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Bits of the (Birth) Net

The following is a collection of the bits and pieces that caught my attention and then were shared via my Talk Birth Facebook page during the last two weeks.

Listening

From a good article by the National Association of Mothers’ Centers in Mother Support: When Words Get in the Way

Words, whether written or voiced, are so very fragile. They can be bent or twisted, even become unrecognizable from their initial intentions. They can have different cultural meanings, regional understandings, and generational perceptions.

There will always be the opportunity for miscommunication…

Such a good reminder. What you say and what people hear are often two different things. What you say and what you mean can be different. How your words are received and interpreted can be very important and intent in many ways doesn’t matter! Communication is transactional process. A two-way process. And, it is symbolic. Meaning can never be fully interpreted and understood completely.

This article also reminded me of one of my own older articles, Listening Well Enough, which came to mind because I’m finishing up with the training of two women. The essay describes my own experience when I was training as a breastfeeding counselor in 2005.

Privacy

The topic of what to risk sharing online came up with friends recently and I enjoyed this article about answering the question of How Much Of Your Private Life Should You Keep Private On Your Blog?

Childbirth Education

Childbirth education is beginning too late in pregnancy; it needs to begin in the first trimester or even before women become pregnant…

The above is one of the concluding points from an interesting article from Birth Works International about supporting women without epidurals.

Good article from Lamaze about your breath and how it can help during pregnancy and birthing!

Virtual labor simulator!

Pushing Positions

Very interesting article on What is the Evidence for Pushing Positions?  Apparently there is more blood loss and second degree tears with upright pushing positions. Personally, I CANNOT imagine giving birth in a supine position. But, I’m also really, really, tired of tearing (tired enough that it is one of the factors in our decision not to have “just one more!” baby). For more thoughts about pushing, see previous post on Following Your Body’s Urges to Push…

And speaking of upright birth, Barbie homebirth photos! 🙂

Informed Consent

Valuable article addressing 10 Responses to Pressure to Consent (remember, it isn’t “informed consent” if you do not have the option of saying NO!)

Posts I’ve written about informed consent:

Prenatal Yoga

Online video prenatal yoga class: Prenatal Yoga – when you feel good, your baby feels good.

And my own prior posts on the subject:

Birthing Room Yoga Handout

Birth, this elegant, simple, yet intricate process has had unnecessary, complex, expensive technology superimposed onto it, creating a dangerous environment for birthing women.” -Alice Bailes

Loved this article on what really matters for midwives!

Epigenetics

NEW STUDY: Epigenetics: Mother’s Nutrition — Before Pregnancy — May Alter Function of Her Children’s Genes. “As parents, we have to understand better that our responsibilities to our children are not only of a social, economical, or educational nature, but that our own biological status can contribute to the fate of our children, and this effect can be long-lasting,” said Mihai Niculescu, M.D., Ph.D., study author from Nutrition Research Institute at the University of North Carolina at Chapel Hill, in Chapel Hill, N.C.–Epigenetics: Mother’s Nutrition — Before Pregnancy — May Alter Function of Her Children’s Genes

After CAPPA this year, I wrote about epigenetics here: Epigentics, Breastfeeding + Diet, and Prenatal Stress

Call the Midwife

Fun! Ms. Magazine linked to one of my blog posts about midwifery in their post about the PBS show Call the Midwife!  And, after posting to the CfM Facebook page about how I didn’t get to watch the show myself because I have no TV channels, CfM fan Jackie clued me in that Call the Midwife is available online (no TV channels required!) Yay! 🙂

Older Posts of My Own

Birth Culture: “Birth is cultural, the way eating is cultural. We don’t just eat what our bodies need to sustain us. If we only did that, there would be no reason for birthday cake. Birthday cake is part of our food culture. The place you are giving birth in has a local culture as well. It also partakes of our national birth culture. Not everything doctors do regarding birth makes the birth faster or physically easier for you or the baby. Some things are just cultural.” -–Jan Mallack & Teresa Bailey

Creating Needle Felted Birth Art Sculptures: My first foray into birth art, before I fell in love with using polymer clay!

Centering for Birth: “Centering is a breath awareness strategy that I’ve adapted for use in birth classes based on the ten second centering process described in the short book Ten Zen Seconds…” Free handout available about centering for birth! (I was reminded of this post by Enjoy Birth!

Breastfeeding as an Ecofeminist Issue:“What happens when society and culture pollute the maternal nest? Is that mother and baby’s problem or is it a political and cultural issue that should be of top priority? Unfortunately, many politicians continue to focus on reproductive control of women, rather than on human and planetary health…”

During a week when I didn’t have time to craft delightful new blog posts, it was fun to have a post from a couple of months ago suddenly getting all kinds of hits and Facebook shares. Thanks, internet! ;-D (Around 150 shares on Facebook apparently. I ♥ Facebook!)

On Parenting Books

Mama Birth: Sadly, Parenting Books CAN’T Actually Raise Your Child: Enjoyed this post! (But I recommend NOT reading the comments on the original article she links to about “detachment parenting.” I lost about 30 minutes of my life, felt my blood pressure rising, and only made it to page three!)

The revolution must have dancing; women know this.
The music will light our hearts with fire,
the stories will bathe our dreams in honey
and fill our bellies
with stars.
-Nina Simons via Rebecca A Wright, Doula

New Birth Skills Workshop!

