Call for contributions: personal birth stories for new booklet on birthing positions

Oct18

I received an email this weekend from a woman who is writing a booklet about birthing positions (non-profit and free for distributing when finished!). She is seeking contributions of birth stories to use in the book. Below is her message:

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My name is Megan Layton. I have a strong interest in Women’s Health, current issues in obstetrics, as well as the cultural perceptions towards childbirth in general.

As well as being a Missouri native, a supporter of midwives and a woman’s right to an active role in childbirth, I am also a graduate student at the School of the Art Institute of Chicago. Currently I am working on a small, illustrated publication that focuses on birthing positions. The small book will be informative, fun, attractive, and free for distribution and copying. It is my intent to emphasize a woman’s choice during labor and childbirth, and not advocate for any particular position, provider, or setting, but merely convey the options available as well as the potential for birth to be a profound, empowering experience.

Part of the booklet will be first hand accounts of birth—oral histories from women who have had many different birthing experiences.

This is the reason I write to you: to ask that you share this with women who would be willing to share their personal stories, as well as any advice they could give to a woman who is about to experience childbirth for the first time.

Long or short, joyous or rational, funny or sad–any and all stories are welcome, and will be greatly appreciated. At the end of reviewing the narratives, I will ask those women whose stories best suit the publication for permission to use them. As well, I will send copies to all those who graciously allow me to reproduce their words.

All stories, narratives, and questions can be emailed via this link.

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It sounds like a wonderful project to me!

It also reminded me of my previous postings about how to use a hospital bed without lying down. I tell all my clients if they remember only ONE thing from my classes, it is see the hospital bed as a “platform” and a tool in their toolbox—NOT as a place to lie down!

And, here are links to my own birth stories (each which involved freedom of movement during labor as an integral piece!)

First son’s birth (at freestanding birth center): https://talkbirth.wordpress.com/2009/02/25/my-first-birth/

Second son’s birth (at home): https://talkbirth.wordpress.com/2009/02/25/my-second-birth/

Third son’s birth (miscarriage at home at 15 weeks): https://talkbirth.wordpress.com/2010/05/03/noahs-birth-story-warning-miscarriagebaby-loss/

Birth Waves

Sep18

‎”Uterine contractions are felt by many women to sweep towards them, rise in crescendo and then fade away like waves of the sea, so that wave imagery is very useful when describing the sensations they produce. This wave imagery is closely associated with the idea of rhythm, which is all important in harmonious psychosomatic adaptation to labor.”

–Sheila Kitzinger (Education and Counseling for Childbirth)

Sheila Kitzinger is one of my all-time favorite birth writers and I quote her frequently. She has such a beautifully lyrical writing style.

I’ve noted before that even though I’m not much of a “water” person, wave/water imagery and analogies always strike me as very right/true for my own birth experiences. I shared the quote above on the CfM Facebook page and one person made a comment that quotes like the one above “hide” the truth about how birth is painful and that perhaps we should stop talking in flowery images and instead address how it really is. What was interesting to me is that I do not associate “wave” images with lack of pain or lack of intense sensation. Indeed, somewhat of the opposite! This is one of my personal experiences that leads me to identify with quotes about waves, water, and birth:

With my second baby, I described the contractions as having a “sharp edge” to them. My mental imagery of water and birth was not so much of peaceful, lapping waves, but of intense waves CRASHING into/around a rock. They would then part and flow around the rock (i.e. me), so it wouldn’t get knocked down by them but would be there waiting for the next wave to crash into it…I actually have this same image come to mind during the tough moments of parenting young children!

Additionally, the way contractions build to a peak of intensity much the way waves crest and break, as well as the unstoppable rhythm and flow of them also held power and relevance for me. The ocean is BIG and waves are powerful and so is birth!

Humor and Labor

Sep16

“Don’t forget to bring your sense of humor to your labor.” ~ Ina May Gaskin

I chose this quote to share on the Citizens for Midwifery Facebook page this week because it made me think about my own labor experiences.

I made jokes during the end of all of my labors and then laughed at my own wit—in a stroke of coincidence, one of the jokes was actually about Spiritual Midwifery ;-D I had just been told I was fully dilated with my first baby and I couldn’t believe it and said I was, “feeling all trippy like in Spiritual Midwifery.” With my second baby, I had inadvertently started saying “ouchie, ouchie” at the peaks of contractions and then joked, “ouchie, ouchie is a dorky thing to be saying!” With my third labor, which was an early second trimester miscarriage, I even managed to find some humor, joking to myself that I really should, “get into extreme sports” rather than keep having babies.

