Book Review: Home/Birth: a poemic

Apr22

Book Review: Home/Birth: a poemic
By Arielle Greenberg and Rachel Zucker
1913 Press, 2011
ISBN 978-0-9779351-7-8
208 pages, softcover, $11

http://www.1913press.org

http://www.facebook.com/pages/HomeBirth-A-Poemic/

Reviewed by Molly Remer, MSW, ICCE, CCCE
https://talkbirth.wordpress.com

Co-authored by a pair of long-time friends, the “poemic” book Home/Birth reads as if you are eavesdropping on a lengthy, juicy, engaging, thought-provoking conversation about homebirth, birth in America, maternity care, and feminism. The book has a lyric, narrative, stream of consciousness format linked together with segments of poetry.

The text does not differentiate between the two speakers/writers, though through the “call and response,” back-and-forth exchange between the two authors, you quickly begin to recognize two distinct voices (as well as other fragments from birth books, bumper stickers, midwives, etc.).

The book was written during Arielle’s second pregnancy, which ends in the stillbirth of her baby boy. Arielle had one prior homebirth and one subsequent homebirth. Rachel had two hospital births and a homebirth prior to the writing of the book.

While the style in which it is written takes some time to get used to, once you tune in to its rhythm, Home/Birth is a unique and fascinating journey. Because it is so distinctive, I find it difficult to describe in writing—you need to make sure to read it for yourself!

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

ICAN Conference Thoughts

Apr13

This past weekend, I attended the ICAN conference in St. Louis. I was really excited that the conference was in my own back yard (well, two hours from my back yard). I enjoyed seeing lots of people that I know from Friends of Missouri Midwives as well as other friends and contacts from other organizations. And, I got to meet some people in real life (like Jill from the Unnecesarean), who I previously only “knew” online. I also bought myself a pretty awesome new ring from the MANA booth (and a t-shirt and a bumper sticker!).

In addition to these things, highlights of the conference for me were:

Hearing Pam England speak and getting to meet her after so many years of being a fan of Birthing from Within. I will write another post soon about her “9 Birth Story Gates” presentation. It was very good.
Taking Amy Swagman’s birth art workshop (Amy is the Mandala Journey artist and was someone else that I enjoyed meeting in person after only “knowing” online). I will write about this soon as well.
Seeing the amazing breech birth videos shared by Gail Tully of Spinning Babies in her presentation about breech birth.
Connecting with another mother during the sand tray art therapy workshop presented by Maria Carella. Though our birth experiences were different, our “processing” of them during the workshop was amazingly similar. More about this later too.

The main reason I wanted to post tonight though was to share my experience in visiting the “Our Voices” room at the conference. This room is a safe, quiet place—a place of silence—in which women can go to to contribute their feelings about their cesareans to the wall displays. They can take their contributions home with them when they leave, or leave them up to be re-installed in the next Our Voices room at the next conference. Every wall in the room, plus the doors and several tables, was covered with women’s words and feelings about their cesarean experiences, subsequent births, VBAC, etc. It is difficult to put into words how potent of an experience visiting this room was. I was not expecting to be moved to tears by it, but I was. It was extraordinary. And, painful. There were other women in the room crying and crying as they composed their additions to the wall, as well as other women walking quietly through and looking and reading. I originally intended to add to the wall—I was told that it was not necessary to have had a cesarean myself in order to add something—but after seeing the room and the women in it, I did not feel “worthy” (so to speak!) of adding to it. It wasn’t my space. It was something I was privileged to witness, but I did not feel it was appropriate to add my own words to these women’s pain and expressive space. I felt like anything I could say would be trite somehow, almost insulting, to the depth of feeling expressed on the walls. Sometimes you really do have to have “been there” in order to fully recognize the experience of another. And, while I can certainly empathize and feel deep compassion, cesarean birth has not been my own personal journey and it just felt like it would be rude almost, to claim enough understanding of it to write on this wall.

This experience also taught me that I am not meant to start an ICAN chapter. I really think our area could use one and I love the work that ICAN does and I had signed up to start a chapter (before coming to my senses and realizing that I am overcommitted to too many projects/organizations right now as it is), but after visiting the Our Voices room, I realized that I am not the appropriate person to lead one. I just can’t really get it even though I can “see” other women and honor their experiences.

