Ringing in the New

The year is almost over. This year has been full of new studies promoting the safety of homebirth. It has been full of ACOG and the AMA fighting against midwives. The cesarean rate continues to climb and women all over are being denied any choice in how their babies will be born.

As they say, it is always darkest before the dawn. If women are going to be able to have any say at all in how they give birth, they must continue to speak up. Ask questions. Don't accept condescending answers. You're the one hiring the doctor, not the other way around. They work for YOU.

I was reading on the My OB Said What? site and today they posted a response where the OB told the laboring mother "You wouldn't tell a pilot how to fly a plane, would you?" I'd like to turn that right around on them. What gives them the authority to tell a woman she must lay on her back with her legs in the air and push uphill? Women's bodies are designed to give birth. If we listen to what our bodies tell us, most of us will end up in positions that work WITH gravity, not AGAINST it. Women should be piloting their births... the doctor can't tell when a woman's body is urging her to rock her hips back and forth or when she needs to stand and lean on something.

Let's make 2010 the year of the Birthing Mother. Let's help women get the autonomy they need for healthy births and healthy babies!

Organic Birth Summer 2009 Issue

At Least You Have a Healthy Baby

"At least you have a healthy baby..." How many times have you heard this? While in the case of an emergency, we would all do whatever was needed to protect our babies, why should this be the standard of care? Why should we expect to undergo interventions that cause our babies stress, violating exams and have to be a spectacle to whoever wants to peek into the hospital room? Why should 1/3 of us expect to be cut open to deliver out babies?

REACHE (Regional Association of Childbirth Educators) of Washington State is presenting a conference called "At Least You Have A Healthy Baby: Exploring the Forces Behind the Cesarean Epidemic" on April 18, 2009. For more information, check out their website at http://www.reache.info.

High Risk

Hi. I'm high risk. If I walked into an OB's office today to get prenatal care, I would be pushed to the high risk category faster than I could say "homebirth." Why? Well, let me count the ways.

Age

At age 44, I am definitely an elderly candidate for motherhood. Somehow when I hit the magical age of 35 I transformed from a healthy young woman to an elderly mother who needs constant surveillance and testing.

Parity

I have eight children. That makes me not only a multip, but a GRAND multip. Everyone knows that our uteruses can only handle a couple of kids, so when you get one as experienced as mine is, it is time to pull out all the stops, because when that baby comes out, my uterus will be so old and tired that it won't clamp down and I'll bleed to death.

VBAC

Once upon a time, way back in the early 1990s, I had a cesarean. Never mind about those seven vaginal births I've had since then.... I've just been lucky.

Large Babies

OMG! I have a history of large babies! Let's see... out of 8 children, half have been over 9 lbs! In fact, the largest was 10 lbs 11 oz! Well, that should have been a cesarean... if I'd come into the hospital like a good little patient, I'm sure they would have taken better care of me and sliced me open right then and there. I must have had Gestational Diabetes to grow such large babies...

Hmmph.

I don't see what my age has to do with anything. If I'm young enough to still conceive, then I'm young enough to grow and birth my babies. I'm healthy and I take care of myself. As for being a grand multip... I'm darn proud of my kids! They are responsible, courteous and bright individuals. I know the symptoms to watch out for regarding hemorrhage and I know how to stop the bleeding. As for VBAC... shouldn't seven vaginal births prove my uterus can not only handle pregnancy and birth, but it is darn good at it! And as for large babies... none have had any problems associated with gestational diabetes or anything else due to their size. Oh, and I did get tested for GD in most of my pregnancies... nada. Zip. No sign of GD. So there.

Pregnant women should be treated as individuals, not lumped into categories for the simplistic reasons of age, parity, baby size and uterine surgery. Every one of us is different. While one person may need extra precautions, the next person of the same age doesn't necessarily need the same precautions.

Likewise, hospital births are not the perfect solution for all of us. We survived as a species this long... but since there are so many reasons to classify us as high risk, how much longer will we last?

Standing Up for Our Rights

I'm a bit late in responding to the whole AMA and ACOG uproar... but I'm going to put in my two cents anyway. They insist the safest place to birth is in the hospital, yet 1/3 of all women birthing there end up with a cesarean, which increases the risk for complications and death. Another 1/3 end up with an episiotomy, a surgical procedure that has been proven to be unnecessary.

