Guest Post: The Midwife as a Storyteller and Teacher by Patricia Harman

Oct18

The use of old-fashioned narrative to influence, and inform patients about health practices

As an author of memoirs, historical fiction and children’s literature, I am a storyteller, but I’m also a nurse-midwife, and I use storytelling as one of my primary teaching tools.

Storytelling is uniquely human. Anthropologists have argued that storytelling is pre-verbal, that pictographs on the inside of caves are in fact stories. Form the earliest days humankind has used narrative to record history, to entertain, to convey experience and to transfer information.

To convey information in narrative form is something no other species can do. It’s an evolutionary advantage and allows each individual to harbor more information than personal experience would allow.

Using stories to teach patients is not unique to midwives. All good providers use stories to illustrate how individuals can make better health choices.

We all know that many patients are non-traditional learners and even those in higher education love a good story. Research and statistics are boring for most people and easy to forget . Many patients, even if given a handout drop it in the trash as they leave our office. They don’t have time to read it or are non-readers.

On the other hand, if I tell a tale, in an amusing way, about a young woman who refused to take her birth control pills because she was worried they would make her fat…and now she’s pregnant…that’s a cautionary tale and brings a smile and a knowing nod from the fifteen-year-old here to discuss birth control: That’s not going to happen to her!

Using self-disclosure about your own life can humanize a professional relationship and help patients be more honest with you about their lives. For example, I might say with a smile, that I’ve gone to Weight Watchers for so long I could teach the class, even though I’ve never reached goal weight. The patient and I share a good laugh and now she feels comfortable telling me she can’t stand to look in the mirror, has tried four different TV diets and is terribly discouraged. A door for real communication has opened. She no longer feels alone and she knows she has me as a non-judgmental advocate.

Stories can accomplish what no other form of communication can do; they can get through to hearts with a message. I might tell a very stressed-out college student, sitting on the end of the exam table, about a patient of mine who had two jobs and was studying nursing full time. Last year she started getting a series of illnesses. Next thing she knew, she flunked two courses, lost her boyfriend and had a motor vehicle accident. The moral is clear: don’t take on more than is humanly possible. And the tale is more likely to induce lifestyle change than a lecture.

All health care providers, surgeons, nurses, physical therapists, family doctors or midwives must be teachers. If you missed that part in school, it’s not too late. With humor and love we can become part of the human story that will bring health and hope to our patients.

For the past twenty years, Patricia Harman has been a nurse-midwife on the faculty of The Ohio State University, Case Western Reserve University and most recently West Virginia University. In 1998 she went into private practice with her husband, Tom, an OB/Gyn, in Morgantown, West Virginia. Here they devoted their lives to caring for women and bringing babies into the world in a gentle way. Patricia Harman still lives with her husband, Thomas Harman, in Morgantown, West Virginia. She recently retired from her thirty-five years of midwifery so she could write more books for people like you!

My past reviews of Patsy’s books:

Past blog posts on the subject of story power:

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Talk Books: Pregnancy, Childbirth, and the Newborn

Mar29

Several months ago, I received an email from one of my former college students. His wife was newly pregnant and they had several specific questions. They asked for my help and recommendations with where to go for answers and without hesitation, I suggested a book: Pregnancy, Childbirth, and the Newborn. I was confident that not only would they find the answers they sought in the book, but also reliable, practical, helpful answers to questions they haven’t even thought to ask yet.

Co-authored by a foremost authority in childbirth and doula education, Penny Simkin, Pregnancy, Childbirth, and the Newborn was one of the first books I bought as a new childbirth educator in 2005. Now, newly revised and updated, the book has a companion website packed with resources to help you have a healthy pregnancy, a rewarding birth, and a nurturing postpartum.

One of the things I’ve always enjoyed about this book as a wonderful resource for childbirth educators are the line March 2016 119 drawings illustrating a variety of positions and concepts. This new fifth edition has lots of black and white photos as well. The fact that the book is co-authored by a world-renowned doula, a nurse/lactation consultant, a nurse/childbirth educator, a social worker, and a physical therapist, means it is an interdisciplinary resource benefiting from the skills and professional experience of each co-author. Childbirth educators and doulas as well as pregnant couples will want to check out the companion website which has a plethora of pdf handouts available on numerous topics including comfort techniques, nutrition, and parental leave.

Evidence-based, comprehensive, and encouraging, Pregnancy, Childbirth, and the Newborn is an ideal companion for both childbirth professionals and expectant parents.