On a somewhat related note, one of my fears going into my first birth was about “being mean” to my husband and mother during labor. I think this idea came from all the media representations of women being “out of control” and yelling mean things at their husbands and/or grabbing the collars of their shirts and saying, “you did this to me!” and other such things. My actual experience was that I was nicer during labor than I am during my everyday life! I told my husband I loved him several times (perhaps because the normal hormonal symphony of labor was undisturbed) and we hugged and kissed and I felt very connected to him in the process of bringing our baby into the world. I think feeling safe and undisturbed is critical to birth for a variety of reasons, but one of them is to prevent fight-or-flight stress reactions from being activated. I had no reason to “turn mean” and snarl at my support people, because I was in my own protected environment with only a few carefully chosen people around me. When I think about those women snapping at their husbands during labor in media representations (i.e. being used as comic relief, rather than bringing their own sense of humor to labor!), I see a trapped, mistreated animal snarling and snapping and anyone who comes close 😦

I cannot remember being distressed or annoyed or upset with anything my husband or mom said during my labors. They knew well in advance that having quiet people in attendance is of paramount importance to me—aside from the obvious things, the top element of any birth plan for me is “NO extraneous noise or chatter.” Extra noise causes women to leave their “birth brain” mode (right brain) and switch into the logical, analytical part of their brain (left brain) which is not helpful to a physiological labor. The only person who was allowed to talk (or make jokes!) during my labors was ME! And, I could trust that the people around me would respect that.

Honesty in Birth Preparation

Aug19

Some time ago I came to the disheartening conclusion that what many independent birth educators like myself teach women in birth classes isn’t actually what they can expect, it is what they deserve. And, in our birth culture there can be a dramatic difference between the two. I then wrote an article exploring what many women can expect from a traditional hospital-based “natural” birth—it was published in Pathways magazine and has also made the rounds multiple times as a blog post. So, what then do women deserve? In my mind, they deserve: humane care; respectful, individualized treatment; freedom of movement and choice in a woman-honoring environment; informed consent; the Six Healthy Birth Practices; and the recognition that birth is a significant rite of passage and transformative life event. With this conviction, I therefore refuse to start teaching only what can be expected, because women deserve so very much more than that—but, how to professionally handle the dichotomy in class?

Published in the 80’s, the book Childbirth with Insight by Elizabeth Noble has some thoughts on the subject offer the birth educators of today. In the section addressing the issue of being honest with childbirth education clients about common obstetric practices, she says:

“…instructors in the community cannot afford to discuss obstetric practices in ways that will aggravate local hospitals and obstetricians if they wish to fill their classes. One childbirth educator comments, ‘Imagine if we told couples how it really was…perhaps we’d lose fewer teachers from our group.’ No wonder many of these dedicated and enthusiastic teachers suffer ‘childbirth preparation burnout.’ They are caught in a triple bind. If they describe accurately how birth is managed in some hospitals, couples would become very fearful. If expectant parents anticipate a warm and flexible birth environment and find that such is not the case in the hospital they use, their disappointment is inevitable and bitter. If the instructors advocate childbirth without drugs or anesthesia and these are needed, parents may harbor feelings of guilt and failure.”

The author concludes this segment of the discussion with a very potent and powerful message to birth educators:

“Each instructor must teach what she knows in her bones to be true. A dynamic teacher is constantly changing, becoming more self-aware. At the same time, couples must be warned that almost all hospitals and doctors have expectations based on the mechanical model of birth.” [emphasis mine]

This is such a difficult line to walk—to encourage confidence, trust, and joy in childbearing, while being straightforward about the challenges couples may face when seeking a natural birth experience in a hospital. I always encourage couples to “assume good intent” from hospital staff—they offer medication because they feel like they are helping and also simply because it is the primary “tool” in their medical-model oriented helping toolbox. I also remind them that routines are powerful and if the majority of births occurring at a specific hospital are induced, medicated, heavily intervened with, etc. it can be difficult to buck the trend. Again, not out of some sketchy motive from hospital staff, but simply because of routine or “this is what we always do” or “this is what mothers want from us.”

The very firey, bold, honest, and passionate 1990’s manifesto on VBAC, Open Season even more bluntly addresses the issue of transparency in maternity care and also the effectiveness of childbirth education in this quote:

“If childbirth classes really ‘worked,’ more women would be having babies without interference. More women would be recognizing the complete naturalness of birth and would remain at home, delivering their infants with feelings of confidence and trust. More and more, midwives would be demanded. The names of those hospitals and doctors who treated women and babies with anything less than absolute respect would be public knowledge, and childbirth classes would be the first place these names would be discussed. ‘You’re seeing What’s-His-Face? He’s a pig! In my opinion, of course,’ I tell people who come to my classes. I then proceed to give them the names of people who have used Pig-face. They can always ask Dr. P. for the names of people who have used him and been satisfied with their births, for balance.”