Active Birth and Labor Support

Saturday November 17, 6-9:00

Location: Tara Day Spa in Rolla, Missouri

Cost: $35 for the pregnant woman + one support person (husband, partner, relative, friend…)

Workshop description: First, practice active birth techniques and learn about working with pelvic mobility. Next, spend some time learning labor tips and tricks and practicing comfort measures with doulas! Then, enjoy a friendly Q & A session all about what you most want to know. You will have access to three birth professionals for the price of one! We will close with some relaxation skills practice and a guided visualization.

Interested? Please email me and I’ll send you the registration form!

Becoming an Informed Birth Consumer (updated edition)

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“Birth is life’s central mystery. No one can predict how a birth may manifest…Our dominant culture is anything but ‘natural’ so it is no surprise that childbirth, even with the most natural lifestyle lived by an individual family, sometimes needs intervention and medical assistance. This is not to say that any one mother’s efforts to have a natural childbirth are futile. Just that birth is bigger than one’s personal desires.” –Jeannine Parvati Baker (in The Goddess Celebrates: An Anthology of Women’s Rituals, p. 215)

It’s Labor Day and it is also the start of Empowered Birth Awareness Week! A blog carnival is in full swing at The Guggie Daily and I’ve been having some thoughts about birth as a consumer issue. Very often, it appears to me that responsibility for birth outcomes is placed on the mother—if only she’d “gotten educated” she would have made “better choices.” Many people have a tendency or overlook or minimize the impact of the context in which she makes her choices. In that way, I appreciate Baker’s observation about that birth is bigger than one’s personal desires. That doesn’t mean that we can’t take vital steps to alter the larger culture of birth in which we make our choices, however, and one of those ways is to remember to think about birth as a consumer issue.

Though it may not often seem so, birth is a consumer issue. When speaking about their experiences with labor and birth, it is very common to hear women say, “they won’t let you do that here” (such as regarding active birth–moving during labor). They seem to have forgotten that they are customers receiving a service, hiring a service provider not a “boss.” If you went to a grocery store and were told at the entrance that you couldn’t bring your list in with you, that the expert shopping professional would choose your items for you, would you continue to shop in that store? No! If you hired a plumber to fix your toilet and he refused and said he was just going to work on your shower instead, would you pay him, or hire him to work for you again? No! In birth as in the rest of life, YOU are the expert on your own life. In this case, the expert on your body, your labor, your birth, and your baby. The rest are “paid consultants,” not experts whose opinions, ideas, and preferences override your own.

There are several helpful ways to become an informed birth consumer:

  • Read great books such as Henci Goer and Amy Romano’s new book Optimal Care in Childbirth or Pushed by Jennifer Block.
  • Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital. (I’m sure there are lots of great educators who work in hospitals, but in order to make sure you are not getting a “co-opted” class that is based on “hospital obedience training” rather than informed choice, an independent educator is a good bet.)
  • Consider hiring a doula—a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include CAPPA, DONA, and Birth Arts.
  • Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National or International Cesarean Awareness Network.
  • Check to see if you have a local birth network in your own community or even start your own (I recently co-founded one in my town!)
  • Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different. Pay attention to their experiences and how they feel about their births. If they are dissatisfied, scarred, unhappy, and disappointed, don’t do what they did.
  • Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn’t a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don’t dismiss concerns your may have over the care you receive or decide that you can make different choices “next time.”
  • Find a care provider that supports Lamaze’s Six Healthy Birth Practices and is willing to speak with you seriously about them:
  1. Let labor begin on its own
  2. Walk, move around and change positions throughout labor
  3. Bring a loved one, friend or doula for continuous support
  4. Avoid interventions that are not medically necessary
  5. Avoid giving birth on your back and follow your body’s urges to push
  6. Keep mother and baby together – It’s best for mother, baby and breastfeeding

These care practices are evidence-based and form an excellent backbone for a solid, mother and baby friendly birth plan.

Why “evidence-based care” though?

Because maternity care that is based on research and evidence for best practice is not just a nice idea or a bonus. It isn’t just about having a “good birth.” Evidence-based care is what mothers and babies deserve and what all birthing mothers should be able to expect! Here is a great summary of pregnancy and birthing practices that the evidence backs up:

20120903-142510.jpgRemember that birth is YOURS—it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants—hired by you to help you (and what helps you, helps your baby!).

“As long as birth- metaphorically or literally-remains an experience of passively handing over our minds and our bodies to male authority and technology, other kinds of social change can only minimally change our relationship to ourselves, to power, and to the world outside our bodies” – Adrienne Rich (Of Woman Born p185)
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Related posts:

Birth class handouts

Can I really expect to have a great birth? (updated edition)

What to Expect When You Go to the Hospital for a Natural Birth

Active Birth in the Hospital

The Illusion of Choice

Musings on Story, Experience, & Choice

This post is updated from a previous edition.

Can I really expect to have a great birth? (updated edition)

Given my limited situation, can I really expect to have a great birth today?” For the woman who asked me this question a homebirth, a birth center, a midwife, and a doula were all not remotely feasible options. My answer to her question is a qualified “yes!” and it really got me thinking about ways to help yourself have a great birth when your overall choices are limited. In fact, there is a long list of ideas of things that may help contribute to a great birth!