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Pregnancy, Childbirth, and Newborn is published by Meadowbrook Press, an award-winning publisher specializing in pregnancy & childbirth, baby names, parenting & childcare, and children’s books & poetry: Meadowbrook Press. Pregnancy, Childbirth, and the Newborn

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

Tuesday Tidbits: Waterbirth & Healthy Babies

Jan26

“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)

via Tuesday Tidbits: Human Rights and Birth | Talk Birth

Tanner, our last baby, was my first waterbirth. I didn’t really consider water for my first baby. I did for the second and had a birth pool and supplies on hand, but he was born so quickly we had no time to use it. Alaina was born in the deep winter, so water didn’t appeal to me at all and I never considered having a waterbirth with her. With Tanner’s pregnancy, I was interested in trying things I’d never done before. I’d also read that water helps reduce or prevent tears and I really, really, really wanted to avoid tearing again and I thought it would be my last chance to try water and see if helped. He was born in the water and I did tear. I have no regrets about having opted for water with him, other than wishing I would have been able to get out of the pool a little earlier since he got pretty chilled from it. (In case you missed it: his birth story and birth video.)

So, I was interested to read this article about the safety of waterbirth. The conclusion was that water birth is safe, but that women actually had a higher, not lower, chance of tearing…

The findings revealed babies born in water, as well as their mothers, were no more likely to require a transfer or admission to a hospital. Moreover, the babies born in water did not receive a low Apgar score. This quick test is performed on a baby one minute after birth in order to determine how well the baby tolerated the birth, and five minutes after birth to tell doctors how well the baby is doing outside the womb.

Despite the positive, the researchers did find an 11 percent increase in perineal tearing, or vaginal tears among mothers who gave birth in water…

Source: Pregnancy And Water Birth: Giving Birth In Water Tub Poses No Risk To Mom Or Baby, Says Study

A commonly asked question about waterbirth is whether or not water slows down water (the consensus is that it often can if the woman gets in the birth pool “too soon”):

A woman should be encouraged to use the labor pool whenever she wants. However, if a mother chooses to get into the water in early labor, before her contractions are strong and close together, the water may relax her enough to slow or stop labor altogether. That is why some practitioners limit the use of the pool until labor patterns are established and the cervix is dilated to at least 5 centimeters.

Source: Does Water Slow Down Labor? | Talk Birth

I was 35 when Tanner was born, technically of “advanced maternal age.” Luckily, new research also indicated that us “advanced” types have a higher chance of living to “extreme old age” (maybe that should be “advanced, old age”?)

A Boston University School of Medicine study found that women who can still give birth naturally after age 33 have a higher chance of living to extreme old age than those who had their last child before age 30. But the report, published in the online version of the journal Menopause in April 2014 doesn’t imply that putting off pregnancy will add years to your life. “If you physically delay having children, that’s not going to help with longevity, Paola Sebastiani, a Boston University biostatistics professor and study co-author, told OZY. A woman with a natural ability to have children later in life suggests that her body – including her reproductive system – just happens to age at a slow pace. Some women’s biological clocks simply tick more slowly than most.

Source: Late Kids, Long Life? | Acumen | OZY

And, switching gears slightly, I enjoyed this post about that “a healthy baby is all that matters” refrain, that, while seemingly sensible on the surface, is actually an insidious phrase used to shut down women’s voices and deny their completely legitimate right to humane care in pregnancy and birth:

When a woman gives birth, a healthy baby is absolutely completely and utterly the most important thing. Got that? OK – do not adjust your wig, there’s more… It is not ALL that matters. Two things – just to repeat: a healthy baby is the most important thing, AND it is not all that matters. Women matter too. When we tell women that a healthy baby is all that matters we often silence them. We say, or at least we very strongly imply, that their feelings do not matter, and that even though the birth may have left them feeling hurt, shocked or even violated, they should not complain because their baby is healthy and this is the only important thing.

Source: A healthy baby is not ALL that matters – The Positive Birth Movement

This reminds me of the “birth and apples…” example I’ve used in teaching and activism for a long time:

It is not helpful because the expectation was not to not have a healthy baby–the expectation was to have a vaginal birth. It is comparing apples to oranges since there were two separate individual hopes: one the joy of a baby, the other her experience of bringing that baby into the world. The apple being the healthy baby we all want and usually bear, the orange being what we hope for in our trials and tribulations on the way there…

Source: Birth & Apples | Talk Birth

And, it also makes me remember that your baby’s birth is the beginning of a fresh new, lifelong relationship, one worthy of being treated with dignity and respect and honored as an important rite of passage. I explored a relational analogy in one of my most popular past posts…

You ask when the ceremony can begin and the clerk tells you not until your fiancé’s heart rate has been monitored for twenty minutes—“We need a baseline strip on him, hon. After all, you do want a healthy husband out of all this, don’t you?!” she says. You are asked to change out of your wedding gown and into a blue robe. When you express your dismay, you are reminded that your dress could get messy during the wedding and also, “Why does it really matter what you’re wearing? In the end you’ll have your husband and you’ll be married and that’s really what counts.”

Source: All That Matters is a Healthy Husband (or: why giving birth matters) | Talk Birth

In totally separate news, I have an upcoming free Womanspirit Wisdom mini class. Feel free to join!