While I’m not personally to the point of taking the “Dr. Pig-face” approach from Open Season, I’ve decided that honesty is the best policy and I’ve started to be very upfront about my challenge with the couples in my classes. Lately, I say, “here’s where I’m wrestling with something. I’m teaching you what you deserve, but it isn’t necessarily what you can expect…” and we proceed to explore choices, talk about communication skills, talk about evidence-based care, making sure the care provider’s words and actions thus far are matching, etc. However, my basic dilemma remains—I am not changing a broken system by teaching individual couples how to navigate it more satisfactorily, I’m actually supporting the broken system (right?!). While one-on-one change efforts have value and are personally rewarding, what I know in my bones to be true is that what we actually need is widespread maternity care reform and systemic change on a global level…

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(I originally posted some content from this post on the ICEA blog.)

Ecstatic Birth

Aug12

The beautifully organized hormonal symphony of labor was mentioned by several speakers at the CAPPA conference in North Carolina.

Here are two lovely quotes from Sarah Buckley about ecstatic birth and the role of birthing hormones:

“Giving birth in ecstasy: This is our birthright and our body’s intent. Mother Nature, in her wisdom, prescribes birthing hormones that take us outside (ec) our usual state (stasis), so that we can be transformed on every level as we enter motherhood.” –Sarah Buckley

“This exquisite hormonal orchestration unfolds optimally when birth is undisturbed, enhancing safety for both mother and baby. Science is also increasingly discovering what we realise as mothers – that our way of birth affects us life-long, both mother and baby, and that an ecstatic birth —
a birth that takes us beyond our self — is the gift of a life-time.” –Sarah Buckle

While I definitely do not feel like “orgasmic” is an accurate descriptor of my own birth experiences, I really like the term “ecstatic birth.” According to Sarah’s descriptions/definitions of ecstatic birth, I feel like I’ve had three ecstatic births (including a second-tri miscarriage-birth—the hormonal “symphony” was the same as with full-term labor and my sense of exhilaration and accomplishment and almost “pride” was the same as with my other babies, except then I also had the accompanying overwhelming grief at not having a living baby to exalt over).

When I think about the term “ecstatic birth” and recall my own feelings and experiences, I think I’m thinking of the immediate post-birth ecstasy/euphoria I experienced and still remember so profoundly. The I DID IT moments. And too, the other-plane-of-existence feelings/consciousness of being in labor and working in harmony with my body. The Laborland stuff—which is that indescribable, surrendered, sort of “hypnotized” state of truly embodied experience.

Childbirth Education Curriculum Preparation Resources

Aug10

Recently, I received a question from a new childbirth educator seeking resources for developing her class curriculum. I emailed her back with a couple of ideas and thought I would also share them here. Here are several of the most useful tools I’ve discovered for birth class curriculum development:

Prepared Childbirth, The Family Way: Educator’s Guide (from www.thefamilyway.com)
The teaching manuals sold (very affordably) by ICEA are EXTREMELY useful: Family-Centered Education: The Process of Teaching Birth is one of my favorites as is Teaching Pregnancy, Birth and Parenting. If you can get the ICEA Educator’s Guide, it is quite useful too (they used to sell it for around $7, but I don’t see it on their site right now).
Empowering Women: Teaching Active Birth, by Andrea Robertson is a class resource for developing birth classes—can be hard to find lately though.
I love The Pink Kit for all kinds of strategies and information about the pelvis and working with pelvic mobility.
Transition to Parenthood has a full curriculum outline available online as well as several great handouts and activities.

The ICEA resources have been my overall favorite, though I’ve added things from all kinds of other sources, as no single resource everything I want to share in a class-—I add information from all kinds of books, videos, reading, journal articles, etc. Every class I teach is a little bit different because I add and subtract things all the time! I only have one page outline for each week of class and it is PLENTY. I do not use power points or anything like that. Just me, lots of hands-on activities, a few visual aids, and the rapport established with my clients.

Good luck with your journey and enjoy making these classes your own!

And What’s This? More Birth Quotes!

Aug9

I decided to split my most recent Facebook quote sharing into two posts, because it was becoming overwhelmingly long. These are the quotes I’ve shared on the Citizens for Midwifery Facebook page since April. While I realize that I don’t “own” these quotes—other people said them, not me!—I do have quite a bit of legwork invested in seeking and sharing these quotes (I mostly get them from my own reading) and if you re-post one or more of them on your own Facebook page, blog post, or book, I really appreciate acknowledgement and/or link back to this site or to my FB page, that this is where you originally got the quote!