  • Choose your doctor carefully—don’t wait for “the next birth” to find a compatible caregiver. Don’t dismiss uneasiness with your present care provider. As Pam England says, “ask questions before your chile is roasted.” A key point is to pick a provider whose words and actions match (i.e. You ask, “how often do you do episiotomies?” The response, “only when necessary”—if “necessary” actually means 90% of the time, it is time to find a different doctor!). Also, if you don’t want surgery, don’t go to a surgeon (that perhaps means finding a family physician who attends births, rather than an OB, or, an OB with a low cesarean rate).
  • If there are multiple hospitals in your area, choose the one with the lowest cesarean rate (not the one with the nicest wallpaper or nicest postpartum meal). Hospitals—even those in the same town—vary widely on their policies and the things they “allow” (i.e. amount of separation of mother and baby following birth, guidelines on eating during labor, etc.) Try checking with Cesareanrates.com for local information!
  • When you get the hospital, ask to have a nurse who likes natural birth couples. My experience is that there are some nurses like this in every hospital—she’ll want you for a patient and you’ll want her, ask who she is! If possible, ask your doctor, hospital staff, or office staff who the nurses are who like natural birth—then you’ll have names to ask for in advance.
  • Put a sign at eye level on the outside of your door that reads, “I would like a natural birth. Please do not offer pain medications.” (It is much easier to get on with your birth if you don’t have someone popping in to ask when you’re “ready for your epidural!” every 20 minutes.)
  • You might want to check out either or both of these two books: Homebirth in the Hospital and/or Natural Hospital Birth
  • Work on clear and assertive communication with your doctor and reinforce your preferences often—don’t just mention something once and assume s/he will remember. If you create a birth plan, have the doctor sign it and put it in your chart (then it is more like “doctor’s orders” than “wishes”). Do be aware that needing to do this indicates a certain lack of trust that may mean you are birthing in the wrong setting for you! Birth is not a time in a woman’s life when she should have to fight for anything! You deserve quality care that is based on your unique needs, your unique birthing, and your unique baby! Do not let a birth plan be a substitute for good communication.
  • Two resources I particularly enjoy that shake up the notion of a birth plan are, 1. the birth as a labyrinth metaphor from Birthing from Within and 2. this article about how does one really PLAN for birth.
  • When making a birth plan, use the Six Healthy Birth Practices as a good, solid foundation.
  • Cultivate a climate of confidence in your life.
  • Once in labor, stay home for a long time. Do not go to the hospital too early—the more labor you work through at home, the less interference you are likely to run into. When I say “a long time,” I mean that you’ve been having contractions for several hours, that they require your full attention, that you are no longer talking and laughing in between them, that you are using “coping measures” to work with them (like rocking, or swaying, or moaning, or humming), and that you feel like “it’s time” to go in. If you’re worried about knowing when you’re really in labor, check out this post: how do I know if I’m really in labor?
  • Ask for the blanket consent forms in advance and modify/initial them as needed—this way you are truly giving “informed consent,” not hurriedly signing anything and everything that is put in front of you because you are focused on birthing instead of signing.
  • Have your partner read a book like The Birth Partner, or Fathers at Birth, and practice the things in the book together. I frequently remind couples in my classes that “coping skills work best when they are integrated into your daily lives, not ‘dusted off’ for use during labor.”
  • Practice prenatal yoga—I love the Lamaze “Yoga for Your Pregnancy” DVD—specifically the short, 5-minute, “Birthing Room Yoga” segment. I teach it to all of my birth class participants.
  • Use the hospital bed as a tool, not as a place to lie down (see my How to Use a Hospital Bed without Lying Down handout)
  • If you feel like you “need a break” in the hospital, retreat to the bathroom. People tend to leave us alone in the bathroom and if you feel like you need some time to focus and regroup, you may find it there. Also, we know how to relax our muscles when sitting on the toilet, so spending some time there can actually help baby descend.
  • Use the “broken record” technique—if asked to lie down for monitoring, say “I prefer to remain sitting” and continue to reinforce that preference without elaborating or “arguing.”
  • During monitoring DO NOT lie down! Sit on the edge of the bed, sit on a birth ball near the bed, sit in a rocking chair or regular chair near the bed, kneel on the bed and rotate your hip during the monitoring—you can still be monitored while in an upright position (as long as you are located very close to the bed). Check out the post Active Birth in the Hospital for some additional ideas.
  • Bring a birth ball with you and use it—sit near the bed if you need to (can have an IV, be monitored, etc. while still sitting upright on the ball). Birth balls have many great uses for an active, comfortable birth!
  • Learn relaxation techniques that you can use no matter what. I have a preference for active birth and movement based coping strategies, but relaxation and breath-based strategies cannot be taken away from you no matters what happens. The book Birthing from Within has lots of great breath-awareness strategies. I also have several good relaxation handouts and practice exercises that I am happy to email to people who would like them. One of my favorites is: Centering for Birth.
  • Use affirmations to help cultivate a positive, joyful, welcoming attitude.
  • Read good books and cultivate confidence and trust in your body, your baby, your inherent birth wisdom.
  • Take a good independent birth class (not a hospital based class).
  • Before birth, research and ask questions when things are suggested to you (an example, having an NST [non-stress test] or gestational diabetes testing). A good place to review the evidence behind common forms of care during pregnancy, labor, and birth is at Childbirth Connection, where they have the full text of the book A Guide to Effective Care in Pregnancy and Childbirth available for free download (this contains a summary of all the research behind common forms of care during pregnancy, labor, and birth and whether the evidence supports or does not support those forms of care).
  • When any type of routine intervention is suggested (or assumed) during pregnancy or labor, remember to use your “BRAIN”—ask about the Benefits, the Risks, the Alternatives, check in with your Intuition, what would happen if you did Nothing/or Now Decide.
  • Along those same lines, if an intervention is aggressively promoted while in the birth room, but it is not an emergency (let’s say a “long labor” and augmentation with Pitocin is suggested, you and baby are fine and you feel okay with labor proceeding as it is, knowing that use of Pitocin raises your chances of having further interventions, more painful contractions, or a cesarean), you can ask “Can you guarantee that this will not harm my baby? Can I have in writing that this intervention will not hurt my baby? Please show me the evidence behind this recommendation.
  • If all your friends have to share is horror stories about how terrible birth was, don’t do what they did.
  • Look at ways in which you might be sabotaging yourself—ask yourself hard and honest questions (i.e. if you greatest fear is having a cesarean, why are you going to a doctor with a 50% cesarean rate? “Can’t switch doctors, etc.” are often excuses or easy ways out if you start to dig below the surface of your own beliefs. A great book to help you explore these kinds of beliefs and questions is Mother’s Intention: How Belief Shapes Birth by Kim Wildner. You might not always want to hear the answers, but it is a good idea to ask yourself difficult questions!
  • Believe you can do it and believe that you and your baby both deserve a beautiful, empowering, positive birth!

