaffold to cross and join together as it healed.

Within weeks, the amnion was covered and we couldn't see it anymore. Her body had absorbed it... made it her own.

What a miracle our bodies are!


Anonymous said...

I gave birth to my third child unassisted and in the caul. in a home environment there may or may not be hospital style cleanliness and most mothers including myself poo a little while giving birth. but hey, clean baby as its still wrapped up. there was no blood on baby either.

Navelgazing Midwife said...

Oh, I certainly understand the not wanting the hospital germs... they may think they look clean, but we know better, don't we?

Poop? Who cares! We just wipe it without ever saying anything about it... it really is no big deal. (Although, I have worked with women who said their midwives made a big deal about pooping... that is just ridiculous, in my mind.)

Glad you had a wonderful birth. Thanks so much for sharing your story!

Kya said...

Neat caul stories and pics!

Did you catch me saying that my grandmother's mother was born in the caul? Her mother had kept it, folded away, and brought it when they made the trip to America from Europe. The story my grandmother told me was that there was a storm during the crossing and the sailors were giving up hope. But Great-great Grandma told the men that her daughter was born in the caul, showed it to them and convinced them that the ship would pull through because, as everyone knows, if you're born in the caul you simply cannot die from drowning.

I have no reason to believe that my Grandma doesn't believe in the story she tells. It just seems hard to believe that 1) grown men with experience sailing ships could be reassured by such a "trivial" thing and 2) my Great-great grandmother would cherish her child's membranes in such a fashion.

Maybe it just makes me jealous of the three placentas (and membranes)I lost to the infamous red trash bags before I ever realized that placentas aren't merely "trash"?

Anyway, thanks for sharing. It's been a long night reading everything! :)

Anonymous said...

My son was born in the caul with meconium staining, but did not have any complications. I always wondered what kind of interventions we might have had if the hospital staff had seen that prior to the birth.
We managed to avoid them all with the help of experience (my second natural birth), midwife, doula, partner, friends and our amniotic sac.

cheri said...

My son was just born in the caul this past Saturday, August 19, 2006. He was born in the caul in an underwater birth, so that was interesting for the family to watch. He was lifted out of the water and the midwife removed the caul from his face as I took him from her. He let out a very lusty cry as it was removed from his mouth. Thank you for your website- it was nice to read about this type of birth in this way instead of the other more mysterious and frightening myths that are attributed to caul biths.

Anonymous said...

i had the labor and delivery of my dreams with my second child. my first labor was so long (and failed to progress past 5cm) that i honestly can't remember any pain, just utter exhaustion. but the second labor was, well, a dream come true! 5 to 8 cm in less than an hour. powerful, but forgiving contractions. i kept telling baby to 'come down baby, please come down.' and she did! was at the hospital less than 2 1/2 hours before i delivered my second daughter, with bag intact and all! her birth was a true gift, and she is the gentlest sweetest thing i've ever seen.

koolz said... name is Koula...17 years ago..this april..I gave birth to our wondrous son ...he was a caul birth this day when ever i share my birthing experience with anyone...they are left with a sense of boy was born with the amniotic sack in did not rupture at all!! could say he as hatched!! ... the nurses and mid wife..were so exited ...especially one mid wife who took time to have a talk to me during my hospital stay.. and the best of her ability..what caul her then thirty years of nursing...that was her first caul has been a pleasure to watch him grow..thus far...may be a mum thing...maybe not...but I Do believe he is here to make a difference...thankyou for reading a snipit of my caul birth experience..

koula said...

This a foot note ...doula...///me Koula...greek/psychic connection... The word doula comes from Greek, and refers to a woman who personally serves another woman. In Greece, the word has some negative connotations, denoting "slave" or "servant of God," as some doulas have inadvertently discovered through their international social networks. For this reason, some women performing professional labor support choose to call themselves labor assistants. Anthropologist Dana Raphael first used this term to refer to experienced mothers who assisted new mothers in breastfeeding and newborn care

Anonymous said...

Hello Navelgazing Midwife,

I was born in a veil. Certainly, my life is very strange and fascinating. I think that I have second-sight as well, at least I have had incidences of perception that very closely resemble the descriptions of second-sight that I have read. I'm also bipolar though, which makes understanding and processing different life experiences very difficult. Mania can be very enlightening though, at least my mania can be.

I have a couple questions if you would be so kind to try and answer them:

It seems like the belief of the caul's association with second sight is cross-cultural. Why would so many cultures arrive at the same or very similar beliefs when it is unlikely that they could have interacted with one another until recent centuries? What is it about children being born in cauls that speaks so profoundly to the human psyche that we would formulate such beliefs?

I guess I'm a very rare breed from what I have read. Not to many people are born in veils. However, the few statistics I have read seemed to vary widely. From your work, what do you estimate the chance ocurrance of a baby being born in a veil to be?

I really dug your blog on the caul. Hope all is well. Take care.

Meg said...

My 10+ lb son was born in the caul, and with nuchal arm, in a homebirth VBAC. I am certain the unruptured sac made it easier to push him out, although it still wasn't *easy*. Easier than with a ruptured sac I think. Anyway, I would like to find out whether the rarity of caul births extends to other large hominids (the great apes), because en caul birth is certainly the norm amongst most mammals, and I wonder whether its rarity in humans is due to interventions, or happens rarely also in unintervened births.

Anonymous said...

All three of my children were at-home water-births. My second and third were both born in the caul. My son's caul (the second birth) was completely intact. I'm not sure about my daughter's caul (the third birth) being complete, as I delivered her myself before the midwife got there. All three births were extremely fast! I've read about the rarity of caul births, but do you know of the rarity of two of them to the same mother?

david said...

one more thing on my story I was born with a full head of flaming red hair. I am a self taught composer and artist.

Anonymous said...

I was born"wrapped in a balloon", according to my mother. She also said my grandfather kept it for good luck. I never gave the thought a special attention until I read about "caul".
I'm now turning 40 and I believe I am truly blessed. I could not ask for more. About psychic ability, I could sense some potential but I'd rather not tap it.
Bottom line is, whether the caul has something to do with my fortune or not, we have to thank God for all the blessings He gives and share it in any way we can to the less fortunate.

Chava said...

I've worked L&D in quite a number of places and placentas never went anywhere but biohazard and to the incinerator. I think your mistaken about them winding up in cosmetics - maybe confusing it with the foreskin argument?

Courtney H said...

My son Liam was born in his 'sac' or caul as you put it,until this day I never knew such a thing existed but I do remember him being born that way but never really thought much of it.
Liam is now 5 and an exceptional child,I swan everyday in the sea that I was pregnant with him and he entered the water at a week old and has never looked back,he has a love of the water that is astounding.
He is an excpetional child,highly intellignet and an avid animal lover.He's fiercley independant even at such a young age.
When he was an infant,people used to stare at him in awe n caress him,strangers that in were literally held in rapture.I know it sounds bizarre but its true!! I never really noticed until my Mum pointed it out,he just drew people n still does,to me he was just my lil baby n he was beautiful and still is