‎”When a woman births without drugs…she learns that she is strong and powerful…She learns to trust herself, even in the face of powerful authority figures. Once she realizes her own strength and power, she will have a different attitude for the rest of her life, about pain, illness, disease, fatigue, and difficult situations.” –Polly Perez

“It is a curious commentary on our society that we tolerate all degrees of explicitness in our literature and mass media as regards sex and violence, but the normal act of breastfeeding is taboo.” – American Academy of Pediatrics (via Baby Bloom Doula Service)

“The way a society views a pregnant and birthing woman, reflects how that society views women as a whole. If women are considered weak in their most powerful moments, what does that mean?” –Marcie Macari

“Attempting to fulfill an idea of the ‘perfect’ mother can only prove soul-destroying, as no such person exists.” –Adela Stockton

“In the sheltered simplicity of the first days after a baby is born, one sees again the magical closed circle, the miraculous sense of two people existing only for each other.” –Anne Morrow Lindbergh

Giving birth is an experience carried not only into the first days of motherhood but also throughout life, having far-reaching effects on the mother’s self-esteem and confidence.” –Gayle Peterson

‎”I think one of the best things we could do would be to help women/parents/families discover their own birth power, from within themselves. And to let them know it’s always been there, they just needed to tap into it.” –John H. Kennell, MD

“As doulas, midwives, nurses, and doctors, it’s important to never underestimate how deeply entrusted we are with someone’s most vulnerable, raw, authentic self. We witness their heroic journeys, see them emerge with their babies, hearts wide open…” –Lesley Everest (MotherWit Doula)

“…advocates of home birth have never suggested that all women should give birth at home, only that it is a reasonable choice for some women. Given that rather modest claim, the force and vehemence with which home birth is opposed by ACOG seems out of all proportion.” –Elizabeth Armstrong (Princeton University)

“Few healthy, low-risk mothers require technology-intensive care…Yet…the typical childbirth experience has been transformed into a morass of wires, tubes, machines and medications that leave healthy women immobilized, vulnerable to high levels of surgery and burdened with physical and emotional health concerns…” –Maureen Corry (quoted in Lamaze International‘s journal)

“At a time when Mother Nature prescribes awe and ecstasy, we have injections, examinations, and [cord] clamping… Instead of body heat and skin to skin contact, we have separation…Where time should stand still for those eternal moments of first contact as mother and baby fall deeply in love, we have haste to deliver the placenta and clean up for the next ‘case.'” –Sarah Buckley

“Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be?” – Marianne Williamson

“…celebrate ourselves for our courage to birth. The real question becomes not, ‘Have you done your breathing exercises?’ but rather, ‘Can you love yourself no matter how you birth, where you birth, or what the outcome?'” –Claudia Panuthos

“Whenever a woman has a problem, I believe that she herself can find the answer, provided she is given adequate information and support. I firmly believe in women’s strength and resourcefulness; I’ve witnessed these time and again. Women care about the continuation and continuity of life; they are intrigued by relationships, how things fit together.” –Elizabeth Davis

“Deep relaxation, surrender, letting go: when midwives are asked to disclose the secret of giving birth with relative ease, these are the words we choose. More than metaphors for coping, these responses are based on physiological imperatives…” –Elizabeth Davis

“The greatest joy is to become a mother; the second greatest is to be a midwife.” –Norwegian Proverb

‎”Brick walls eventually crumble precisely because people keep busting their heads against them.” –Barbara Wilson-Clay (IBCLC)

“Some midwives pull women up the hill and say I will get you through this. Other midwives walk behind quietly and gently say, ‘I believe in you.'” -Patricia M. Couch (via Wellpregnancy Childbirth Educator Trainings and Childbirth Classes)

‎”In our own world today, motherhood is rarely sufficiently honored. One day each year, there are brunches and corsages and little gifts of love. But the rest of the time? As a culture, we do not respect the great gift of mothering. Women’s work in raising the next generation is taken for granted. Yet it is a vital service to humanity, one that deserves to be acknowledged continually.” –Patricia Monaghan

‎”Becoming a mother does not need to rob you of your selfhood. Stay away from martyrdom. Martyrs never make good mothers; what is gained in giving is taken away in guilt.” –Gayle Peterson

“The midwife cannot be skilled without being caring. She cannot be truly caring without being skilled.” –Sheila Kitzinger

“The two most beautiful sights I have witnessed in my life are a full blown ship at sail and the round-bellied pregnant female.” –Benjamin Franklin