I realize that some of these strategies may seem unnecessarily defensive and even possibly antagonistic—I wanted to offer a “buffet” of possibilities. Take what works for you and leave the rest!

I posted on my Facebook page asking for additional thoughts and suggestions and I appreciated this one from doula and educator, Rebecca:

“I think I’d tell people to stop closing doors on themselves you know? Stop making assumptions about what is possible and be open to creating new possibilities – maybe not perfect and exact but inviting in opportunity. No money doesn’t mean no doula in most cases.”

She’s right! A lot of doulas-in-training will offer free birth services, many doulas and midwives do barter arrangements or other trades, and many non-traditional birth professionals also have sliding scale rates.

Great births are definitely possible, in any setting, and there are lots of things you can do to help make a great birth a reality!

This post was revised (from this one) to participate in… And the Empowered Birth Awareness Blog Carnival!

Birth Customs

“Pay attention to the pregnant woman! There is no one as important as she!”

(Chagga saying, Uganda)

The book Mamatoto is a look at birth in a variety of cultures (including the US) that was published by The Body Shop in 1991. Even though it is “old” it isn’t really dated since it is a brief overview of different customs and rituals and so forth and not a lot of statistics. There are a lot of absolutely fabulous (and fascinating) pictures and illustrations and these are the highlight of the book. Each chapter is followed by a “black page” of “facts you don’t want to know” about such things are reproductive health care policies in Romania and things like that.

One of the things that struck me about this book was that there is little distinction made between the customs of other cultures and the customs of the US. For example:

“People in Tibet believe that whether or not labour is due, a child won’t come out into the world unless the star under which it’s destined to be born is shining. Western medicine has developed a way of starting labour artificially, by injecting into a woman’s blood a simulation of the hormone oxytocin, which triggers contractions. For several years during this century, an unusual number of women laboured between the convenient hours of nine and five on weekdays…As the Malaysians say, a baby is like a fruit; it will be born when it’s ripe.”

I absolutely love seeing Western culture put into the proper context like this. Too often we see our way as THE way and forget that much of what the dominant culture views as normal for birth is not necessarily truly normal, but is instead an artifact of, or custom of, our culture. Viewed from a distance, the routines of birth in America are just interesting customs—in Tibet, born when the proper star is out, in the US, born when artificial hormones are injected…

(Since first reading this, I use the baby is like a fruit quote regularly.)

I may not be explaining myself clearly, but I find this distance in perspective refreshing and interesting. It reminds me of the work of anthropologist Robbie Davis Floyd whose book Birth as an American Rite of Passage explores the “ritual” elements of hospital birth in America and compares and contrasts the “technocratic” model of care with a holistic, woman-centered model of care (an example of which would be the midwives model of care). She asserts that there are many elements of hospital births that serve as rituals to reinforce the technocratic model (rather than to serve actual purposes, but instead to send cultural messages as well as to initiate the baby into the technocratic model). Examples of ritual elements include putting on a hospital gown, riding in a wheelchair, and having a routine IV. These elements serve to enculturate the woman and baby into a particular model–a ritual function–rather than an individually appropriate method of care.

Another example from Mamatoto that I enjoyed is as follows:

“‘Home birth’ can mean different things to different people. It can mean a bedroom, dimly lit and scented with myrr; a sweatbath perched on a Guatemalan hillside, or a birthing pool in an English flat; a warm fireside in a Himalayan kitchen; the packed-snow sleeping platform of an Inuit igloos; or a one-room shack in Jamaica, with a washing line dividing the family bed and the children waiting on the other side for a first glance at the baby who will be held up for them to see. When a woman gives birth at home, she and her family have a degree of control over the event; it’s their domain.”

In short, at home the family is in their own personal culture rather than having to adapt to the customs, culture, and “ritual elements” of an out-of-home environment.

When I think about American birth customs and culture, the first thing that comes to mind is this potent illustration from Mothering Magazine’s powerful article Cesarean Birth in a Culture of Fear, which was then published in booklet form by Childbirth Connection:

20120813-083208.jpgIn this image we see a woman immersed in the hospital birth culture found in many hospitals in the US.* She is hooked up to a potential of 16 different attachments. When I see this image, I instantly see why women might not want to “be martyrs” and thus go ahead and have any medications offered to them. It can be very difficult to stand in her personal power and embrace her own body’s rhythms and rituals when she is literally strapped down in this manner. I also think of this quote:

“Since beliefs affect physiologic functions, how women and men discuss the process of pregnancy and birth can have a negative or positive effect on the women that are involved in the discussion. Our words are powerful and either reinforce or undermine the power of women and their bodies.”–Debra Bingham

*Note: I am fully aware that this may not be what birth looked like in your hospital, but I’m speaking generically about many hospitals in the nation.