Tuesday Tidbits: Joyful Birth + New Year Resources

Dec29

“As mothers, we discover that we love our children in whatever form they are in: a kicking bulge in our womb; a baby sucking at our breast; a toddler leaving play-doh crumbs on the couch; a pierced and tattooed teenager blasting rap music at midnight. We love them when they’re I’ll and when they are damaged. We love them long after they haw died. And in discovering this, we open to a kind of love that transcends form and time. It’s at the heart of our humanness, yet you might call it divine.”

–Susan Piver (Joyful Birth)

I found myself feeling startled at several points during the holidays. One moment came in looking at my “memories” from Facebook and seeing pictures of myself last Christmas with my tiny bundle of a sweet new baby against my chest. This year, he opens presents and crows, “yaaaaaay!”

Still plenty of eyebrow action a year later!

The second moment was in talking to my sister-in-law about homebirth + composting toilets (not an ideal combo, fyi). When Zander was born in 2006, we were living in our temporary shop house and didn’t even have a composting toilet, just a not-very-nice outhouse. I remember having to walk out there in labor and feeling like it was not a fabulous thing. I looked over at Zander, now nine, and had such an intense moment of remembering what it was like to be that mom in that temporary house with my new little baby and my other toddler son. That version of me seems far away now, as does that baby-version of Zander, and yet, here I am still nursing a small boy to sleep and throughout the night…

“For me, giving birth was more gritty than romantic–and much more potent. Like a lotus that rises up from the mud, joy at seeing my daughter blossomed from the experience of reaching my physical and emotional limits.”

–Susan Piver (Joyful Birth)

I see this face a lot–the “uhhhhhhh!” pick me up, face.

This morning I read an article about why everyone deserves a doula:

Doula and mother-to-be form a relationship with each other throughout the pregnancy. The doula meets with the expectant mother, talks to her, and earns her trust and affection (or in my case, a full on girl crush). Whether the mother hopes to give birth hanging from a tree by her armpit hair or is planning an elective caesarean, the doula is there. Whether she wants an epidural from the onset or plans on going utterly drug free, the doula is there. Completely without judgement, she only serves to support the mother in the birth that she desires.

Source: Why Everyone Deserves a Doula — Pregnant Chicken

And, this quote about the physical intensity and potency of birth and the joy that accompanies it:

“Giving birth, in fact, is a messy business for any mother. Whether you have a midwife or a doctor, a homebirth or a hospital birth, a natural birth or an assisted birth, birth has a physical intensity, involving blood, pain, uncertainty, and risk. It is a physical, mammalian experience, organic, animal, earthy, direct. Yet in that very earthy messiness, as we are pushed to our limits, there’s the potential for joy. By Joy, I don’t mean a superficial pleasure that comes and goes and depends on conditions being to our liking. I’m talking about a different joy, tinged with sorrow. It is the tender heart of love.”

–Susan Piver (Joyful Birth)

I have been enjoying the relatively quiet days between holidays and read this post about the silence of this time of year, the lull, the liminal space before the birth of a new year (is this the rest and be thankful phase of the year?).

The most subversive thing is silence. In this odd interregnum, in the days caught between Christmas and new year, the world suddenly falls quiet. Unless you are determined to face dubious sales, there is nothing more to buy. Travel, especially if you use public transport, is curtailed. We are forced to look at ourselves, to our own company, and those nearest us.

Source: With Christmas gone and new year approaching, now is the time for silence | Philip Hoare | Opinion | The Guardian

And, I enjoyed this post about the value of solitude for parents (and the difficulty in carving out time for it):

Solitude is like punctuation. A paragraph without periods and commas would be exhausting to read. In the same way, conducting relationships without the respite of solitude can lessen the benefits of those relationships. Downtime is important for you and your kids. They benefit from solitude too. Taking care of your own solitude will not only help you restore yourself but also show your kids this positive model of self-nurturance

Source: Solitude is Going Extinct: The Stress of Modern Parenting

On the porch of the former clubhouse turned tiny temple/workspace for me to work in solitude.

I’ve started working on my 2015 review for my 2016 Shining Year workbooks and am feeling a certain resistance towards doing it this year (I also got my 2015 Year in Review from wordpress: Your 2015 year in blogging). I found this worksheet for kids on doing a year in review and I printed it out to do with my own kids on New Year’s Eve: 2015 Year In Review Printable – Skip To My Lou Skip To My Lou

The Brigid’s Grove etsy shop is open again with limited inventory. We will be back with our complete assortment of sculptures and ceremony kits (plus, new surprises!) after the first of the year.

The next section of my Womanrunes Immersion course begins on January 5th. This course takes you on a 41 day journal through the runes and includes journal and photo prompts, worksheets, full moon and new moon rituals, and access to the 2016 Calamoondala class.

“To parent well, you have to have the gentleness and courage of a warrior.”

–Carol (in Joyful Birth by Susan Piver)

Talk Books: Q & A with Jenny Kitzinger

Sep3

“These hands are big enough to save the world, and small enough to rock a child to sleep.”

–Zelda Brown

Childbirth education pioneer and feminist icon, Sheila Kitzinger has five daughters. After reading and reviewing Sheila’s passionate, beautiful, inspiring memoir: A Passion for Birth, published shortly before her death this spring, I did a short interview with her daughter, Jenny Kitzinger…

How has your own work been influenced by your mother?