“When you have a baby, your own creative training begins. Because of your child, you are now finding new powers and performing amazing feats.” –Elaine Martin

“…in a time lacking in truth and uncertainty and filled with anguish and despair, no woman should be shamefaced in attempting to give back to the world, through her work, a portion of its lost heart.” –Louise Bogan

“If the baby’s body is a joy and a delight in the mother’s arms, that same body will become a joy and a delight to its owner later on.” –English & Pearson

“Even if I am simply one more woman laying one more brick in the foundation of a new and more humane world, it is enough to make me rise eagerly from my bed each morning and face the challenge of breaking the historic silence that has held women captive for so long.” –Judy Chicago

“Children are the power and the beauty of the future. Like tiny falcons we can release their hearts and minds, and send them soaring, gathering the air to their wings…” –Skip Berry

“Mama exhorted her children at every opportunity to ‘jump at de sun.’ We might not land on the sun, but at least we would get off the ground.”- Zora Neale Hurston (via Literary Mama)

“That they can strengthen through the empowerment of others is essential wisdom often gathered by women. “—Mary Field Belenky (via Applaud Women)

“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 (I was inspired to share this quote today by a conversation with Kerry Tuschhoff 🙂

“Learn to respect this sacred moment of birth, as fragile, as fleeting, as elusive as dawn.” ~ Frederick Leboyer (via From Womb to Cradle Doula Services)

‎”It takes force, mighty force, to restrain an instinctual animal in the moment of performing a bodily function, especially birth. Have we successfully used intellectual fear to overpower the instinctual fear of a birthing human, so she will now submit to actions that otherwise would make her bite and kick and run for the hills?” –Sister Morningstar (in Midwifery Today)

“Birth is women’s business; it is the business of our bodies. And our bodies are indeed wondrous, from our monthly cycles to the awesome power inherent in the act of giving birth.” –Sarah Buckley

“When a man is truly ‘present’ for the birth of his child and allows himself to be touched by the mystery unfolding before his eyes, he will have an unquestionable experience that can catapult him into the next phase of his development as a mature human being. His encounter with the power of birth…can connect him to his partner and his child in ways that sustain him for the rest of his life.” –John Franklin

“When he becomes a father, a man leaves behind his life as a single individual and expands into a more inclusive role. He becomes a link in an unbroken chain. And in doing so, he himself undergoes a birth process–the birth of himself as a father.” –John Franklin (FatherBirth)

‎”We are volcanoes. When we women offer our experience as our truth, all the maps change. There are new mountains. That’s what I want to hear–to hear you erupting. You Mount St. Helenses who don’t know the power in you–I want to hear you…If we don’t tell our truth, who will?” –Ursula K. Le Guin

“For most people, modern life meanders along a path of ups and downs, by and large devoid of high-voltage experiences that have the power to alter our lives in significant ways…The birth of a child is one of those significant experiences.” –John & Cher Franklin (FatherBirth)

“Pregnancy and labor are periods of vulnerability. This vulnerability is not weakness, but softness, which later contributes to adjustment to motherhood. Feeling dependent may open you to your need for help, and the ability to accept help from others can increase your strength and endurance for labor. Each of us must come to terms with our own feminine strength and our need for protection.” –Gayle Peterson (An Easier Childbirth)

“Labor is also teamwork. It is a mother and baby learning together how to push and how to be born, how to yield and separate from the union of pregnancy. You are not in control nor are you out of control during labor. The best way to approach labor is with an attitude of learning rather than controlling.” –Gayle Peterson (An Easier Childbirth)

“Midwifery calls upon you to be the best you can be: the best advocate, guide, healer, counselor, mother, comrade, and confidant of the women seeking your care.”— Anne Frye

“The birth of a baby is the birth of family. Myriad births take place at once: Women become mothers, husbands become fathers, daughters become sisters, and sons become brothers. One birth ripples through generations, creating subtle shifts and rearrangements in the family web.” –Gayle Peterson

“The family’s trust in the midwife and the midwife’s trust in the competence of the family members are the basis of caring that has the power of magic.” ~ Mary C. Howell (from Midwifery Today e-news)

“Birth is not a cerebral event; it is a visceral-holistic process which requires all of your self–body, heart, emotion, mind, spirit.” –Baraka Bethany Elihu (Birthing Ourselves into Being)

“Fear is completely intertwined with what we experience as labor pain…And it is the fear in our physicians and nurses as much as the fear within ourselves.” –Suzanne Arms (Immaculate Deception II)

“There is no place for ideology in birthing. Each birth has its own story and we must respond to what the baby tells us.” –Spinning Babies.com (via Kelly Caldwell)

I do think there is a place for ideologies/philosophies about birth and as guides for humane care/practice and as guides for making prenatal care and birth care decisions (before the birth), but in the actual moment, release of attachment is often necessary.