I’ve noted before that I feel like my experiences with pregnancy loss opened my heart more fully to the full range of birth loss (which includes many women’s feelings about their cesareans) and birth/pregnancy trauma. Before loss, I only saw the “pretty” side of birth. Well, not pretty, exactly, but the empowering and triumphant and exciting side. After my birth-miscarriage, my world was opened to the wider world of birth experiences and feelings. I feel like there are—somewhat surprising—parallels between pregnancy loss and the loss of a vaginal birth women experience with cesarean, but it is also different and the Our Voices room at the conference was a sacred space for those with cesarean experiences. It was both humbling and moving to hear their voices in this way.

There are pictures of the room and the contributions at the ICAN Conference Facebook page.

Birth Strength

Apr1

“Women are strong, strong, terribly strong. We don’t know how strong until we are pushing out our babies. We are too often treated like babies having babies when we should be in training, like acolytes, novices to high priestesshood, like serious applicants for the space program.” –Louise Erdrich, The Blue Jay’s Dance

This is one of my favorite quotes to share at blessingways. The Blue Jay’s Dance is a memoir of the writer’s first year with her third baby (sixth child). She isn’t particularly a birth advocate, the book is a general mothering memoir, but at one point she says the above and I love it. Though, I should note that I think there are all kinds of strengths to be found in birth—not just in pushing out a baby. One can experience “terrible strength” in coping with an unexpected cesarean also. And, of course, womanpower can also be found in other non-birth experiences. When I shared the quote on Facebook, some people commented that they hated it or that it was offensive. I have been surprised by how very personally some of the birth quotes I post on Facebook are taken. There have been several occasions where I’ve felt so upset about it that I thought maybe I should never post quotes ever again! (now who’s taking something too personally? ;)). Then, I realized a strong personal reaction is normal, because birth is such a strong and personal issue, so now I try to be extra mindful of the subtexts that might be perceived in a quote (regardless of original intent) and clarify that below the quote. I truly think the intent in this one is of the potential to discover our own hidden strength via birth, not to say that birth is the only powerful experience available to women. I know that I draw on my “birth strength” in other important moments in my life. I also realized after the miscarriage-birth of my third son that the strength found in birth is present in women, period. It is woman strength and it rises up during birth, but it is always there.

During a recent women’s retreat we reflected on sources of personal power and how we feel when we are standing in our personal power (this question comes from a fabulous book, A Mother’s Guide to Self-Renewal). When I first considered this question, I was somewhat sad to discover that the only instances of personal power I could come up with from giving birth—it would be nice to have piles of personal power experiences! More reflection revealed that I also feel like I’m standing in my personal power when I teach. Not a sense of “power over,” but in power with. More freshly, I’ve realized that I find personal power in Goddess spirituality/images and ideas of the Divine Feminine. And, I also experience personal power when I am alone. I feel most whole and authentic when I am just by myself. I like quiet space in my own head in which to think and I also enjoy my own company 🙂

“A woman meets herself in childbirth” –Cynthia Caillagh

Each time I gave birth I realized I was a pretty amazing person with inherent worth and value. The woman that I met in birth was very strong and very capable and very focused. And, she is me.

I hope my baby girl grows up standing in her own personal power and having a profound sense of her own worth.

Baby's First Bindi--taken at a recent blessingway for my good friend

Labor Pictures

Mar28

I’ve mentioned before that I was disappointed not to have any birth pictures from my last baby. What I do have is quite a few labor pictures and I want to share them in a post since labor pictures don’t often get as much “glory” as birth pictures 🙂 I didn’t have any birth pictures with my first son either, though we have several immediately after as was my preference at the time. I have two labor pictures with him, this one, taken in fairly early labor:

Trying to decide whether or not this is it!

Then, my mom took this one of me after I got out of the shower. I was going to try to go to bed, because the birth center staff seemed pretty sure I wasn’t really in labor and should just get some rest. This picture was taken about 5-6 hours before he was born:

With my second son, my mom took a great series of birth pictures as he was emerging. They’re really good and step by step as he comes out—however, the angle is a very direct “rear view” that I don’t feel comfortable putting on the internet! With that birth, there is only one picture from the actual labor (and, it is a nice active labor picture that isn’t too graphic and it has actually been printed in several publications):

About 30 minutes before giving birth to second baby

I like how you can see all of my older son’s playdoh creations in the foreground. That’s homebirth for you!