I grew up knowing that the ‘personal was political’ – including issues such as birth, marriage and death – and believing that nothing was taboo or closed off for discussion.

My early work on AIDS, and then on child sexual abuse, as well as my most recent work on the treatment of patients in long-term coma, has all been fundamentally influenced by my mother’s approach to life and work.

What was it like to grow up with a birth activism “celebrity”?

To me my mother was just normal – so I took for granted her passion, determination and impact on the world, and the privilege we had as children of meeting lots of interesting people from the world of women’s rights, politics, and the arts.

I was struck by the focus on humanitarian work in Kitzinger’s memoir. Do you have any childhood memories of these experiences and their influence? Are you still involved in cause-oriented work as an adult?

We often had people staying who needed support – it was lovely to meet the different people who came into our home – and to see the practical support and nurture my mother offered them. Sheila was also clear that the personal was political and that alongside supporting individuals it was necessary to learn from them and work alongside them to tackle root causes of problems.

My sister Tess was centrally involved in support for refugees – a cause also close to my father’s heart (he came over to England as a refugee in 1939). I was involved in setting up one of the first incest survivors refuges. Polly was also active in disability rights, advocating for people with mental illness. Our oldest sister, Celia, is a leading campaigner for sexual equality and equal marriage.

Since my sister, Polly’s car crash in 2009, Celia and I have worked together to examine the treatment of people with catastrophic brain injuries, including rights at the end-of-life. Although we are both full professor, and publish academically, we are committed to making work accessible to families, health care practitioners and policy makers. That is why we designed an online support and information resource about the vegetative and minimally conscious state.

How many times did you hear birth stories around the dinner table?

We are a loud and talkative family. We would often discuss childbirth issues around the dinner table – alongside topics such as sex. This was fine at home, but I think when we went out to eat in restaurants I am not sure next door tables always enjoyed either the content of our lively debates, or the volume of the conversation as we became engrossed in family debate and everyone spoke at once!

What do you feel like is your mother’s most enduring legacy?

The transformation of assumptions about childbirth – alongside a broader contribution to respecting women’s experience and supporting their rights to have choice and control over their own healthcare decisions.

A Passion for Birth, My Life: anthropology, family and feminism by Sheila Kitzinger

(Pinter & Martin)

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Tuesday Tidbits: How to Make Life Easier as a New Parent

Aug11

In all my years as a birthworker, I still find that one of the most overlooked topics in childbirth preparation is adequate preparation for postpartum—those early weeks, or months, with a new baby. In my personal life, I experienced a difficult postpartum adjustment with my first baby, an easier one with my second baby, and two delightful, nurturing babymoons with my last two babies. Years after training as a postpartum doula, good postpartum care remains one of my passions, so I really enjoyed this post from a mother of five. Her feelings of rushing to get back to “normal” feel very familiar even though almost twelve years have passed since my first, tender, postpartum adjustment:

“I remember coming home from going out for the afternoon with Hero at 7 days postpartum. After we got back to our tiny apartment I came down with a fever. I was probably wearing the cutest non-comfortable outfit I could squeeze into. I probably didn’t think that 7 days after giving birth required anything of me other than “getting back to normal.” Life went on, and I urged it faster. In fact, that’s the way I parented, too. Smile, laugh, roll over, sit, crawl, walk, run, milestone, milestone, grow, grow, grow…

When I think back on my postpartum times (for the most part) I remember being exhausted, being emotional, being upset at Kirby for not doing enough, feeling fragile, feeling sad, and feeling weak. And then I got pregnant with Peter… And by the time I had him, I had interacted with enough wise mothers who had screwed up enough to know better and they told me what to do and I listened. After five babies I could finally say I did it right. I’m not saying you have to do it like me. Maybe you’ve already got your postpartum flow down and you need no such advice. In that case, a w e s o m e…”

Now I realize that some moms can just go, and they are happier that way! I get that. But it took me too long to realize that that’s not me. And I don’t want you to spend too much time thinking that should be you if it isn’t. Don’t spend four days, don’t spend four weeks, and certainly don’t spend 4 entire babies feeling like a shell of a person trying to figure it out…

The Fike Life: How to postpartum like a boss.

Unlike my early memories of my first son’s life, rather than looking back with sense of regret and fatigue, I look back on the weeks postpartum with Tanner (fourth and final full-term baby) with a tinge of wistfulness for the sweet, delicate, care-full time we spent together, nestled in bed in milky, marveling wonder. The author of the post above describes it as a “little sacred space,” and that is exactly how I feel. It also needs to be fiercely protected.

I look at that one week postpartum as a little sacred space that I will never get back. It’s a space where, for the most part, it’s just that brand new baby and me. And I’m selfish about it. And not sorry. Life will keep plummeting forward rapidly and I won’t ever stop it. But I can have a week with a floppy new baby on my chest in my bed and I’ll take it. And I’ll protect it.