“To be pregnant is to be vitally alive, thoroughly woman, and undoubtedly inhabited.” ~Anne Buchanan (via CAPPA)

“Your doc/friend/mother-in-law may be saying, ‘Don’t be a hero, get the epidural!’ But this isn’t about heroics, this is about protecting your body…” –Jennifer Block (via @Spirited Doula Services)

“Giving birth in ecstasy: This is our birthright and our body’s intent. Mother Nature, in her wisdom, prescribes birthing hormones that take us outside (ec) our usual state (stasis), so that we can be transformed on every level as we enter motherhood.” –Sarah Buckley

“The mystery of life and birth is a profound invitation to be authentic as you trust and tremble your way through labor’s Gates of doubt and fear. It is possible that you will become more intuitive during labor than at any other time…Allow your body to guide you in your breathing, in your unique movement, in knowing …what to do…even when you don’t know what to do.” –Pam England (The Labyrinth of Birth)

“Every great dream begins with a dreamer. Always remember, you have within you the strength, the patience and the passion to reach for the stars to change the world.” ~ Harriet Tubman (via Midwifery Today e-news)

“Midwives can create a spirit of beauty at a birth or they can desecrate it. They can create a sacred space around a birthing woman that drives out fear & inspires the mother’s belief in herself, which ultimately determines the outcome of the birth. Midwives can be a channel of Grace in ways they never imagined & in doing so they create a spirit of reverence. Reverence in these days and times is not a common thing.” Caroline Wise, Birthing with Reverence (Midwifery Today)

Re: “advice” for someone who is pregnant: “…if you know that you are pregnant and if you know when you conceived your baby and you think that everything’s okay, doctors can probably do nothing for you. Women need to realize that the role of medicine in pregnancy is very limited…What’s important is for a mom-to-be to be happy, to eat well, to adapt her lifestyle to her pregnancy, to do whatever she likes to do…I think that’s what we have to explain to women. They have to realize that doctors have very limited power.” –Michel Odent (in Optimal Birth)

Opening for Birth

Jul24

Some time ago, I bought several large binders of back issues of The International Journal of Childbirth Education (ICEA‘s publication). The December 2001 edition of the IJCE contains an article titled “The Pelvis Revisited” by Elizabeth Noble. An interesting article overall, I particularly enjoyed the language of the section titled Opening for Birth:

“Birth is what women do. Women are privileged to stand in such power! Birth stretches a woman’s limits in every sense. To allow such stretching of one’s limits is the challenge of pregnancy, birth, and parenting. The challenge is to be fully present and to allow the process because of inner trust. How can women find their power, claim it, and stand firm in it throughout? The vertical position comes again into prominence. Women must ‘stand up’ for what they want and ‘on their own two feet’ by refusing to take their birth ‘lying down’! Being upright is essential for pelvic power–psychological strength, pelvic mobility, gravity’s assistance, pelvic pump efficiency, and the hygienic downflow of bodily fluids.”

In the September 1999 issue, the article “Belly-Dancing Through Pregnancy: A Way to Give Birth and Not Be Delivered” by Gaby Mardshana Oeftering caught my eye. In it, she also addresses the needs to build inner trust and to open to birth through physical movement and an active approach to birthing:

“Women expecting their second or third child don’t necessarily need this [traditional prenatal classes]. They are looking for a way to relax, find their inner selves, and get better acquainted with their bodies, their babies, and the process of birthing. When allowed to move during childbirth, many women instinctively start moving their pelvis in hip circles which are typical of belly-dance…All soft and gentle belly-dance movements are beneficial to pregnant women; for example, hip circles, the various hip-eights, and hip rocking. The rule is: all horizontal movements relax the uterus; vertical movements excite it. Physically speaking, all these movements strengthen and mobilize the pelvis and the legs and train the pelvic floor. They also activate deep abdominal breathing…the hip movements demand a lot of attentiveness and body awareness. On a mental level, this leads to better consciousness of tension and relaxation—a body feeling that is needed during birthing.”