I have heard horror stories of how women are treated in the hospital while giving birth. They suffer at the hands of people who just don't care about them, their babies or the process of birth. How can that possibly be the safest place to be????

The AMA and ACOG are willing to create model legislation to make it illegal to birth anywhere else. Excuse me? They want to make it illegal to birth anywhere but in the aforementioned torture chamber?

Now I know that not every nurse and obstetrician contributes to scenes like I have learned about. Some are truly caring, wonderful people who try to do what is best for mothers and babies. But it sure seems that they are few and far between.

I certainly could not walk willingly into a hospital to give birth knowing that I'd have to fight for every little bit of freedom I may need to birth optimally. My first was a cesarean. One that probably could have been avoided if my CNM and the staff nurses had been willing to work with an inexperienced mother-to-be instead of pushing pain medications. But then, I may not be on the path I am today.

Women... stand up for your right to birth without intervention! While it isn't outlined specifically, it should fall under pursuit of happiness if nothing else.

Midwives... band together. Sue the AMA like the chiropractors did in the late 1970s for preventing them from practicing their trade.

We can do this. The AMA and ACOG are worried about midwifery and home births because more women are finding out they don't need to be treated like idiots and sliced open unnecessarily.

How Baby Experiences Birth

Have you ever noticed in a hospital birth how the baby is treated as an incidental passenger? The mother is encouraged to have drugs and lie on her back. Hmmm. The drugs DO cross the placenta and lying on her back can compress the large arteries that feed the uterus and placenta, and then the baby. I wonder why baby is distressed?

Next, the baby is unceremoniously pulled out with hands, vacuum extractor or taken out surgically, depriving baby of the tight squeeze that is needed to press fluid from the lungs in preparation for breathing.

The baby is suddenly in a very bright place (ever seen how bright those lamps are they point at the birthing mother's vagina? Yikes!), the temperature drops, and in many cases baby is whisked away to an exam table, without feeling a comforting touch from his or her mother. How frightening would that be?

What do you think is going through that baby's mind? Despite what tradition says, babies are very aware. They are aware of what is going on before they are born, and interact with mom or dad when they push on baby's foot through mom's belly. The baby needs to be with mom immediately. If there are problems, at least keep baby within mom's reach so she can reassure baby by touching an arm or leg. The baby knows what mom's touch is like... s/he has felt it through her belly since they were large enough to press against it.

There is some research that suggests babies know if they are wanted or not. They feel fear, rejection, love and comfort. How can anyone separate a baby from its parents when first born? How can they poke a newborn with needles, shove tubes down their throats and handle them roughly? How can they take newborn boys and circumcize them? They are so open and vulnerable.

As human beings, we need gentle, loving touch to survive and thrive. How can we expect babies not to carry trauma from a rough entry into the world when it was just a "typical birth?" Babies are born ready to be imprinted with their parents' faces and touches. Instead the first touch they feel is to be yanked out. The first face they see is most likely wearing a mask. What would you feel if you were to enter a place like that and have no way to escape?

All babies deserve love, gentleness and comfort. They deserve to be treated respectfully. There is the saying that in the eyes of a newborn baby you can see the wisdom of the universe. How sad that we don't pay attention to that wisdom. Instead we feel it is our duty to strip these babies of any wisdom they had to impart to us. I say it is time to learn from our babies. I know mine have taught me more than I ever imagined was possible.

Happy Mother's Day!

Mother's Day. Today is the day we honor those who have given birth. I would like to honor all those women today who have given birth. That includes moms who have given their babies up and moms who raised their children. Moms who suffered through stillbirths, miscarriages and loss. Moms who did their best to have the birth of their dreams only to end up under the surgeon's knife. Moms who continue to fight for the birth they want. Moms who were unable to give birth themselves, but they love their adopted children every day, meeting their needs just as surely as if they had birthed those children themselves. Every mom, everywhere, who has ever loved a child.

Happy Mother's Day!

Choosy Moms Choose Cesareans Article

Time magazine just ran an article entitled "Womb Service: Choosy Moms Choose Cesarean." The article outlines the story of a psychiatrist who chose an elective cesarean because she was afraid of laboring and then requiring a cesarean anyway. It goes on to discuss how vaginal birth can result in incontinence and pelvic damage, while cesareans can result in respiratory problems for the baby. It ends with the hope that "perhaps more women will feel less defensive about making the same choice."