AND IF THAT DOESNT TUG AT YOU MOTHERLY HEARTSTRINGS KNOW THIS… (super practical advice I got from my midwife with Peter)

When you have a baby you are recovering from an injury that is deeply internal. Your blood needs to stay concentrated there to bring essential nutrients to heal your organs and make you strong again. When you get up and walk around, your blood abandons your core and flows into your extremities, which can massively prolong your recovery. Stay rested and keep yourself down as much as you can. Just think of your organs! They need you!

via The Fike Life: How to postpartum like a boss.

It isn’t just the weeks following a new baby’s birth that matter, the first hour matters too and can set the tone for the rest of the postpartum journey:

…The way your baby is cared for and nurtured immediately after birth significantly impacts their transition from the womb to life outside.

In a culture that commonly separates mothers and babies for routine procedures such as cleaning, weighing and measuring, most babies are missing that critical time of being skin to skin with their mothers, which has short and long term consequences for all.

As these procedures are not necessary to maintain or enhance the wellbeing of either mother or baby, there is no reason why they cannot be delayed beyond the first critical hour.

via 7 Huge Benefits of An Undisturbed First Hour After Birth | BellyBelly.

Why doesn’t this uninterrupted hour and subsequent caring postpartum support happen for all new families? One reason is related to the “treatment intensity” of the US birth culture:

The questions you post in your article are good ones: Are midwives safer than doctors? How can homes be safer than hospitals and what implications does this study have for the US?

It’s a super knotty issue and it shouldn’t be about the superiority of midwives over doctors or homes over hospitals. The debate we should be having is over “treatment intensity” in childbirth and when enough is enough. The concern is that patients can be harmed by doing too much and by doing too little–in the US I worry that we cause avoidable harm by always erring on the side of too much.

via An Unexpected Opinion on Home Birth | Every Mother Counts.

Another is related to routine hospital practices that are not evidence based:

1. Start with giving the birthing woman antibiotics in high doses so that the baby develops candida (thrush) and colic. Then mix in a lot of stitches, either to repair the perineum or the lower belly/uterus.

2. Separate the mother and newborn. Make the mother walk a long distance (with her stitched body) to be able to see/feed her newborn…

via 6 Point Recipe for Making New Parenthood as Difficult as Possible | Wise Woman Way of Birth | by Gloria Lemay.

On a related note, we find that breastfeeding gets off to a better start when birth is undisturbed. We also find that decisions about breastfeeding may be made months before the baby is actually born:

…Recently, a nurse contacted me asking for ideas for teaching an early pregnancy breastfeeding class. I think this is a great idea, since mothers’ decisions about breastfeeding are often made before the baby is conceived and if not then, during the first trimester.

via Breastfeeding Class Resources | Talk Birth.

It isn’t just postpartum during which we need these reminders about the “cycle of care.” The cycle of care of young children can be largely invisible, both to those around us and to ourselves. I’ve taken some time this week to appreciate my investment in my baby and cut myself a little slack on the other things I always want to “get done.” Brain-building is important work too!

Speaking of said baby, who has been taking his first steps this week at nine months old, I was amused this week to come across one of my older posts on family size decisions, in which I decreed my doneness with my childbearing years. Instead of embarrassing, I find the post oddly affirming or reinforcing that at some level I really did know that we weren’t quite “done,” there was still space in our family (and our hearts!) and there really was one more baby “out there” for us.

We decided we’d make the final, ultimate decision after she turned two, because too much longer after that point would make more of an age gap than we’d want. I posted on Facebook asking how do people know they’re “done.” I had an expectation of having some kind of blinding epiphany and a deep knowing that our family is complete, as I’ve had so many other people describe: “I just knew, our family was complete.” I didn’t have that knowing though—I vacillated day to day. What if I never know for sure, I fretted. Perhaps this sense of wistfulness and possibility with continue forever—maybe it is simply normal. One more. No, finished. But…ONE more?! And, I have a space in my heart that knows with great confidence that four (living) children would be the ultimate maximum for us. I definitely do not want more than four…so, does that mean there still is one more “out there” for us?

via Driveway Revelations (on Family Size) | Talk Birth.

However, I also find it to be true that four is most definitely the ultimate maximum. We laughed earlier this week remembering that a couple of weeks after Tanner was born I kept saying that I thought maybe we’d picked the wrong name for him. Mark asked me what I thought it should be and I said I kept thinking that maybe it should have been “Max.” While we joked at the time that this was because he is Maximus Babius, I only now caught on to the unintended double joke that he has definitely pushed our family size to our “max”!

Other tidbits:

I got this book about midwives in Mexico to review and have been zooming through it. It is SO good!

We’ve been working on new sculptures!

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We’ve added some new Moon Wisdom/First Moon bundles to our shop:

And, our new blessing cards came in. We were printing these on regular printer paper and are excited to have nice, professional cards instead!

