Archive | June 2010

How Do Women Really Learn About Birth?

April 2015 123“I usually claim that pregnant women should not read books about pregnancy and birth. Their time is too precious. They should, rather, watch the moon and sing to their baby in the womb.” –Michel Odent

Related to a previous post about the difference between information and knowledge, I have been pondering how women really learn about birth. Where does birth knowledge they can really use when they need it come from? Is it from birth classes, reading, or from other sources? Though I teach birth classes and believe that childbirth education has important value, I continue to return to thought that what women truly need to give birth does not come from (traditional) classes and it doesn’t come from books either.

Ever since I posted the above quote from Michel Odent on my Facebook page, I have been reflecting back to my pregnancy with my own first baby. Personally, I love books–-of all sorts-–and reading is the top way for me to learn about anything. I think some of the best preparation I did before having my first baby was to read and I always give a recommended reading list to my clients. And, while I “hear” the sentiment in the quote and honor it, my personal opinion is that in our current birth culture it is nearly impossible to go into birth just planning to “go with the flow” and let labor unfold without expectation (if you are birthing in the hospital that is—because the hospital is FULL of expectations and those will often run right over your flow).

When I was pregnant the first time and approaching my first birth, I was hungry for birth information and keenly felt the mystery and unknowableness of the challenge I was about to face. I described it as feeling like I was preparing for the biggest test of my life, but without knowing what the test was. So, how did I learn what I needed to know about giving birth? AND, perhaps most importantly, what had I learned before birth that actually spoke to me while in labor? What did I use and how did I learn about that? Obviously, women are different and have different learning styles and each birth is different, but reflecting on these questions, several things arise as most helpful for me in real preparation:

  • Other women’s experiences—these were frequently what floated through my head during labor and were what I drew on for information and guidance, not “technical” childbirth books, but the stories and opinions and reflections I had read in birth stories and from the participants of the newsgroup misc.kids.pregnancy.
  • Birth art—I created a series of needle felted birth goddess sculptures during my pregnancy that had a “message” for me (that what I needed to give birth—that wild, intuitive knowledge—was already inside me).
  • And yes, reading (and to some extent, classes). I didn’t necessarily use or remember things that I’d read (other than other women’s “voices” through birth stories), but reading definitely helped me prepare—so, while I was not necessarily conscious of book or class-knowledge when I was actually in labor, I was informed by it, yes. During all my reading what I really wanted to to figure out and know was, how am I going to do this? This is the same question that most women who come to my classes have (and my answer is really, “you just will”). The books that were of most value to me were Birthing from Within and An Easier Childbirth. These were the books that had “right brain” lessons to share, even though it was the “left brain” books that I “studied” harder.
  • Yoga—I spontaneously adopted poses used in prenatal yoga during my first labor without even knowing it was “prenatal yoga.” It was an example of how the knowledge already existed inside my body and spontaneously arose when given the space to do so. I also used yoga poses during my other births—not consciously (“I think I’ll try child’s pose now”), but spontaneously and instinct-driven.
  • My blessingway experience/memories—particularly the chant Woman Am I, which I hummed over and over again during my first labor.
  • Voice—talking to myself (inside my head or our loud), verbally coaching myself.
  • My husband—his presence just there with me. I felt like we were one person. This isn’t something I feel like you can “train” for. It too was naturally arising and just pure.
  • Holding a fused glass touchstone and having my favorite pillow (in my third labor, it was holding my goddess of Willendorf pendant).

For me, it all came down to FREEDOM and space for me—I was not in an institutional setting, I was in my own “nest” and that was very key for letting my own body’s wisdom unfold and find expression.

