Pain with a Purpose?

“The desire to help is so great, even from well-meaning, beautiful midwives, that they use intervention. We want to help. But what’s missing in our culture is that there is pain with a purpose, and that helping is sometimes interfering.” –Augustine Colebrook, CPM (quoted in “Do-it-Yourself Birth” article in Mothering mag)

When I shared this quote on the CfM Facebook page, a reader added: “Dr. Bradley wrote about ‘pain with a purpose’…Problem is, in our society, we don’t value the process of childbirth. Therefore, whatever it is you have to do to get thru it… Hence epidurals & nubain, and on and on. Please know I’m not dismissing your experiences if you went that route. But that phrase alone resonated with me when I was giving birth and helped me. I wish it would do so with more women.”

I’ve written a lot about birth having inherent value in its own right. Process AND “product” (i.e. healthy mom, healthy baby) are both important. A de-emphasis on the birth process and its significance in a woman’s life only serves to disempower, silence, invalidate, and violate women.

That said, I do also value the work of organizations like Hypnobabies that questions the very notion of pain as being an inherent part of birth.

So, what about pain?

I find that couples who come to my classes often have pain and managing pain (or witnessing pain) as their top issue of concern. For this reason, I spend time addressing the subject straight out and yes, I have been known to use the dreaded “pain with a purpose” phrase. Some would say that the word “pain” has no place in birth classes—that it sets women up for just that experience—however, as I noted, my clients come with “pain” on their minds and I find I need to use the p-word and sort of clear the air/get past that hurdle, before we do the rest of our work together. Also, as one of my clients once noted, “it wasn’t you who planted that seed [of pain being possible]. It was planted deeply a long time ago!”

And, what would be the purpose of pain in labor?

It is actually part of a beautiful hormonal symphony of labor—the sensations of labor signal our brains to release more endorphins, more endorphins leads to more oxytocin, and more oxytocin leads to increased intensity, which leads to more endorphins, etc., etc. When the pain to brain feedback loop is interrupted with medications, so too, are the oxytocin and endorphin messages that we need to get our babies born—and more interventions to “augment” labor are then likely to follow. As Preparing For Birth notes: “It is true that naturally occurring labor can feel larger and greater than the woman birthing. This is not so as she creates from within the very hormones that increase the strength, power, and frequency of her work of labor. That is the good news, it is from her, for her, by her.”

But, all these things said, I simply think the word “pain” is woefully inadequate to describe the feelings of labor. I like this description from Stephanie Soderblom better:

“VITA MUTARI – the literal translation from Latin to English is ‘Life Transformation.’ That is the closest thing I could think of the feeling of labor/birth…what you are feeling isn’t pain, it’s life transformation. Is it dramatic? You bet! I think it should be!”

I also love the description from Painless Childbirth:

“When I say painless, please understand, I don’t mean you will not feel anything. What you will feel is a lot of pressure; you will feel the might of creation move through you. Pain, however, is associated with something gone wrong. Childbirth is a lot of hard work, and the sensations that accompany it are very strong, but there is nothing wrong with labor.”

Now that’s what I’m talking about, might of creation moving through you. The word “pain” is way too puny to hold that!

I always explain to my clients that the sensations of labor are more similar to the exertion of intense physical effort more than the pain associated with accident, illness, or injury—both the effort AND the exhilaration are similar to doing good, hard, challenging, limit-testing, but doable work (though even bigger and more important). We need a bigger and broader vocabulary for completely describing the breadth, range, intensity, and beauty of birth experiences! What if we had more choices other than “painful” and “painless” to describe the experiences of birthing our babies? Though I wouldn’t say my births were “painless,” when I describe my own birth experiences, “pain” is simply not the word that rises to the top as the most appropriate descriptor.

“So the question remains. Is childbirth painful? Yes. It can be, along with a thousand amazing sensations for which we have yet to find adequate language. Every Birth is different, and every woman’s experience and telling of her story will be unique.” –Marcie Macari

We end up limited when we use only “pain” based language that fails to embrace the broadness and complexity and enormity of the experience.

Newborn Alaina, January 2011

Effectiveness of Childbirth Education?

Oct4

Some time ago a study was picked up by the media as proving that childbirth education “doesn’t work”. This BJOG study compared two groups of women—one group had 8 hours of childbirth classes that also included information about natural childbirth. The other group had classes that did not include natural childbirth information. The epidural rates for the two groups were the same and the couples’ satisfaction levels with their births was also the same. After this media attention, several birth bloggers addressed the study in-depth. The Science and Sensibility blog in a post titled Do Breathing Exercises Work? and The Family Way Publications in Natural Childbirth Class Not Useful?