We also still have five spaces left in the Red Tent Initiation program beginning at the end of the month:

Sign up for the Brigid’s Grove Newsletter for resources, monthly freebies, + art and workshop announcements.

And, as is our tradition, in honor of World Breastfeeding Week and National Breastfeeding Month, you can get 10% off items in our shop throughout August: WBW10OFF.

Talk Books: A Passion for Birth

Aug7

“We are only now beginning to discover the long term destructive effects on human beings and families of treated women as if they were containers to be opened and relieved of their contents.”

–Sheila Kitzinger

Sheila Kitzinger’s new autobiography, A Passion for Birth, is an absolute treasure. One of the most long-term and pivotal influences in the world of birth activism, I have quoted her work more times than I can count. In fact, I judge the quality of a book by the number of pages I dog-ear to return to. I turned down the corners of so many pages in A Passion for Birth, that it will take me a year’s worth of blog posts to share all the provocative quotes that caught my attention! While Sheila always included a personal flavor in her other books, this book is truly about her, her life, her passions, her family, her activism, her work. Interwoven throughout is the social justice oriented thread of her absolutely devoted dedication to women, feminism, and childbirth activism. Her book is very real, relatable, and readable as well as often charming. She doesn’t hold back from treading into controversial waters, however, and she is straightforward and unapologetic even when writing about topics that can be divisive in the birth world.

I was pleasantly surprised to discover the full-color series of photos in the center insert to the book, they range from Kitzinger’s childhood, a homebirth picture of the birth of one of her daughters, and ending with a poignant photo of Sheila’s casket, decorated by her family, resting easily on some chairs in the dining room of home she so loved.

An internationally recognized author and expert, Kitzinger was an anthropologist and one of the first professional people to acknowledge that women’s birth wisdom, stories, and experiences are worthy of study and attention. Spanning an impressive career of more than fifty years, Kitzinger’s anthropological and activist work was undertaken at a global level and her clear and unwavering commitment to social justice work and activism is a thread running strongly throughout her entire autobiography. The book takes us from Sheila writing and studying while sitting in a playpen in her yard (an effort to have a work area undisturbed by her five children!) to traveling with her family to Jamaica to study the birth customs and stories of the women there. Her identity as an anthropologist is clearly reflected in the cross-cultural birth experiences she surveys and describes and the autobiography includes lots of travel! It also includes homey touches like favorite recipes and descriptions of family traditions as well as stories of her own four homebirths, including that of twin daughters. I found myself wanting more content about her life with children, her life as a mother, which, while acknowledged and integrated through the text, was curiously absent from much of the narrative’s exploration. I was also curious to know more about the accident and serious brain injury experienced by her daughter Polly, which was mentioned somewhat incidentally (though it clearly had a significant impact on the family), as was the passing mention in a photo caption referencing her husband Uwe’s eye removal surgery.

Highly recommended to anyone with an interest in birth work, birth activism, feminist studies, women’s health, or anthropology, A Passion for Birth was compelling, inspirational, funny, straightforward, assertive, honest, candid, wry and dedicated.

“The way we give birth is an expression of culture. It can be spontaneous and instinctual, but it is still patterned by the society in which we live.”

–Sheila Kitzinger

Stay tuned for an ongoing series of themed posts based on additional content and thought-provoking quotes!

In a pioneering career spanning more than 50 years she campaigned for and oversaw a radical change in maternity care, placing women’s rights and choices at the very heart of childbirth. Her passion, research and knowledge of childbirth have had enormous impact on millions of women worldwide.

A Passion for Birth | Sheila Kitzinger | Pinter & Martin Publishers.

Publishing and purchasing details:

Author: Sheila Kitzinger
Published: 7 May 2015
Binding: hardback
Format: 240 x 160 mm
Pages: 384
Illustrations: colour and b/w photographs
Pinter & Martin edition available: worldwide
Translation rights: Pinter & Martin

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

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What should I pack in my hospital bag?

Jul20

Packing a bag of labor and birth supplies to bring to the hospital or birth center has become a modern-day ritual of birth preparation. Plan to have your bag packed and stored close to the front door of your home (or in the trunk of your car) several weeks prior to your due date.

Here are some ideas of what to pack in preparation for birthing day:

General

Your birth plan! Pack several copies.

A sign for your door indicating your desire to labor without medication (if this is part of your birth preferences).

Edible Supplies

Hard candy or little lollipops for a quick boost of energy.

Honey sticks: These sealed, clear plastic straws hold about a tablespoon of honey and are another excellent source of quick energy. You can often find them at farmer’s markets or health food stores.

Clear liquids to drink: Herbal tea, sports drinks, apple juice, or white grape juice.

Water bottles for you and your partner.

Light snacks such as crackers (Curious about eating during labor? See past posts: Can I Eat During Labor? and Can I Eat During Labor?)

Personal Supplies

Lip gloss or lip balm (many women find their lips getting dry during labor).

Your own nightgown or large, long t-shirt to wear instead of a hospital gown. (Why wear your own gown in the hospital? Many women find this comforting, comfortable, and an excellent reminder of personal autonomy and individuality).