Recently, I feel myself intrigued by the possibilities of working with these women—those who are on their second or third pregnancies and who are seeking to “go beyond” traditional birth class information (that often assumes first baby status). I know that I, personally, have wanted new, fresh, inspirational birth information during each of my pregnancies—labor and birth 101, stages of fetal development, or even labor support and comfort measures isn’t “enough” for me anymore (and wasn’t after my first baby). The desire to honor the pregnancy experience, prepare for the birth experience, and to work with psychological and emotional elements of childbearing are still very much present though! I envision doing a series of “pregnancy retreat” type of things or other types of workshops that “go beyond” and help second, third, or fourth time mothers to spend some dedicated,special attention to each pregnancy and birth experience in a personally enriching and rewarding way 🙂

Book Review: Giving Birth with Confidence

Jul6

Since I recently wrote a post inspired by a quote from The Official Lamaze Guide: Giving Birth with Confidence, I figured it was high time that I share the review I wrote of the book! The review was originally written in 2007 for CfM News.

The Official Lamaze Guide: Giving Birth with Confidence. By Judith Lothian & Charlotte DeVries. Published in 2005 by Meadowbrook Press (307p), $12.00. ISBN: 088166474X

Reviewed by Molly Remer, MSW, CCCE

Very few pregnancy books deliver the message that we think pregnant women need to hear most: Birth is a normal and natural part of life….We believe deeply that birth is a process you can trust just as millions of women before you have. This belief isn’t sentimental; it’s based on our thorough understanding of the physiologic birth process and research that confirms interfering in that process is harmful unless there is clear evidence that interference provides benefits.

So begins an opening section of the book The Official Lamaze Guide: Giving Birth with Confidence. The degree to which the book accomplishes its simple message can be summarized with a simple review: Excellent! The Lamaze Guide is digestible and reasonable for busy people to manage at less than 300 pages of text and it contains a simple, profound, and elegant message that women in the U.S. desperately need to hear.

The book begins with defining normal birth as “…a normal birth is one that unfolds naturally, free of unnecessary interventions.” It then briefly explains the history of birth and how and why normal birth is not actually the norm in our culture. The authors then clearly address the following areas in one chapter each: early pregnancy; choosing a caregiver and birth site; middle & late pregnancy; preparing for labor and birth; the simple story of birth; keeping birth normal; finding comfort in labor; creating a birth plan and a baby plan; communication and negotiation; greeting your newborn; and early parenting. The authors are clearly very supportive of midwifery and the Midwives Model of Care (though it is not referenced by name) as well as of the benefits of a doula in the birthing room.

The book is framed in the context of Lamaze International’s powerful foundation, the Six Healthy Birth Practices:

The book is also guided by Lamaze’s comprehensive and lovely philosophy of birth:

Birth is normal, natural and healthy.
The experience of birth profoundly affects women and their families.
Women’s inner wisdom guides them through birth.
Women’s confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.
Women have the right to give birth free from routine medical interventions.
Birth can safely take place in homes, birth centers and hospitals.
Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

After effectively bolstering the confidence of women in birth, The Lamaze Guide concludes with several useful appendices. The first is the excellent tool “Effective Care in Pregnancy & Childbirth: A Synopsis.” Though this information is easily available on the internet (see www.childbirthconnection.org), I find that many parents do not come across it on their own. How powerful to have it included for easy reference of indisputable evidence based practices. The Mother-Friendly Childbirth Initiative is included in another appendix as well as the always excellent text of The Rights of Childbearing Women. I was delighted to see all of these powerful documents in one place—and, in the hands of consumers who need to be aware of them.

This book is a refreshing presence on the shelves of my local bookstore (yes, there is only one retail book shop in my community and The Lamaze Guide is the only “alternative” birth book stocked in the store!). As I read the book, I kept nodding along and wishing it was in the hands of each pregnant woman in my community. Lamaze has a “name recognition” that gives this book the potential to have a wider and broader impact than other alternative birthing books which, though brilliant contributions, may only end up in the hands of “the choir.” The Lamaze Guide is written in such a matter-of-fact and comforting tone that I cannot see it being off putting to the average consumer as having “hippie” language or “extreme” ideas. The blueprint for normal birth that the book lays out is extreme compared to the standard practices at most hospitals, but the way in which the information is presented opens doors of communication, understanding, and exploration as well as providing the evidence basis to back normal birth. I would not hesitate to lend this book out as it will not scare anyone away with “weird” ideas. With the other books in my personal library, I have to carefully consider my audience before choosing which book has the right style and blend of information—not this one! It is good for everyone with its open, simple message. It is a good addition to lending libraries, personal libraries, to give as a gift, or to recommend to others. The Lamaze Guide is straightforward and clearly written with an unabashedly honest and truthful message of what normal birth is and how it can either be supported or undermined.

My only critique of the book is that in contains no real acknowledgment of the several other well known and effective organizations that train and certify birth educators (other than Lamaze International itself). Conspicuously absent from the resources pages are any of these other organizations.