Modified from a post originally posted at Citizens for Midwifery

Amazon affiliate links included in book titles.

Women’s Power & Self-Authority

“I know myself linked by chains of fires,
to every woman who has kept a hearth.
In the resinous smoke
I smell hut, castle, cave,
mansion and hovel,
See in the shifting flame
my mother and grandmothers
out over the world.”
–Elsa Gidlo

I used the quote above as my winter solstice Facebook posting last year. It reminds me of a quote from Margaret Atwood used in the book Sacred Circles, “Sons branch out, but one woman leads to another.” One of the powerful gifts of feminist spirituality is the sense of intergenerational connectedness to all women of all time. We begin to sense the buried matrilineal links across time and culture. Links that have often been culturally, socially, and religiously broken on purpose as a way to separate and disempower women and to bury women’s wisdom. I believe a potent source of female power lies in the female body and that body wisdom has been suppressed and denied over the course of many years as a means of oppression and control. One of the root issues of patriarchy is who “owns” women’s bodies—is it men, is it the government, is the medical system, or is it the woman herself? (you know my pick).

Body wisdom and sources of power

Considering power, sources of power, and body wisdom, I appreciated reading Barbara Starrett’s essay The Metaphors of Power in the book The Politics of Women’s Spirituality. While she used abortion as her example, I have modified and paraphrased her thoughts to make the idea about birth instead. Starrett originally states, “We can create power centers both within and outside ourselves…Power is where power is perceived. Power resides in the mind. We can give or withhold power through our beliefs, our felt thoughts.” Medical professionals can make decisions about a woman’s body and birth choices effectively only as long as women believe that the professionals have the right to do this. When women reclaim the power to decide for themselves about birth, the doctors proclaim in a vacuum. Their power depends on the transference of our power, through our belief that this is right…Power is where power is perceived. This also means that in any given in-the-world situation, we can intentionally set up our own power centers. If we believe that power resides in those centers, it will. We will act successfully on this belief. Women’s organizations, unions, birth coalitions, etc., will never work unless we regard them, “as the legitimate centers of power…We must grant our own power to ourselves” (p. 191).

Lucky to have such a great group of friends to gather in the park to take part in the Our Bodies, Our Votes campaign.

While this comes a little too close for comfort to me with the idea that “we create our own reality” (which I cannot fully embrace due to the logical extension into blaming the victim that it creates), I connect deeply with the idea that we must treat women’s organizations and work as legitimate power sources. I think of books/movements like Our Bodies, Ourselves, for example. To me, this is a definitive women’s health resource—by women, for women and separated from the medical establishment that often dehumanizes women. If we continue to believe our “alternative” structures are just that, “alternative,” then the dominant model is still the norm and still accepted, even by us, as “normal.”

Starrett continues her essay by sharing that “It is necessary for some women to risk total reclamation, to risk the direct and intentional use of power, in bold, even outrageous ways. It takes only a minority of women to alter present reality, to create new reality, because our efforts are more completely focused, more total.” (p. 193) This is the risk that the creators of Our Bodies, Ourselves took. It is the risk birth activists and women’s health activists continue to take.

Peggy O’Mara tackles a similar topic in her essay, “Holy Mother,” in her collection of essays The Way Back Home, observing:

We live in a society…that romanticizes and trivializes the feminine…we live in an economy that regards women as cheap labor. In the marketplace, women work for less than men. At home, we do the large majority of the work. I believe that we enslave ourselves.

Is it any wonder, then, that we have not successfully resolved the childcare debate? Child care and national family policy are process issues, and thus sexist issues. Women themselves engage in sexism when they debate the either/or dichotomy of work or home. Too often, we do not realize the devaluation involved in playing by the crumbling rules of a male-dominated society rather than making up our own. The matriarchal process-based model comes from a religious belief system in which the Divine is immanent, within life, within us, ascribing sacredness to the ordinary processes of daily life. Rather than choosing between opposites, let us evolve a culture that values both the product and the process, a culture that synthesizes both the patriarchy and the matriarchy.

…we must put all of our loves–work and family, mothering and career, self and others—on the bargaining table at once, and not assume that because we are women, we must acquiesce to the cultural ideal. To run our personal lives in enslavement to an economic reality that does not serve our needs makes society crazy.

In a brief except from author Libba Bray, she states that for years she “…heard feminist Gloria Steinem described as ‘shrill’ and ‘hostile’ and many other dismissive, denigrating terms. But after reading about her struggles as a human being and as a leader of feminism’s second wave…I got a truer picture…I learned that it’s far too easy for women to be shamed into staying quiet about their lives–their dreams, needs, desires, anger, aspirations—and that the old adage, ‘Well-behaved women seldom make history’ is all too true.”

Consult your health care provider?