——

A powerful pre-birth lesson in my body’s wisdom actually came from an assassin bug (of all things!). Assassin bugs have very potent, poisonous bites (and in some countries carry hideous diseases). During my first pregnancy I was bitten multiple times in the night by one of them. I had bites on my face (lip) as well as in a row on my arm. The bites caused swelling, ongoing stabbing pain, and joint aching (as well as intense palm-of-hand and sole-of-feet itching when they first occurred). I turned this into a practice experience for myself in coping with labor—figuring that, like labor, this was something uncomfortable and out of my control, but that would eventually pass and that my body would take care of without my needed to actively do anything about it. The stabbing pain was also intermittent (like a pulse), so I thought that was good practice too. I practicing “softening” around the sensations and “being” with the discomfort. I reminded myself that my body knew what to do and that it would heal itself. And, guess what? It did. Each day as the bites healed, I would marvel, “look how much my body knows! Look what it can do without me even knowing what or how it is doing.” Of course, it took several days of stabbing and aching pain for this process to occur, whereas my first labor involved only 5 hours of intense sensation as well as several preceding hours of totally manageable sensation and my subsequent labors only involved 2 hours each of fairly intense sensation. This experience in watching my body take care of itself using its own inherent wisdom was a potent (and unexpected) lesson for me in approaching my first birth.

My Message?

The Orgasmic Birth fan page on Facebook was having a giveaway and to enter the contest the following question was posed:

You are given the chance to speak to the world about childbirth. What is your message?

What a great question! This was my response (as I re-read it, I see I answered as if I was only speaking to one person and not the world. Darn it. I want to speak to the world!):

Birth can be a beautiful, powerful, joyful celebration and a transformative experience. Women’s bodies have a deep knowing of how to give birth and I encourage you to choose a birth setting the supports the unfolding of this knowledge. Women can safely and joyfully give birth in any setting, but freedom, privacy, individualized care, and respect make a HUGE amount of difference in how readily you will be able to have the birth you imagine–so, choose carefully. You do have options. This baby will only be born once, so don’t wait for “next time” to have the birth that you and your baby both deserve.

The needs of mothers and babies during birth are intimately entwined–what is good for mother is also good for babies. Do not ever be misled into thinking that you have to choose between a “good birth” or a “healthy baby”–good, satisfying births are exactly the kind that are most likely to produce that healthy baby!

A Weaning Ritual

The suggestion is often made to have a “weaning party” when a toddler is ready to be weaned. Recently I have been reading the book Seven Times the Sun and she mentions a lovely, simple  little weaning ritual that she did with one of her daughters (18 months). I wanted to share it, because I think a lot of people think about doing something to commemorate weaning, but that it can be hard to find ideas of what exactly to do. Both of my weaning experiences occurred during subsequent pregnancies and I was never quite sure when that “last nursing” would be. Both kids (during the different experiences—I never ended up tandem nursing) gradually cut down on their nursings per day until they were only nursing once a day. I was eager to leave this final nursing behind, because I am someone who finds nursing during pregnancy to be very unpleasant. However, I didn’t want to miss the “last time” and spent weeks remembering to cherish each nursing and fix its every detail in my mind so I would remember it if it turned out to truly be the last—I wanted the last to be emblazoned in my memory. I did successfully manage to note the last nursing for each of them in my journal (and fix some of the details in memory—though not as detailed as I had hoped, because there were so many potentially last nursings!), but we did not have any other sort of weaning party or commemoration.

Okay, on to the ritual idea:

The child is invited to nurse for the final time. Then, offer the child a small round object (like a pebble) and say, “From the time you were a tiny seed inside me, you were fed from my body.” Next, give the child a small baby doll or figure and say, “When you were born into this world as a baby, you were fed from my breasts.” And finally, give the child a silver cup (engraved with their name) and say, “Now I give you this cup, so you may feed yourself.” Then sing a song or blessing and close. The author of the book said their ritual took about 7 minutes, but was a profound memory for the family. I thought it was a delightful idea.

One Woman Awake

Several years ago,  I received a card from the National Association of Mothers’ Centers with the following poem printed on the front:

One Woman Awake
Awakens another,
The second awakens her next door neighbor.
And three awake can rouse the town,
And turn the whole place upside down.
And many awake
Can raise such a fuss
That it finally awakens the rest of us.
One woman up,
With dawn in her eyes,
Multiplies.