Excuse me? Cesareans are major abdominal surgery. I know. I've had one. And I certainly wouldn't have chosen to have it. I did labor and end up in surgery. At least at the time I felt I had done all I could to have my baby the way nature intended. Cesareans have more risk than just possible respiratory problems for the baby. Both mother and baby have a bigger chance of dying from a cesarean than from a vaginal birth. I guess that isn't important.

And vaginal birth doesn't equal incontinence and pelvic damage. Studies have shown that women of comparable age who did not birth vaginally (or even have children at all) had the same chance of developing incontinence as those who had birthed vaginally.

If I decide I want to get my appendix removed, I should just be able to schedule the surgery whether I need it or not, if cesareans should be just another choice. It shouldn't matter that my appendix is perfectly healthy, right?

I have a fundamental problem with the argument that many obstetricians put forth that an elective cesarean is just another birth choice. At the same time, they are putting down home birth and unassisted birth as not being safe. I still have less of a chance of dying if I have my baby home alone than if I opted to go under the knife. How is this "just another choice?"

Okay, I'm even willing to compromise here. If cesareans are allowed to be just another choice, then they should concede that homebirth is also just another choice and leave it at that. If the OBs are allowed to promote the "safety" of surgical birth and point out the "dangers" of homebirth, I should be able to do the opposite. Studies have shown that homebirth is as safe or safer than birthing in the hospital. At least you won't be given pitocin and drugs that will cause the baby to go into fetal distress at home.

What about if we actually teach women that labor is nothing to be afraid of? There's a unique idea. Labor is a natural function of a woman's body when it is time for a baby to be born. There, I said it. Having a baby is something we are designed to do. In fact, it seems to be a rather well-kept secret that women are actually good at having babies, too.

It sounds to me like instead of choosy moms choosing cesareans, it is uninformed moms, coerced moms and frightened moms who choose cesarean. Most women are not told all the risks of having a surgical birth. A cesarean can cause problems for future pregnancies if the placenta in a subsequent pregnancy implants over the scar. A cesarean can result in infection for mom and/or baby. Hemorrhage is common. The baby can accidentally get cut. The incision can open up during recovery. The baby can have respiratory problems. Post-surgical pain can last for several weeks, and recovery time is longer than with a vaginal birth. The list goes on and on.

All I can say is this choosy mom will choose to birth at home.

Giving Birth

The terminology of birth gets to me sometimes. Women are not "delivered," we give birth. It sounds like we need to be saved from this most womanly of experiences. It really is disempowering and sad to hear our power removed from this most powerful of times. Giving birth is my passion, my life. If I am not the one doing it, I want to help others find this same elation, this same boundless sense of being.

My baby grows from a tiny seed deep within my body to an individual who is all their own. My baby signals when she is ready to leave that snug warm nest, and together we strive to bring baby forth.

My uterus tightens snugly around my baby, gently nudging her toward the world. My baby responds, pushing against the fundus with her feet, propelling herself closer to her first breath. Labor is a dance between mother and baby... an intimate ballet where mother moves to help baby do the pirouette through her pelvis and into the world.

To carry and bring forth life is a gift. To feel the butterfly flutters of a growing child within is pure happiness. To labor and birth a child is an expression of love.

Birth

Birth. I think about it a lot. Not only processing my own memories and what I felt went well and what didn't, but about birth in general.

For my first birth, I did everything I was supposed to do. I read books. I went to a childbirth class that was not hospital-based. I had a CNM. I had a cesarean with an epidural. Not by choice... I had every intention of not having drugs of any kind. But my inexperience, my willingness to think that my CNM knew best and my own beached whale mentality put me in that OR as surely as if I had scheduled it.

By the time I had my last birth in 2007, I was doing my own blood pressure checks, I didn't bother with weight checks and only did urine tests close to my due date. My midwife dropped by and we listened to the baby and we talked to the baby. It was fun. I finally figured out how to hear with a fetoscope... I'd been trying since my 5th baby. When I went into labor, my midwife came over and camped out with the kids. She gave me quiet suggestions occasionally, and my baby was born into my arms with hardly anyone's input at all. The biggest effort was to get up off the floor and move to the sofa.