With my daughter, my mom took a series of labor pictures and while I’m sad not to have birth pictures too, I like the story that these pictures tell:

Taken during the morning of birthing day–wanted one last “belly picture” of pregnancy.

Spent a lot of time on the ball with Mark at my side

My birth nest is all ready! (on floor outside bathroom) Notice that my birth altar is set up nearby.

More time on the ball…

Proving I can still smile one hour before she is born! (+ advertising my alma mater)

Accidentally got trapped on floor in horrible and painful position.

The closer I get to having a baby, the nearer to the floor I get (hands and knees is right for me)

Switched into ridiculous too-small PJ shirt right before pushing.

She’s here! Closest thing to a birth picture that we got.

First nursing

Birth Story Wordle

Mar22

I’ve done Wordle images before using the text of this blog, but I didn’t realize that you could make one using only one particular post. A couple of nights ago when I was up late with the baby, I made one using Alaina’s short birth story! I made it the day before her two month birthday—I also took her out to show her the supermoon 🙂 I like it—I find it meaningful that my husband’s name is the second largest word after the word “birth.” I also find it significant that the word baby is above the word birth, since for me this time, the baby ranked above the birth in my emotional experience of birthing. In an ultimate reckoning, The baby is always more important than the birth, of course, but my feelings about the two are usually interlocked and go hand and hand and I believe that birth has inherent value as an experience—this time I felt exhilirated about the baby and then secondarily had separate feelings about the experience of birth.

Book Review: Times Two

Mar18

Book Review: Times Two: Two Women In Love & the Happy Family They Made
By Kristen Henderson & Sarah Kate Ellis
Free Press, 2011
ISBN 978-1439176405
224 pages, hard cover, $14.81

Reviewed by Molly Remer, MSW, ICCE, CCCE
https://talkbirth.wordpress.com

Written in a she said/she said format, Times Two is an engaging memoir of two women’s journey into parenthood. I was immediately entranced by their story and devoured the whole book in less than 24 hours. A professional couple living in New York, Kristen and Sarah embark on various fertility treatments and experience a devastating miscarriage before both becoming pregnant—with the same donor and with due dates only three days apart. The rest of the book chronicles their progress through their dual pregnancies, the births of their nearly-twins, and a brief discussion of the postpartum adjustment period. It was interesting—and sad—to read about the hurdles faced by same-sex couples in achieving legal parenting rights.

I was especially interested in their birth choices. While beginning with very different goals, the mothers-to-be hire a doula and find the private birth classes she offers to be a transformative influence. Sarah successfully turns her transverse baby with moxibustion shortly before her due date and avoids a scheduled cesarean and both women give birth with doula support (and eventually epidurals) during the same month.

The book is fast-paced and reads like a novel. A nice, extra touch is a series of color photos in the middle of the book—ultrasound pictures, double-belly pictures, and photos of the babies and family. The tone of Times Two is fairly lightweight and casual and the dialogue felt somewhat stilted or artificial, but this unusual double narrative kept me captivated.

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

Threshold Moments

Mar16

In cleaning off my desk this weekend, I found the following note from a webinar by Rose St. John that I attended some time ago:

“Labor is all about finding your threshold and learning you can go beyond it.” –Rose St. John

Threshold Stone, Newgrange, Ireland

I think one of the powerful lessons of birth is about one’s own immense capacity—each of my births has had a “threshold” moment and, indeed, I have some notes taken for a possible future article about “At the Threshold: Pivotal Moments in Birth.” With my first son it was during pushing when I realized I had to just do it, I had to push him out even though it was scaring me to do it. With my second son, it was when I realized that I was actually in labor—I had a distinct sense of literally crossing a threshold. A sense of, “there is no turning back now. I’m going back into the house and I’m having a baby.” With my third son, it was when I got up in the night feeling contractions and went into the kitchen. There, I talked to the baby, telling him it was time to let go of each other—“Lets do this. Lets get it done by 3:00” (and we did).With my last baby, it was when I was talking to myself prior to pushing—fretting that I was too “in my head” and not letting go enough. After this moment, I did let go and she was born very rapidly after that.

So, looks like I had two “pushing” thresholds and two “bring it on—labor is beginning” thresholds. The pushing thresholds occurred during my longer labors and the bring it on moments during my short labors.