——

It has been hanging on the wall behind my computer since 2007 and it still gives me chills to read it. Of course, it can be applied to many elements of women’s lives, but I look at it through the lens of birth advocacy. I always say that what I want to do with my life is simply to transform the birth culture in the U.S. A lofty goal maybe, but if many awakened women raise enough of a fuss, it could happen!

150 Word Birth Story

Birthing Magazine had a contest recently involving birth stories in 150 words. I edited my second son’s story down and submitted it and it was published in their summer issue. I wanted to go ahead and share the super-abbreviated story of Z’s birth here also:

Open channel
Feeling a familiar sharper edge to my contractions, I woke my husband and got my birth ball. The contractions suddenly picked up to one minute apart. I hung on my husband during contractions and felt some pressure. I reminded myself to be a clear, open channel for birth. I said, “It’s okay baby, you can come out!”

I dropped to my hands and knees, saying, “This is MAJOR!” I talked myself down out of feeling out of control with an ongoing chant of, “It’s okay, I’m okay, it’s okay.” I pushed a little and my water broke.

Zander’s head was fully crowning as our midwife came in. I pushed him out and as I held him, I saw that he was a boy. I could barely believe that after two hours of labour, my baby was here! Zander weighed nine pounds, two ounces.

—-

The much longer version of his birth story is here.

The benefit of participating in the contest is that I discovered what a super-cool resource Birthing Magazine is. It has TONS of great content and I’m excited to read the whole issue!

Pain Pie Exercise for Birth Classes

I address the issue of pain in several ways during my classes. I have struggled with doing this—by mentioning pain do I plant the seed that their births will be painful? etc. I’ve eventually come to a place where I feel like it is important to mention pain directly and to look at it head-on. Many people have the perception that birth is THE most painful thing ever and essentially the most painful thing anyone could ever imagine. So, I feel like by not talking about pain in class, I would be ignoring the elephant in the room of THE (cultural) pinnacle of pain. While I have no doubt that birth can be very painful for some women, I deeply feel that our current birth culture and manner of treating birthing women makes birth painful for more of them.

A very useful tool in exploring sources of pain is the “Pain Pie” idea from Teaching Pregnancy & Birth: A Childbirth Educator’s Perspective by Marcy White (published by ICEA).  With this tool, you create a red circle with the word pain on it and a separate set of white wedges (pie pieces) each containing a supportive element, such as “movement” or “relaxation techniques.” Each piece of pie covers up a portion of the red “pain”—as elements of the pie are removed, the pain piece gets bigger and bigger (an alternative presentation is to add pieces, so that the pain gets smaller).

I mention that too often women in our society are left feeling as if they “couldn’t do it” or that their bodies failed them, but in reality their coping pieces of the pie were stripped away from them (sometimes forcibly). I also talk about how sources of distress to the mother during labor: lack of emotional support, disrespect, ignoring of needs, repeatedly offering medications when none are desired, and restriction of movement, often have little to nothing to do with pain, but instead to what is happening around her (environment and caregivers).

Book Review: Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child’s First Year

Book Review: Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child’s First Year
By Cassandra Vieten, Ph.D.
New Harbinger, 2009
ISBN 978-061531935-3
200 pages, softcover, $16.95
www.mindfulmotherhood.org

Reviewed by Molly Remer, MSW, CCCE

Written for pregnant women and for mothers embroiled in the intense rite of passage that is baby’s first year, Mindful Motherhood is a practical and simple guide to the practice of mindfulness during everyday life. “Mindfulness is moment-to-moment, nonjudgmental awareness of your present-moment experience…so that you can be connected to your baby even in times of distress, be less overwhelmed by distressing emotions and less caught up in negative thought patterns, and enjoy the simple pleasures that suffuse each day of being a mom.”

The book is composed of many small chapters each containing a 5-10 minute exercise readily incorporated into daily life with a baby. It also includes a line-drawing illustrated “mindful motherhood yoga series” of gentle, basic poses, which are an excellent prelude to meditation.