In my own life, I am frustrated by the ubiquitous phrase, “Consult your health care provider.” No thanks. I prefer consulting myself, my books, google, my own research, and my friends. Last time I checked, my doctor did not own my body nor did she have divine revelation as to what I need in my life. I am a breastfeeding counselor providing phone and email support to women who have breastfeeding questions. Women frequently receive very poor breastfeeding “advice” from their doctors—to the extent that I honestly think they’d receive better information by polling random strangers at Wal-Mart with their questions (and, yes, I will actually tell women this). One caller once used the phrase, “but, I don’t want to disobey my doctor” and I found this extraordinarily telling as well as depressing. I recognize that doctors have special training and can be life-saving, however, what does that say about mothering in our culture that a woman would not act on behalf of her own baby and herself because of fear of being disobedient to a professional that she has hired? She is a consumer of a service, not the subject of a ruler!

This brings me to a thought by Dr. Michelle Harrison, author of the book A Woman in Residence: “I used to have fantasies…about women in a state of revolution. I saw them getting up out of their beds and refusing the knife, refusing to be tied down, refusing to submit…Women’s health care will not improve until women reject the present system and begin instead to develop less destructive means of creating and maintaining a state of wellness.” Indeed! And, in an essay by Sally Gearhart’s about womanpower, she notes: “…there’s no forcing any other woman into a full trot or a gallop; she will move at her own pace, but at her own pace we can be sure she will move. At this point I always remind myself that the patriarchal use of crash programs is antithetical to organic movement; in a crash program the theory goes that if you can get nine women pregnant you can have a baby in one month; it takes women, I suppose, to understand that it doesn’t work that way.” (p. 202-203)

Reclaiming power

So, how do women reclaim power? I think story holds a key to power reclamation in this context. As I’ve referenced before, Carol Christ describes it thusly, “When one woman puts her experiences into words, another woman who has kept silent, afraid of what others will think, can find validation. And when the second woman says aloud, ‘yes, that was my experience too,’ the first woman loses some of her fear.” As I touch on above, for me it is to see myself and my body as a source of wisdom and to refuse to participate in structures that do not honor my power and personal agency. It involves more often turning to my peers, to other women, for advice and comfort and support, rather than to experts.

Returning to Gearhart, she states: “If I can move out of the patriarchy for my re-sourcement, then I do indeed march to a different drummer; but I have to march with the consciousness in my very bones of the cost in blood and pain and death that is somewhere being paid for my personal growth.” (p. 203)

I’ve written before that I am a systems thinker. Women’s choices about their bodies and about birth are not made in personal isolation, but in a complexly interwoven network of social, political, medical, religious, and cultural systems. As Gearhart notes, “There may be no ‘enemy’ except a system. How do we deal with ‘the enemy’? As seldom as possible but when necessary by opening the way for [their] transformation into not-the-enemy. What weapons do we use? Our healing, our self-protection, our health, our fantasies, our collective care…” (p. 203).

And, in closing I like this reminder:

“Study after study has taught us that there is no tool for development more effective than the empowerment of women. No other policy is as likely to raise economic productivity, or to reduce infant and maternal mortality. No other policy is as sure to improve nutrition and promote health—including the prevention of HIV/AIDS. No other policy is as powerful in increasing the chances of education for the next generation. But whatever the very real benefits of investing in women, the most important fact remains: Women themselves have the right to live in dignity, in freedom from want and from fear.” —Former UN Secretary-General Kofi Annan

This is the whole point—women’s rights aren’t about “taking” rights from anyone else OR about demanding “special treatment,” they are important for a HUMANE WORLD for all people. I think it is hilariously awful that “women’s rights” are considered a political issue and that there is a section about “women’s rights” in the “opposing viewpoints” database for my social policy class. As long as women’s rights are considered a political issue or as something about which an opposing viewpoint can be held, rather than as self-evident, we are in continued, desperate need of revolution.

—-

(note: portions of this post are excerpted from one of my essays for a class I took about Goddess Traditions)

Incorporating Prenatal Yoga into Childbirth Education Classes

Incorporating Prenatal Yoga into Childbirth Education Classes

By Molly Remer, MSW, ICCE, ICPFE

Note: This is a preprint of an article published in the International Journal of Childbirth Education, Volume 27, Number 2 (April 2012)

The essence of yoga can be distilled into four key elements: breath, feeling, listening to the body, and letting go of judgment and expectation (YogaFit, 2010). When considering the essence of yoga, it is easy to see what a natural complement it is to conscious, active preparation for a healthy birth. Most birth educators would agree that paying attention to her breath and to her feelings, listening to her body, and letting go of preconceived expectations of what birth will be like are perhaps the most crucial messages to convey to the pregnant woman and her partner. Additionally, experts widely agree that exercise during pregnancy has beneficial effects for the cardiovascular and musculoskeletal systems and is associated with physical and psychological well-being. There is also some evidence that recreational exercise may reduce the incidence of premature labor and low birthweight babies (Hyatt & Cram, 2003).

Anyone involved with educating adult learners (in any context) is likely to be familiar with the concept that people are most likely to retain information that they have actually practiced (versus reading about, hearing about or seeing demonstrated). I have found that incorporating a few simple yoga poses into each class session is a beautiful way of illustrating and applying many important elements of childbirth preparation. In approximately 10 minutes of movement, important points can be underscored without having to actually say anything or “lecture” to clients. The hope is that as we move together through a carefully chosen series of poses, subtle emotional development and trust in birth occurs—again, in a more effective manner than by the childbirth educator saying during class: “Trust birth!”

One rationale for incorporating yoga into prenatal classes is as follows: First, people often learn and retain information more effectively by actually doing something. Practicing the yoga poses together allows experiential practice of pelvic floor exercises, pelvic rocks, tailor-sitting, leg cramp alleviation, and back pain coping techniques, to name a few, instead of just hearing me talking!