What stood out to me in the article was the emphasis on breathing techniques. There is a lot more to childbirth education than “the breathing” and if that is all the “natural birth” classes had to offer, no wonder the results were what they were! As was noted in one of the blogs cited above, it is also significant that the women were randomly assigned to either group, indicating that they did not have a strong interest in natural birth (if they did, why risk being assigned to the non-natural birth classes!), so that perhaps the personal investment element was missing. A woman has to want to experience natural childbirth in order to do so!

Another birth educator commenting on The Family Way’s blog post, made an excellent observation that I think really got to the true heart of the issue. She said, ” Until childbirth educators emphasize this key component of CONGRUENCY in their classes women will continue to seek ‘care’ from professionals and institutions incompatible with their professed desire for natural birth. (emphasis mine) All this study proved to my mind it that both types of classes offered were ineffectual in promoting the with-women model of care in labor and birth… Both types of classes failed to address the real crux of the matter…are you receiving care from a provider/institution compatible with the kind of birth you want?” I explain to people in my classes that in the hospital women’s coping mechanisms are often stripped away from them-–sometimes by force, sometimes by misinformation, sometimes by excuses. I tell them over and over again to “ask questions before their chile is roasted” (Pam England). People tell me they can fight for what they want or that their husbands are good at “standing up for me” and I remind them that birth is not a time in a woman’s life when she should have to fight for anything! The time to get good care is NOW, not while “fighting” during labor and not during the “next birth” either (see more thoughts about “the next birth” here).

So, does childbirth education matter or not? Is the birthing woman’s environment of greater influence? I don’t think we have a full answer to this question. I do feel in my heart that childbirth education has important things to offer (otherwise, I wouldn’t be in the field!), but I also know in my heart that an unsupportive birth environment can steamroller right over most of the benefits. Birth is a lived experience and as such is greatly impacted by going on in the “here and now,” rather than past learning or ideas. Recently, I shared this quote from Suzanne Arms on my Talk Birth Facebook page:

“The knowledge of how to give birth without outside interventions lies deep within each woman. Successful childbirth depends on the acceptance of the process.”

In the comments, I noted: also helpful is to birth in an environment that shares that acceptance!

In July, I attended the annual CAPPA conference and enjoyed hearing Polly Perez speak about the benefits of childbirth education. She shared the following evidence-based benefits:

Knowledge
Less fear
Student more able to take responsibility for their own health care
Less need for medications/anesthesia
More satisfaction with birth experience
Life skills!

I definitely have been witness to the reduced fear as well as to the development of life skills that will continue to serve parents on the parenting journey. My own personal observations of additional benefits would be:

Increased confidence in their bodies, the birth process, and their own capacities
Enhanced father participation
Increased prenatal bonding/connection with baby and positive feelings towards baby
Reframing of birth from something to fear/greet with anxiety to something to embrace and greet with anticipation and enthusiasm.

It is hard for me to identify if these benefits carry over from my actual classes into the birth room, however, and this is an issue and question that I continue to ponder.

On a related note, here is a handout from Mother’s Advocate on choosing a childbirth class.

Book Review: Understanding Pregnancy and Childbirth: Your Complete Guide

Sep6

Book Review: Understanding Pregnancy and Childbirth: Your Complete Guide

By Linda Ayertey, CCCE
Resolve Medical Services, 2008
ISBN 978-9988-1-2163-1
152 pages, softcover

http://www.resolvegh.com

Reviewed by Molly Remer, MSW, CCCE

Written in simple, straightforward language, Understanding Pregnancy and Childbirth is a basic guide intended primarily for first-time mothers. It would be appropriate for clients with low literacy levels. With sections covering each trimester of pregnancy, physical changes, labor, comfort measures, and postpartum, the book is a handy, portable size that makes it easy for reference.

Published in Ghana by a midwife working in a small maternity hospital that she founded with her husband (an OB), the book contains some country-specific phrases and suggestions that may be mildly confusing to readers based in the U.S. I noted a higher than average number of minor errors in the text as well as some incorrect information (such as calling all morning sickness “hyperemesis gravidarum” and the advice to shave your pubic hair regularly because otherwise it, “may cause you to have an unpleasant odour”).

Overall, the information provided by Understanding Pregnancy and Childbirth is very basic as well as conventional. There is a nice illustrated section of positions for labor. However, the only “delivery” position described is the standard semi-sitting position and episiotomies are discussed without criticism (as are other interventions like IVs). The illustrations in the book (aside from cover image) are all of women, couples, and babies of color, which is a welcome change from many similar books on the market.