Warm socks: Many women’s feet get cold during labor.

Toiletry bag with toothpaste, deodorant, etc.
Hair ties or elastic bands to hold long hair away from your face

Comfort Supplies

Back massager (or, simply, a tennis ball for someone to roll over your back).

Your own favorite pillow.

Rice sock or corn sock to heat in microwave for moist heat on your back or belly. (Interested in how to make a corn or rice sock?)

Flexible straws and a cup to make getting a drink easier.

Special picture or artwork to look at during labor (if you’ve created a birth plan poster bring it to hang on the wall of your room)

If you are planning to use aromatherapy during labor, pack your special essential oils.
Supplies for a birth altar for inspiration, encouragement, and support during labor. (I make birth art sculptures as well as birth blessing pouches that can be wonderful for this purpose.)

A “touchstone” object to hold during labor—this could be a special smooth rock, a little stuffed animal, a piece of jewelry, or other meaningful small object that feels good in your hand.

Special birth music on a birth playlist on your phone or MP3 player.

Birth Partner Supplies

Snacks: Things like granola bars, fruit leathers, or other quick snacks that do not have a strong smell are ideal.

List of people to call with the happy news.

Toiletry bag with toothpaste, deodorant, etc.

Change of clothes.

After the Birth Supplies

Nursing nightgown (any gown that opens in the front for breastfeeding).

Breast pads (disposable or washable cotton).

Pads for post-birth bleeding (lochia).

Books or other reading materials (either about breastfeeding, baby, or postpartum care, or a favorite hobby or interest).

Clothes for baby to wear home.

Comfortable clothes for you to wear home (loose cotton pants—even maternity pants—work better than jeans)

Supplies That Won’t Fit Into a Bag

Birth ball (some hospitals have them available to use).

Car seat for your newborn properly installed in the backseat of your car.

Best wishes for a beautiful birth!

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Guest Post: How does your body know when to go into labor?

Jul17

I recently received the following news story to repost. Many women have questions about when they will go into labor or concerns about pre-term labor. They may also worry about “never” going into labor on their own and may face pressure from care providers or family members towards induction. We often rely on signs like cervical changes, contractions, and increased cervical fluid (as well as proximity to due date) in order to help us anticipate the birthing day. I distinctly remember the interesting and counterintuitive experience of having the question of, “WHEN,” somehow feeling more and more mysterious and hard to predict the closer I drew to my own due dates (when really, the closer you get, the fewer birth-day possibilities remain! While it is very normal for babies to be born after their estimated due date, the possible window of when the baby will be born narrows with each day of pregnancy, simply because: babies do come out). Turns out, your baby’s birth-day timing has more to do with what is going on at a molecular level, than what you can observe from the outside!

(If this guest post is too heavy on molecules and too light on personal experience, you might want to check out one of my most popular blog posts: How do I know I’m really in labor? | Talk Birth.)

Key components of interest from the research below:

The molecule that triggers birth is the TLR4 molecule.
This molecule is activated by other molecules produced in the mothers tissues due to uterine stretch, by proteins that are released from a baby’s lungs just before birth, and by the placenta as it begins to reach the end of its life.
Factors that can contribute to a surge inTLR4 and lead to premature birth are:
- Bacterial infections
- Damage to the placenta
- multiple pregnancy

Here is the guest post with more!

———————————————————————————————————————————-

RESEARCHERS at the University of Adelaide have identified that the activation of the TLR4 molecule is key in controlling the timing of birth, acting as a trigger common to both preterm and on-time labour.

Professor Sarah Robertson, Director of the Robinson Research Institute and lead author of the study published this week in Endocrinology, said the research was likely to lead to new therapies in preventing preterm labour.

“Preterm labour, birth at less than 37 weeks gestation, affects 5-13% of pregnancies worldwide. It accounts for 28% of all neonatal deaths and can result in major health consequences for surviving children,” says Professor Robertson.

“In order to prevent preterm birth, we need to understand the physiological responses which lead to normal on-time birth, and our new research pinpoints a ‘master switch’ that influences the timing of birth.

“We know that several agents can bind and trigger the molecule TLR4 after release from fetal and maternal tissues in late gestation, including proteins that are released from a baby’s lungs just before birth.

“Other molecules that activate TLR4 are produced in the mother’s tissues due to uterine stretch, or when the placenta begins to reach the end of its life.”

Professor Robertson says that there are other factors that lead to a surge in TLR4 and premature birth, including local bacteria infections, damage to the placenta due to inflammation, or even multiple pregnancy.

“This is a surprising finding because TLR4 is generally thought to be involved in the immune response to infection, and had not previously been linked with normal processes in pregnancy,” says Professor Robertson.

“Now that we know how critical TLR4 is in regulating the timing of birth, we can commence testing drugs that target the TLR4 pathway.

“While this is yet to be looked at in a clinical setting, we believe this finding will ultimately lead to methods to effectively protect women at risk of going into labour early,” she says.