Second, and most important, Yoga in prenatal classes emphasizes that birth happens in the body. As childbirth educators we spend a significant amount of time talking and sharing information, but birth does not only happen in the mind. Birth happens most profoundly in the body. Not only does birth happen in the woman’s body, but supporting and being with a woman in labor is also an intensely physical process, so it is important for partners to try the yoga series.

People today spend much of their time “living in their heads”, and many of us do not feel comfortable with, or at home in, our bodies. Practicing poses in class helps couples out of their heads and into their bodies and begins a process of feeling comfortable with moving and using their bodies in positive ways. This may help them develop the trust and confidence that will contribute to a smooth and peaceful birth process.

Each pose is followed with a birth affirmation such as, “the magic and mystery of birth delight and amaze me” (Miller, 2003). Positive affirmations help plant positive seeds of confidence and trust in the wisdom of women’s bodies and of the beauty of birth. These cognitive adjustments may also send a welcoming message to the woman’s body and baby as they both prepare for birth.

Opening classes with a series of poses is an effective way to “frame” the class. Class can be opened with a brief check-in period asking how people are feeling, about recent prenatal appointments, and any questions can be addressed. A transition from “regular time” into “class time” occurs with a brief series of simple poses. This routine helps people transition from their normal days into feeling ready and excited for birth class information.

Each pose was chosen because it has specific birth- or pregnancy-related benefits. Begin with healthy sitting—seated crossed legged or tailor-style on the floor with spine straight. Do some neck rolls and shoulder rotations to help release tension. Move into a brief series that includes knee-rocking, leg stretches, Divine Mother Pose, Star Pose, pelvic rock, standing squat, Palm Tree Pose, Half Moon Pose, Triangle Pose and seated Mountain Pose. There is an additional short series of “birthing room yoga” poses described with photographs that is available as a free handout here.

The series is closed with a very brief meditation or visualization exercise. The series of poses and the affirmations are kept the same each week for retention purposes, but the meditation is varied. A quick visualization or relaxation exercise (under two minutes) is often more effective and more readily welcomed by couples than the longer visualization exercises often used in classes (which can seem esoteric to some people). A mindfulness meditation that is effective is:

Inhale and repeat silently: “I exist in the here and now….”

Exhale and repeat silently: “The present moment is all I have to be with…”
Continue inhaling and exhaling as you silently and simply repeat: “Here and now…present moment.”

A favorite resource for easily and smoothly incorporating yoga into classes is The Prenatal Yoga Deck by Olivia Miller, published by Chronicle Books in 2003. The poses listed above were selected from this deck. The deck contains 50 cards, so the educator can easily build a series for use in classes. Each pose card is accompanied by a lovely affirmation. The deck also includes six cards with simple meditations (the meditation above is adapted from one in the deck). The deck format, tidy box for holding the cards and sturdy card for each pose is an ideal format for transport to class as well as serving to provide subtle reminder cards as you lead couples through poses. Each card has a line drawing on the back illustrating the pose, so assessing whether you are doing the pose correctly is easy (sometimes just reading a description of the pose is more complicated than seeing it completed).

Occasionally the childbirth educator may get some eye-rolling or “weird, hippie exercise!” responses from pregnant couples. Regardless of how much or how little they appreciate the practice of yoga in classes, the poses used lay a physical foundation for a positive attitude toward birth and a sense of confidence as a birth-giving woman or supportive partner. Through the simple incorporation of yoga into birth classes, the expectant couple receives an irreplaceable, experiential grounding in the rhythm, focus, release, and conscious awareness so essential to the intensely embodied experience of birthing.

 Molly Remer, MSW, ICCE, ICPFE is a certified birth educator, writer, and activist. She is a professor of Human Services, an LLL Leader, editor of the Friends of Missouri Midwives newsletter, and a doctoral student at Ocean Seminary College. She has two wonderful sons and a toddler daughter and she blogs about birth, motherhood, and women’s issues at Talk Birth (http://talkbirth.me)

Suggested Resources for Birth Educators
The Prenatal Yoga Deck: 50 Poses and Meditations, Olivia H. Miller, ChronicleBooks, (2003)
YogaFit: PreNatal DVD, YogaFit (2009)
Yoga for Your Pregnancy DVD (2004)

All available via Amazon.com

All photos of the author, January 2011, 37 weeks. (c) Karen Orozco, Portraits & Paws Photography

References

Hyatt, G.& Cram, C. (2003). Prenatal & postnatal exercise design. DSW Fitness, Tuscon Arizona (training manual for the ICEA Certified Prenatal Fitness Educator Program)

Miller, O. (2003). The prenatal yoga deck: 50 poses and meditations. Chronicle Books, San Francisco, CA.

Remer, M. (2007). Incorporating prenatal yoga into childbirth educationclasses. Midwifery Today, 4(84), 66.

Talk Birth. (2011). Retrieved from https://talkbirth.me/2010/03/10/birthing-room-yoga-handout/

YogaFit PreNatal/PostpartumSpecialty Program Manual. (2006). YogaFit Training Systems Worldwide, Inc. , www.yogafit.com.