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

Childbirth and ‘Flow’ Experiences

Aug26

One of my areas of interest within childbirth education is about the importance of birth as an experience. I know this isn’t necessarily a popular approach—more popular is to focus on evidence-based care, because using the dreaded “experience” word implies something too esoteric or “woo-woo,” OR it implies that women value the “experience” over a healthy baby (the very notion of which is so insulting to mothers that I can hardly stand it). However, I tend to think that an overemphasis on evidence-based care simply isn’t enough to explore and describe all that birth means for women. Women deserve even more than evidence-based care! (I actually have an article brewing that addresses this subject.) All too often women’s plans for beautiful births are dismissed with comments such as, “all that really matters is a healthy baby,” or “birth is just one day in a woman’s life.” I believe that wanting a healthy baby is a given and that giving birth is also a transformative rite of passage and life experience that has value in and of itself.

In the textbook Childbirth Education: Practice, Research, & Theory the concept of birth as a peak, or “flow” experience is addressed several times:

The joy and personal growth that can result from successfully meeting challenging experiences has been described as ‘flow experiences’…such experiences are generally better understood in athletics than in childbirth because the public understands athletic events to be character building and an effort or a struggle that requires skill, practice, and concentration and is not without pain. As such, athletic accomplishments are widely recognized for both the product and process…Society focuses the celebration of birth almost totally on the product–the baby–and is rather neutral about the process as long as the mother emerges healthy.

The book also shares the research that when mothers were interviewed postpartum who had had epidurals, their comments following birth focused almost totally on the baby. Women who had relied on relaxation and other non-pharmaceutical coping methods talked about the baby AND about the emotional and psychological benefits of their birth experiences. Women in both groups expressed satisfaction with their birth experiences, but for those in the epidural group “the element of personal accomplishment or mastery was missing in their comments.”

I believe that starting out the parenting adventure with a sense of “personal accomplishment and mastery” is a tremendous gift and I wish all expectant couples had the opportunity to experience birth in this way. In my classes, I strive to emphasize that both process (giving birth) and product (healthy baby, healthy mom) are important, and indeed, are inextricably linked.

Creating Needle Felted Birth Art Sculptures

Aug24

I wrote this article about birth art some time ago and it has appeared in some form or another in both the CAPPA Quarterly and in the Friends of Missouri Midwives newsletter. Since I posted yesterday about polymer clay birth art figures, I felt like sharing this article today!

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I learned about creating birth art during my first pregnancy in 2003 when I read Pam England’s amazing book, Birthing from Within. Seeing paintings creating by pregnant women, mothers, and fathers was inspirational for me. I was also moved by reading the accompanying explanations of how the art process had helped people on their birth journeys, or on paths to healing from traumatic experiences with past births. In the book, Ms. England primarily discusses the use of journaling, painting/drawing, or sculpting. Though I am an avid journal keeper, I did not find that medium vibrant or visual enough to express the hidden birth wisdom I sensed faintly at the edges of my consciousness, waiting to be given form. Birth art allows you to tap into your “right brain” consciousness and express unexplored gifts, primal wisdom, or release hidden fears. Creating birth art can help you explore your feelings, memories, beliefs, and perceptions surrounding birth outside of the confines of the spoken or written word.

During this time, I had also been experimenting with the craft of needle felting. Needle felting involves using 100% wool fiber, a single felting needle, and your imagination! Needle felting is a dry felting process in which washed and carded wool fleece is sculpted into shape using only a special barbed needle. I decided I had found the perfect medium to express my birth art. I had envisioned creating a Venus of Wilendorf style goddess sculpture. My first attempts left me feeling dissatisfied. I had created the form of a pregnant woman with white wool and then layered colors over it (the effect was cluttered and disorienting—not the inner wisdom I was seeking to explore). I also gave them faces that seemed unfortunately more haunting than wise.

Finally, I created a lushly full figured pregnant woman in white wool in a seated position (my previous efforts were standing) and decided to leave her white and without facial features. I gave her wild, colorful hair in colors representing the four elements. Finally, I felt my vision being manifest! My only concern was how the eye was drawn to her head/hair. One of my fears surrounding birth was that I would be too “in my head” to get into the rhythm of the birth process. I worried that this fear was given visual form in my goddess sculpture—her “energy” was concentrated in her wild, woolly hair, not in her ripe body where I thought it “should” be. Only after I gave birth to my son, did I fully realize what my exuberant goddess was trying to tell me. Her hair and the colors in it were symbolic of the elemental forces and intuitive knowledge that each birthing woman possesses. I had been concerned about being “in my head” with “book learning.” After giving birth, I recognized the intuitive, natural, wild wisdom that I do carry in both my mind and my body.