In conclusion, The Lamaze Guide is a source of information that women need to have and a message that women need to hear. I think Giving Birth with Confidence accomplishes its purpose skillfully and has the potential to be a transformative influence. I hope women read it, absorb it, and begin to Celebrate Birth!

Practical Ways to Enhance Knowledge for Birth

Jun24

Related to my previous posts about information vs. knowledge, I want to share a couple of ideas from an article I wrote some time ago for the International Journal of Childbirth Education. Obviously, I don’t have all the answers, but these are some of my ideas/tips about transferring information into knowledge that will be meaningful to parents when their birthing time comes:

Use “The Ice Cube Minute” exercise from Family-Centered Education: The Process of Teaching Birth. In this exercise, couples hold an ice cube in one hand for one minute and see what coping measures spontaneously arise for them. I do this exercise fairly early in my class series, before we’ve done a lot of formal talking about coping measures. It is very empowering for couples to discover what tools and resources come from within as they try the ice cube minute.
To illustrate the potency of the mind-body contraction, practice two pretend contractions while holding ice. One contraction has an accompanying “stressful” paragraph read with it (“your body fills with tension…it hurts! Oh no!”) and the second contraction has a soothing paragraph read with it (“you greet the wave….it is YOUR power….”). This illustrates the fear-tension-pain cycle viscerally.
Use a five minutes series of birthing room yoga poses to begin the class—birth happens in our bodies, not our heads. Practicing the poses opens space to simultaneously discuss and practice: squatting, pelvic rocks, optimal fetal positioning ideas, healthy sitting, pelvic floor exercises, leg cramp prevention, back pain alleviation, and more.
Role playing cards-—talk through various scenarios. I’ve found that couples are more receptive to talking through the cards than actually getting into a role and playing it through. The activity that seems to work best for actual role play is the labor simulation series available on the Transition to Parenthood site.
Values clarification exercise—participants cut out values from a list and arrange them in a grid to help them figure out if they are in alignment with each other and with their caregivers.
Leg stretch exercise to explore the use of vocalizations and other coping mechanisms during labor.
Ask plenty of open ended questions that stimulate discussion and ideas, “what have you heard about XYZ?” or “what is your experience with…?”
Use birth art processes to “switch” parents from linear, logical, left-brain thinking into the right-brain mode they will also enter in “laborland.”
Media portrayals of birth—show two contrasting clips, such as a birth from a popular TV show (I often show Rachel’s birth from the show Friends) paired with an empowering birth from a film like Birth as We Know It and then have students discuss the two. Sometimes this more clearly brings into focus the influence of our culture on birth practices than a simple discussion does. Since I originally wrote this, the film Laboring Under an Illusion was released which does exactly this—contrast media portrayals of birth with how birth can be. It is a great resource for birth classes.

In classes, I also incorporate the idea of mother-baby symbiosis through:

The use of affirmations—“my baby and my body work in harmony to make birthing easier.”
A discussion of cardinal movements with an emphasis on how the baby moves to help itself navigate the pelvis (thus, helping you have a smoother birth).
Visualization exercises that encourage “seeing” and connecting with the baby while in the womb.
“Belly Mapping” to get a sense of the baby as a person positioned in the uterus. Talking about what baby is like in the womb—when does it kick more, when is it quiet, does it like music, poke you back with you touch it, etc.
Impressing upon participants that it is not selfish to want both a good birth and a healthy baby (I actively challenge statements about, “well, in the end, all that matters is that the baby is healthy”). Laboring women have a basic right to humane care, which supports both a happy, satisfied mother and a healthy baby. I use examples during class to show how these are intertwined—for example, a stressed, unhappy, unsupported, tense mother may have a baby with heart decels and accompanying distress.

I try to build a sense of confidence through:

Opening each class with a brief series of “birthing room yoga” poses to help couples become comfortable using their bodies and moving from “head space” into “body space.” Birth is a physical process and I am convinced that it is vital to include physical movement during every class to bring that message home. Additionally, the poses I teach can all be used while in labor (thus, building confidence in coping “tools” for labor).
Emphasizing active birth—freedom of movement through labor helps baby rotate and descend and helps mother feel more comfortable.
Encouraging active birth on all levels: First, the physical level–being active during the actual physical process of birth. Second, the mental level–mentally engaged with labor. Third, a cultural level—a perspective that sees women as active birthgivers, not victims of birth. Birth is something women do, as opposed to something that “gets” them.
Giving couples plenty of time for hands on practice of labor support and coping measures. I have a personal motto for classes of, “talk less, learn more.” Practicing support tools in class helps them develop a sense of confidence in having a well-stocked toolbox for labor, instead of being a victim of pain.