Birth Culture

Birth is cultural, the way eating is cultural. We don’t just eat what our bodies need to sustain us. If we only did that, there would be no reason for birthday cake. Birthday cake is part of our food culture. The place you are giving birth in has a local culture as well. It also partakes of our national birth culture. Not everything doctors do regarding birth makes the birth faster or physically easier for you or the baby. Some things are just cultural. For example, most hospitals do not offer enemas to birthing women anymore, yet a few years ago, most women who labored in hospitals were required to have an enema whether they wanted one or not. Enemas are sometimes helpful at birth, but not always…But they used to be part of the birthing culture… –Jan Mallack & Teresa Bailey in (p. 32)

I don’t feel like I have time to construct a big blog post about this subject, but I’ve been having big thoughts lately about birth culture and also how we think about and treat women’s bodies in pregnancy, labor, birth, and postpartum. So, this collection of quotes will have to do for now!

In the short book Birth on the Labyrinth Path by Sarah Whedon, I also marked this passage to share: “In the context of modern medicine, the childbearing year is often treated as a healthcare problem and we are alienated from the natural and holy processes of our reproductive bodies. Let us seek more and more ways to reframe pregnancy as a natural part of the human experience and to honor the holiness of this work that brings a pure and tiny spark of the divine into the messy, beautiful drama of life on Earth. Let us guard mothers, fathers, and babies as they grow families. Let us celebrate our sexy, dangerous, bloody, beautiful ability as people to make and love more people…” (emphasis mine)

Later on, Whedon makes these lovely observations about postpartum bodies:

A body that is curvier than it was before, maybe bearing stretch marks or scars from surgical procedures or tearing, maybe producing milk, is a body that bears the signs of delivering a human being into this world. We may mourn our smooth, skinny, unmarked maiden bodies, but at the same time we can celebrate the beauty of our storied, productive, and strong mama bodies….
—-
You may have seen images of new mothers as mama goddesses, resplendent in their fertility, effortlessly suckling a new babe while woodland creatures graze nearby. This is a lovely scene to aspire to, but my personal experience is that new mama goddesses are more likely to be found pinned to a couch by a ravenous infant, wearing pajamas and a messy ponytail, and surrounded by the remains of hastily grabbed snacks and partially read motherhood memoirs. Those mamas are no less goddesses. In fact, a careful Pagan theology of embodiment will recognize that the true mama goddess must include the range of experience of new motherhood, with all the sleepless nights, messy lochia, and milky-sweet sleeping babes.”

I also came across this quote from Sister MorningStar in the Spring 2011 issue of Midwifery Today: “Every mother has a culture. Every mother is a culture. She is born into an ocean of language, traditions and rituals around how she eats, sleeps, poops, makes love or births a baby.”

And, then from Ani DiFranco’s great introduction to Birth Matters: How What We Don’t Know About Nature, Bodies, and Surgery Can Hurt Us by Ina May Gaskin:
“The pains associated with menstruation and childbirth (even the emotional pain) are the price of having agency with the bloody, pulsing, volcanic divinity of creation, and they lie at the core of feminine wisdom. The literal experience of my body is your body your blood is my blood holds great insight into the way of things. A self-possessed woman in childbirth can be a powerful teacher for all (including herself) on the temporality, humility, and connectedness of life.”
I honestly believe that if modern birth culture rested in perspectives like this, our whole world would change!

Strong Women

“The vulva is at its most beautiful when transformed by a crowning baby who slides out into her mother’s hands. Women are strong. Women are powerful. Women were made to birth their babies—in their own time, in their own way and with their own innate wisdom. The natural birth community is full of the strongest, most fearless women on the planet—women supporting women.”
–Care Messer (in Midwifery Today, Spring 2012)

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My 6-year-old son took this picture of part of one of my textbook’s covers as I was typing this post and I thought it seems oddly suited to it!

DVD Review: Expecting More


DVD Review: Expecting More
Prenatal exercise program
Two disc set, 230 minutes
$39.95
Daily Sweat, 2011

http://sarahaley.com/about/expecting-more/

Reviewed by Molly Remer, Talk Birth

Fun, energetic, and challenging, Expecting More is a prenatal exercise program developed and hosted by prenatal fitness expert, Sara Haley. Developed and filmed during her own pregnancy, Sara created Expecting More out of her desire to offer a prenatal fitness experience that is vigorous and more fast-paced than the routines typically offered by prenatal exercise videos.  Offering lots of encouragement to stay “sexy and strong” during pregnancy, the DVD set of two discs includes six different workouts:

Synergy: Create SYNERGY within your body by alternating between Sara’s signature cardio and strength exercises.

Sweat Sport: Discover your inner athlete as you execute sports drills in a cardio session with modifications for all stages of pregnancy.

Sweat Funk: Embrace your sexy pregnant body as you get your FUNK on with hot dance cardio moves.Sweat Strong Down: Sculpt your body DOWN on the floor in a safe and effective way that supports your core and your baby.

Sweat Strong Up: Stand UP and sculpt your body in all the right places to keep you sexy and strong during your pregnancy.

Salutations: Designed to sooth and calm, you’ll breath, stretch, and move with this expression of good will to your baby and your body, your SALUTATION.

The Salutations portion is clearly inspired by both dance and yoga and is based on standing exercises that are less vigorous than the other workouts on the discs, but still very lively and movement oriented. Expecting More is led by a cute, contemporary fitness trainer with a pleasant voice. During some of the workouts, two additional women perform modified versions of the exercises in the background so that it is easy for women with different needs to follow along. I appreciated that the DVD contains lots of reminders about the importance of listening to your body. Expecting More presents exercise as a fun and engaged time to be close to your baby and to pay attention to your body and I feel like this approach contributes to a healthy, active attitude towards giving birth as well.

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