This work was supported by project and fellowship grants from the National Health and Medical Research Council of Australia, the Canadian Institutes of Health Research and the Australian Research Council.

Key contacts

Professor Sarah Robertson Director, Robinson Research Institute University of Adelaide

08 8313 4094 sarah.robertson@adelaide.edu.au

Tuesday Tidbits: Does Giving Birth Have to Be Terrible?

Jul14

“To nurture life is to . . . embody the intelligent Love that is the ground of all being.”

— Carol Christ

Does giving birth have to be a terrible experience involving screaming, swearing, and pooping on the sterile “delivery” table? Anyone who has followed my blog for a while, already knows what my answer to this question is (no!), but here are some additional resources that caught my eye this week. First, erase the idea of maternal-fetal conflict, reinforced insidiously all across the internet and the media, and keep your expectations high:

Birth doesn’t have to suck. Keep your expectations high and do the work to have those expectations met. Don’t let anybody convince you that you need to step aside for your baby. You need to step up for your baby.

via Dear Friend, Birth Doesn’t Have to Suck | ImprovingBirth.

Next, choose your care provider very carefully. Remember, this baby only gets to be born once! Don’t wait for “next time,” to find a respectful provider and the birth setting your heart desires.

But, I have a doula, surely she’ll protect me from my less-than-ideal doctor!

No, again. Protection from other care providers is not a doula’s job. This is a multilayered issue, but here is a good post with some reasons why:

“My own doula and I have had more than one conversation about why she didn’t warn me about my own provider—someone who I now know has a reputation for not following through on promises to patients. “But I asked you!” I’ve said to her. “Why didn’t you tell me?” She has explained patiently, each time, that she gave me the information I needed to make my own decision. What I wanted from her—to say, “Oh, Cristen, you need to switch providers right now!”—is not something she would ever say to a client. Instead, she gave me specific questions to ask. She encouraged me to talk to my provider about my wishes and pay attention to the conversation, to trust my instincts, and to be honest with myself about whether or not I thought my provider was really going to follow through with what she’d promised.”

via Birth Monopoly | Three Things Your Doula Can’t Tell You.

I know you want your doula or childbirth educator to be able to tell you these things straightforwardly. I wish they could. I’ve had birth class clients ask me the, “why didn’t you tell me” question too and it is a very fine balance for birth professionals. I often longed for the freedom to take the Dr. Pig-Face approach, described by Nancy Wainer Cohen in her class birth activism book from the 1980’s, Open Season:

“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.”

–Nancy Wainer Cohen, Open Season

via Honesty in Birth Preparation | Talk Birth.

In addition to high expectations and careful assembly of the birth team, you may also want to keep secret the sensations of early labor. I followed this advice with all of my babies and have no regrets.

When you begin to have sensations, do your best to ignore them as long as you possibly can. You may want to consider keeping these feelings to yourself and having a “secret sensation time” with your unborn baby. Get in as dark a space as you can. Minimize what is happening with your husband, family and the birth attendants. You have control over your body and a say in your hormone activity. Help your pituitary gland secrete oxytocin to open your cervix by staying relax in a dark, quiet room with your eyes closed.”

via Words of Wisdom: Keep the “Sensations” of Early Labor a “Secret” | NüRoo.

Another way to prepare for a wonderful birth is through connecting with your body. One way to do this is through prenatal yoga. The movements and sensations of prenatal yoga sink into you and become a part of your body memory, guiding you through birthing:

“…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!'”

via Incorporating Prenatal Yoga into Childbirth Education Classes | Talk Birth.

Also, prepare yourself for a nurturing postpartum. Your baby will arrive primed for connection rather than separation. The more you are cared for by those around you during this vulnerable and magical time, the more embracing you can be of the delicate, fierce, and encompassing neediness of your dependent newborn:

“The cutting of the umbilical cord tends to herald the arrival of a new and unique life. Though this tiny being began its existence many months before, growing nestled and protected within the womb, the just-born infant is seen as an individual apart from his or her mother. There is, however, a significant error in this thinking, for baby and mother are one, so to speak, and severing this unit denies an empirical truth. Birth should not be a celebration of separation, but rather a reuniting of mother and baby, who joins her for an external connection.”

–Barbara Latterner, in the book New Lives

via Inseparable | Talk Birth.

I’ve spent a lot of time exclaiming: I JUST want to transform the birth culture in the U.S.! Now, you have a chance to share your opinions and experiences in this new survey: Transforming Birth Culture in the United States Survey.

Other tidbits this week:

Lann has a new YouTube channel for his Minecraft and other gaming videos. You can check out Zall Craft here.
I finally took the leap and signed up for Leonie Dawson’s Shining Year Academy. I’ve been buying her annual workbooks for four years, but it is time to grow! We’ve been working through the Double Your Biz Intensive and it has already been worth the price! (*links are affiliate links)
I updated the links/print layout for my three e-booklets. These were all written prior to my birth work. Hope you might find them helpful! Free e-Booklets | Talk Birth