Mindful Motherhood is rooted in attentiveness to needs of the child, present moment awareness—whether comfortable or uncomfortable—and radical self-compassion. “Mindful motherhood, above all, is a way of approaching your experiences during pregnancy and early motherhood with gentleness and friendliness.” The author models this gentle and friendly approach throughout the accessible, supportive, and important guide. What a lovely gift for a woman approaching new motherhood, or for any mother seeking to explore present-moment awareness in everyday life!


Disclosure: I received a complimentary copy of this book for review purposes.

Interview with Elizabeth Stein, CNM

Recently I had the opportunity to interview certified-nurse midwife, Elizabeth Stein, CNM, MSN, MPH. Elizabeth practices in New York and has experience with high-risk populations. Visit her at her website: Ask Your Midwife.

1. Please tell me a little bit about your services as a midwife:

My private practice provides obstetrical care, which includes prenatal care, labor and delivery, postpartum and breast feeding. After delivery, women are seen 6 weeks postpartum. Alternatively, women who had a cesarean delivery are seen for an incision site check at 10-14 days post partum and once again at 6 weeks.

GYN care includes an annual GYN exam, which includes a Pap smear, STD testing and treatment, breast exam, urine test and blood work. I also address common GYN complaints, such as family planning/birth control, basic infertility, and pre/ postmenopausal care. I provide primary care and stress the importance of being proactive.

2. How long have you practiced?

I have been a certified nurse midwife 25 years and have delivered more than 2600 babies.

3. What inspired you to become a CNM?

I was an EMT before I was a nurse. On one occasion, I was working in the emergency room when the director told me to go upstairs to L & D to learn how to do a delivery, since that would be helpful while working in the ER. The female doctor I worked with was so beautiful, calm and relaxed, yet very attentive. She calmly and gently delivered the baby. Instantly, I knew this was what I should be doing!

4. What are the top questions you are asked by expectant mothers?

Is my baby ok? Is it a girl or boy? Where will I deliver? When can I have a sonogram? When is my next appointment? How much weight should I gain? Do I have to take prenatal vitamins? How will I know if the water breaks? How will I know when labor starts?

5. What are your thoughts on current bioethical issues in maternity care? (particularly elective cesarean section)

  • Elective cesarean delivery (maternal request)
  • TOL/VBAC (trial of labor-vaginal birth after cesarean) versus repeat cesarean delivery
  • Home births
  • Circumcisions
  • Cord blood collection (fetal stem cells)
  • Chorionic villus sampling (CVS) and amniocentesis
  • Oocyte and embryo storage (prepregnancy)
  • 6. Any tips for women planning a natural hospital birth?

    The hardest yet most rewarding day of your life! Natural means vaginal versus abdominal (surgical).

  • Baby’s going to come, when the baby’s going to come (doesn’t read the sonogram report or prenatal chart). Baby is in charge.
  • Stay home as long as possible (exceptions: rupture of membranes, group b strep positive, vaginal bleeding, other medical or obstetrical reason to come right in)
  • Your birth plan is a wish list, not a guarantee!
  • Don’t start labor exhausted! Rest!
  • Eat and drink (you may vomit later)
  • Know who will deliver you
  • Know  when to go to labor and delivery
  • Beware of unrealistic expectations. Go with the flow of your body. Be flexible and open minded.
  • Know how you may labor…..in bed, on the ball, walking, on the fetal monitor, in the shower
  • You may have to bail out……and have a cesarean delivery….it’s not a failure, just another route of delivery
  • It’s your baby……everyone wants the baby in the first 5 minutes! Bonding is ongoing and forever
  • Breast feeding is not as easy as it sounds but everyone will help you
  • Nobody is judging you! Once you are a mom, you wear the badge MOM.
  • Whatever pregnancy and birth experiences it took to make you MOM should remain a memory and should not haunt you.

    Enjoy your baby!

    Thank you for sharing your expertise with my readers, Elizabeth!