My own journey to trust birth has encompassed a long road from that initial cesarean. I thought I trusted birth then, but really, I didn't know what it meant. I don't expect to convince every woman to birth like me. I think every woman should follow the path that makes her the most comfortable... but at the same time, I have a hard time hearing about pregnant women continuing to check into the hospital only to leave via the OR. What kind of start is that for them as mothers and for their babies' introduction to life outside the uterus?

Mothers today have more choices than they used to in most states. Where they don't have as many choices, many moms are taking things into their own hands. I think a huge movement away from the managed care system is beginning. Unassisted birth is happening frequently enough that it is becoming big news. More women are hiring midwives and staying home. So much so, that ACOG had to rush to issue a statement against the safety of homebirth after "The Business of Being Born" was released. I've seen the movie. It was difficult for me to watch, because although I knew the statistics, it was difficult to see them in print and said out loud. I think this film will get a lot of women thinking about their options.

There has been a lot of criticism about having the director's birth included, since it was a cesarean. I thought it was good to include it... not because it "balanced" the film, as I've heard, but because it showed her laboring at home, realizing that she needed more assistance, and had plenty of time to get to the hospital for the extra help.

That's my take anyway. Birth is a large part of my life. I hope that never changes. Birth is the beginning. The start of a new person. Full of potential.

Trusting Birth

What does trusting birth mean?

For some, it is a frightening thought. How could we possibly birth without doctors, nurses, surgical procedures, machines and hospitals? But if this is so, how did we get so far? Certainly we haven't always had access to cesareans, episiotomies, IVs and epidurals.

A mere 30 years ago, the cesarean rate was less than 10%. Now it is over 30%. We're still women. Our bodies haven't changed in 30 years. Why can't women successfully give birth today like our parents did?

The answer is that very few trust birth anymore. This is a terrible loss for humanity. We live in fear of a natural bodily function. We see it on television on reality birth shows. We hear it from our doctors who tell us that we are not capable of passing our babies through our pelvises without intervention. We hear from nurses that we won't be able to bear the pain. What else are women supposed to think?

Fortunately, some women are finding the light at the end of the tunnel. Some of us are spreading the word that birth is something we are built to do successfully. As my friend Karen Strange of Newborn Breath says, "Birth is designed to work in case no one is there."

I admit that nothing is perfect 100% of the time. Let's face it... what is? There will always be a very small percentage of births that do need that extra help... and that is what hospitals and obstetricians are for. They are designed to deal with the unusual situation. Normal birth is so boring for them they need to do interventions to make it interesting.

But for those of us who have a healthy pregnancy, all we need is to let our bodies do their thing. Pelvises spread to let babies out. Women who embrace labor and move as their body tells them to help their babies get in the right position to make their grand entrance.

Why do I trust birth? Because I've seen it work. I've lived it. I've done the labor dance and have been the first to touch my baby. I'm not a big person... yet I've birthed babies over ten pounds at home. I have embraced the pain, have felt the baby move from my belly and through my hips. It wasn't easy, but it was worth every minute. I have felt that delicious hormonal cocktail that floods a woman's body after the natural birth of a baby. Flooded with oxytocin and love for my newborn, I have experienced that incredible babymoon while getting to know this new little person.

Maybe my views are a little simplistic. I may not be quite as confident if I were the midwife in charge of someone else's birth. But maybe that is the point. Maybe we should take responsibility for ourselves. Even if we have an attendant, we should be able to make the decision to be responsible for the outcome. Maybe that is the real reason I trust birth. I'm okay with the responsibility.

Inner Knowing

Inner knowing. So many people discount that today. Yet you always hear after a plane crash or other disaster that people just *knew* something was going to happen, so they cancelled their ticket, or changed their plans. So many of us hear this little voice inside and discount its wisdom. Pretty soon, the little voice stops trying to get through to us, and we're left on our own to sink or swim.

So it is with birth. Deep within we know what to do. Our bodies know how to conceive a baby, grow a baby, and push out a baby. The baby knows what it needs to do to help itself be born. Yet again, so many of us don't listen. We hear horror stories, sign up for cesareans and epidurals... anything so we don't have to listen to our own body's wisdom.