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.)

Childbirth Educator as Midwife…

Aug14

“Expectant mothers need to be mothered; their hearts need to be infused with love, confidence, and determination. I now see myself as ‘midwife’ to the gestation and birth of women as mothers.”

–Pam England

This is a beautiful quote that really speaks to how I wish to work with women and what I would like to accomplish.

As I’ve noted before, I have a big binder of back issues of the International Journal of Childbirth Education and they are a real treasure. Here are several quotes that relate to the sentiment above:

From the Sept. 1999 issue in an article called The Challenge of Change: Making Mother-Friendly Care a Reality in Childbirth Education by Mayri Sagady comes a discussion of educator as “banker” or “midwife”:

[the concept of]..traditional education as ‘banking.’ This is where the role of the teacher is to ‘make deposits of information’ into the student’s mind. The student’s job is simply to ‘store the deposits’…the teacher as midwife [is explained as] ‘Midwife-teachers are the opposite of banker teachers. While the bankers deposit knowledge in the learner’s head, the midwives draw it out. They assist the students in giving birth to their own ideas, in making their own tacit knowledge explicit and elaborating it’…Within the field of childbirth education today, there are surely both ‘bankers’ and ‘midwife-teachers’

Then in the December 1999 issue in an article by Celeste Phillips called Family-Centered Maternity Care: Past, Present, & Future, she offers three challenges for 21st century birthing educators:

+”Help men and women understand that birth itself has the potential to change lives for the better.”

+”Give women a sense of fulfillment and tremendous accomplishment.”

+”Give new parents a strong connection to the very essence of life.”

These are formidable—and exciting—tasks! I think it is important to examine our own birth education programs to see how well we are meeting these challenges and also to strive to serve our clients as midwife-teachers rather than as of bankers of information.

And circling back around to my opening quote, I am reminded of another good one, this one from Midwifery Today’s founder/editor, Jan Tritten:

“You will have ideas, options and paths to ponder, but you will also have a sense of possible directions to take as you consider midwifery, childbirth education, or being a doula or an activist. Your path may be circular or straight, but meanwhile you can serve motherbaby while on the path, with a destination clearly in mind.” She also says, “I use the word midwife to refer to all birth practitioners. Whether you are a mother, doula, educator, or understanding doctor or nurse you are doing midwifery when you care for motherbaby.” (emphasis mine)

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)

What To Do When Newly Pregnant and Wanting a Natural Birth…

Aug4

Last month, a friend of my younger sister’s emailed to ask some questions about natural birth. She is newly pregnant and very interested in her birth choices (yay! How exciting!). I shared a couple of ideas with her and thought I would share them with my blog as well:

It can be hard to know where to start—there is SO much information out there. I would suggest getting a good, informative book—though I haven’t yet read it myself, Your Best Birth is a new book that is supposed to be good and very “balanced” at helping you make the choices that are right for you. I also have a suggested reading list here. Mothering Magazine’s Having a Baby, Naturally is also quite good. Speaking of Mothering Magazine, their discussion boards are PACKED with good information and they all come from a natural/holistic perspective (a lot of other message boards have more of an “epidural soon!” culture). You can join a “due date club” there, etc. There is a whole forum just for birth stuff (and a subforum for homebirth), etc. Good resource, as is their entire website. Other good guides include Lamaze’s book Giving Birth with Confidence. One of my favorites as a really good “basic”/intro guide for pregnancy and birth is Pregnancy, Childbirth, and Newborn by Penny Simkin. A brand new edition is out, so think about checking it out!

Particularly if you plan to have your baby in a hospital, a doula would be a really good addition to your birth “team.” Doulas provide non-medical labor support and are there just to support YOU and what you want. It is really good to have continuous labor support. And, she does not replace your partner—he has his own “journey” to take into becoming a father and having a doula there frees him of a lot of the pressure of trying to be your “doula”—he can just be there with you, loving you, rather than trying to remember all kinds of stuff from books!

I would also suggest finding a good independent childbirth educator to take birth classes from when you get closer to your due date (one who doesn’t work in a hospital—it doesn’t matter if you plan to give birth in a hospital, an educator who works for herself instead of for somewhere else, is better able to give you complete information instead of just teaching about the “rules” of that particular location). Read more about “why independent classes” here.

Most of all, spend time celebrating your changing body and marveling at its inherent wisdom. Take time each day to “tune in,” draw inward and connect with your baby. Honor your natural rhythms—eating when you’re hungry, resting when you’re tired. Be gentle and loving with yourself. Know that you already have everything you need within you and strive to create a birth environment that encourages that inner wisdom to blossom and fully respects your right to freedom in birth.