    Book Review: Painless Childbirth: An Empowering Journey Through Pregnancy and Birth

    Book Review: Painless Childbirth: An Empowering Journey Through Pregnancy and Birth

    By Giuditta Tornetta
    Cumberland House, 2008
    ISBN 978-1-58182-640-1
    320 pages, softcover, $16.95

    http://joyinbirthing.com/

    Reviewed by Molly Remer, MSW, CCCE

    Written by a mother of two who is also a doula, childbirth educator, hypnotherapist, Painless Childbirth takes the pregnant mother on a physical, mental, and spiritual journey from conception through postpartum. The text is interspersed with personal stories from the author’s own pregnancies and births as well as those of her doula clients.

    A lot of people are initially skeptical of the phrase “painless childbirth” and I really loved the author’s description of what painless childbirth means: “When I say painless, please understand, I don’t mean you will not feel anything. What you will feel is a lot of pressure; you will feel the might of creation move through you. Pain, however, is associated with something gone wrong. Childbirth is a lot of hard work, and the sensations that accompany it are very strong, but there is nothing wrong with labor.” The book has no rigid concept of what “painless” means and no suggestion that mothers who do not experience birth as painless have “failed.” Painless Childbirth is written in a gently nurturing tone throughout (you can “hear” the author’s doula skills coming through), but is also very assertive that painless childbirth is very reasonable, doable, and is, indeed, the birthing mother’s right.

    The book contains a lot of ideas and concepts that are of use to doulas and childbirth educators. I particularly liked Tornetta’s characterization of the three phases of first stage labor according to the primary means of coping with each phase—distraction, concentration, and surrender.

    After my own experiences with pregnancy loss, I have become more aware of the treatment of the subject in birth books. Painless Childbirth directly addresses childbearing losses in a short, but compassionately written segment about healing past grief. The book also has content about exploring and overcoming fears.

    The book is holistic in its approach, addressing body, mind, and spirit. It contains a lot of spiritual content of a “new age” flavor (for example, lots of references to the law of attraction and the book is organized by month according to fetal development as well as associated body chakra). While I definitely agree that birth is a spiritual event, my practical, down-to-earth side stumbled a bit over some of the concepts and phrasing, and the esoteric content may not appeal to all audiences. That said, Painless Childbirth presents a positive, loving, welcoming approach to giving birth that is both refreshing and interesting.

    Disclosure: I received a complimentary copy of this book for review purposes.

    Birth Warrior?

    On Memorial Day, I shared a “birth warrior” quote on Facebook (I was making a thematic connection). It prompted some interesting comments regarding the appropriateness or not of associating “war” or “fighting” with birth. I shared my personal reasons for enjoying the quote in a FB comment and decided to share those thoughts via my blog as well:

    I recognize that not everyone connects with the “birth warrior” imagery and I have some personal thoughts to share about its relevance in my own experiences. I was surprised to find myself connect with the birth warrior metaphor in labor. Shortly after my first baby was born, I turned to my dear friend who had been present and said, “I feel like I’ve been in a war.” I distinctly recall my sense of vulnerability, amazement, and weariness in saying that. It was my fundamental and deep, heart assessment of how I felt at the time—I mostly associated it with the blood. I tend to have extremely bloody births and there was blood all over my arms, belly, etc. I felt like one of those bloody, battle-weary soldiers staggering off the battlefield. This is interesting imagery for me, because I tend towards the pacifist/antiwar type of mentality. The second birth also involved lots of blood—I had it streaked on my face, the bottoms of my feet, EVERYWHERE. In that birth and with my third as well, I connected with the “hero’s journey” type of metaphor. Like I had journeyed to my personal threshold and successfully, powerfully crossed it.

    So, to me, the “birth warrior” image represents that experience of focusing and channeling and “riding” the waves of intense energy and the feeling of having climbed my mountain, run my marathon, swum my ocean, crossed my threshold, faced my self-doubt, taken my journey, felt my personal POWER, and brought home my prize.

    I agree with Carla Hartley wholeheartedly that birth is not a time when a woman should have to *fight* for anything. I also feel like there is a place for the “warrior” archetype in the birthroom. To me, it represents the active nature of birth and dispels any sense of a passive “patient” lying in a bed accepting her “fate.”

    And, as I often note, I think it is critical that each woman define her OWN experience—and likewise not try to put limits on other peoples’ experiences/descriptions of their feelings.