We are told by the medical establishment that birth is dangerous. At any moment the baby could die. We could die. Come into the hospital and we'll make all the decisions for you. We'll poke you with needles, fill you with pitocin to create tetanic contractions that will send your baby into distress, which will be picked up by our electronic fetal monitors that send sound waves into your uterus to aggravate your baby. What, it hurts? We'll give you this nice epidural so you don't need to feel a thing. Nah... we PROMISE it won't hurt your baby. Now that your baby is in distress, we'll hasten his birth. If it will take too long for a vaginal birth, we'll just roll you into the OR and cut him out. If you get an infection, that's okay... we'll load you up with lots of antibiotics to try and clear it up.

Hmmmm. Sounds inviting, doesn't it? I've had four hospital births, and while all of them were not that extreme, the general theme was the same. If I had a valid reason for birthing there, that would be a different story, but I was a healthy pregnant woman with a healthy baby each time I went there. The first time, I got that lovely cesarean package. My precious baby was lifted out of me behind a drape and I didn't see her until my incision was almost completely repaired. Oh, and I got the bonus of having the epidural wear off AFTER they strapped me down to the OR table, but BEFORE the cesarean took place while they searched for the anesthesiologist. I don't remember anyone being in the room with me... if they were, they certainly didn't respond to my overwhelming urge to push while my legs were tied together and my arms were strapped down. My inner knowing was trying to kick in... and I was trying to listen... but was unable to.

My last hospital birth happened with my second daughter. No meds. Almost no doctor... she rushed in at the last moment when my doula screamed down the hall to the nurse that the baby was crowning. It *almost* happened on its own. Well, actually, it did happen on its own... the doctor wanted me to turn around and sit for the birth, but I wasn't about to change positions... she had to deal with me upright facing away from her on the bed. That inner knowing took care of it all. I had begun to listen. I was in the position that was needed. My little daughter, however, had a bit of a rough start, and needed a little extra care at the beginning. I was somewhere else while they worked on her... my mind was trying to process the intensity of this birth that went from 5 cm to the birth of the baby in only a few contractions. I remember vaguely sitting on the bed staring off into space, idly playing with the umbilical cord that was still attached to the placenta within me while my baby was across the room being suctioned and stimulated. I didn't have the presence of mind to call her name or anything... something that probably would have helped her come into herself. My husband rushed in... he had been out checking on the other children, since I was only at 5 cm. His presence slowly brought me back to myself, and I began asking about the baby and talking to her.

The inner knowing was there... but was interrupted. By removing the baby away for treatment instead of treating her there with me, we both suffered. It took her several minutes to come into herself, and it took me almost as long to come back to myself. Only the presence of my husband pulled me back, then we both were able to communicate with our daughter and let her know it was okay to come into herself. We were there for her. It was okay.

Inner knowing. We all have it. We just need to learn to listen.

The Trust Birth Conference

It is unfortunate that the Trust Birth Conference is over. It was incredible! To those of you who could not come, look for recordings of the sessions to become available in a few weeks at http://aamishop.com .

This conference will go down in history as the conference that really helped bring homebirth into the mainstream. With the release of "The Business of Being Born," more women are able to see this option and question some of the routine practices that dehumanize them in the hospital. This conference built upon that, with the theme: Birth is Safe; Interference is Risky.

Our keynote speaker, Dr. Michel Odent, talked about how disempowering the vocabulary surrounding birth, pregnancy and even genitalia is all about shame and putting the woman in a place of no power. Yet it is she who gives birth.

As women, we should not be delivered. We should be the ones who actively give birth. Birth is a cooperative effort between a mother and a baby. Doctors, nurses and even my beloved midwives should not interfere. If there is a problem, of course they are on hand if needed. Otherwise, they are but witnesses to the miracle of birth.

I learned so much at this conference. Not only about our histories, but how to let the body do its thing instinctually, how to allow the baby his or her part of the birth, and how to promote a woman's abilities to trust birth, her body and her baby.

I am the mother of 8 children. It took me awhile to discover these things and not fight them. It took me awhile to learn to listen to my body and to let it do the work it was designed to do. But I have learned this lesson, and you know what? It works!