The Waters are Breaking…

Feb28

I recently bought a very discounted copy of Penny Simkin’s Comfort Measures for Childbirth video. In the explanatory booklet that comes with it, she mentions the following: “You may also notice the woman’s bag of waters break during a bearing-down effort. This is normal, though quite rare, as the bag of waters is usually broken before this time…” She doesn’t specify whether it is quite rare because the bag of waters is artificially broken before that time for many women, or whether it is just quite rare, period. Regardless, I found it an interesting comment because my personal experiences have all been of this same “rare” type—my water breaks right as I’m pushing out my babies. With my first son, I arrived at the birth center ten centimeters dilated and was told I could push whenever I felt the urge. After about 30 minutes or so, I began pushing sort of experimentally. My water exploded across the room after a few of these mini-pushes. He was then born about an hour after that. With my second son, I was on my hands and knees on the floor feeling the first intense pushes and on the second push, my water broke with a soft, warm gush and ran down my leg. He was born about 5 minutes after that. After these two experiences, my conclusion was that it was kind of a nice benefit to have my water intact until pushing—it created sort of cushion for the baby’s head and (I felt) perhaps lessened the intensity of contractions (I have yet to experience a “freaking out,” identifiable transition stage in any of my births).

Waves breaking at Montana De Oro on CA trip, July 2009.

When my daughter was born last month, it was a slightly different story. As usual, the water stayed intact, but as I began to feel the pressure of her approaching head, I felt like my water really needed to break and wasn’t. It felt distinctly in the way and it was really bothering me. I felt like I could feel it in my “birth path” and it felt like an obstruction rather than a cushion and I was completely annoyed by it. I got on hands and knees on the futon and could feel her head moving down and almost crowning, when the water finally broke and a small trickle of it came out before she did (approximately 12 seconds before!). As I’ve written before, I moved up into a kneeling position then and my entire baby was born all at once along with…a big sploosh of water. Most of it came out after the baby—she was particularly nice and clean after birth too. My sons were very bloody. My daughter had a couple of tiny spots of blood on her head, but the rest of her was pink and vernixy.

I titled my post as I did because during this last pregnancy, I often listened to a CD of chants. One of the songs on the CD has sort of a wailing refrain of, “the waters are breaaaaaaking…all over the world….the waters are breaking!” and I could NOT listen to that song while pregnant (even though it has nothing to do with pregnancy—I’m not sure exactly what it is supposed to mean, but I surmise it is about change in the world). I always ran to skip over it, feeling like to listen to it would be to send some kind of message to my body/baby that I wanted my water to break, when really, I definitely didn’t want it to break early! I wish I would have thought to turn the song on during labor though 😉

Transformation Through Birth

Feb25

One of my favorite birth books is Transformation Through Birth. Written in 1984 by Claudia Panuthos, who also wrote the excellent book Ended Beginnings (about miscarriage, stillbirth, neonatal death, and healing all sorts of childbearing losses), it is one of the books I recommend as “going beyond” typical pregnancy/birth book material. I enjoy books that are designed to help women with the emotional work of pregnancy instead of just the physical work, with a quick dabble into the psyche. I find they are few and far between.

Some quotes and ideas from this book that I particular like:

“In some sense, childbirth is much like a marathon. Once given some general guidelines, marathon runners know how to breathe, to run, and to complete their race according to their own body signals. Similarly, women know how to breathe, to birth, and to complete the delivery according to their own body signals. Marathon runners who are true champions are free to stop the fast pace, and even quit the race without loss of integrity.”

She then makes the point that birth is really more like a “Zen marathon” in that “the focus is to become centered and one with the body, to remain on purpose and directed toward a single goal and to act from the witness or higher mind within” and goes on to say, “Because we view marathon running as an expression of ultimate physical health, a similar attitude toward childbearing may greatly aid in the altering of present attitudes that respond to childbearing as an abnormal condition requiring medical treatment.”

I use the marathon example in my birth classes usually—particularly when talking about “pain” and what birth feels like. I use the marathon analogy to illustrate how the sensations of birth are not like the sensations of accident, illness, or injury, which send us pain signals indicating something is wrong. There is nothing wrong with birth! (well, usually) The sensations of birthing are more similar to the feeling of healthy muscles working hard and working for a long time, but doing something of which they are fully capable.

I’ve posted about this before, but the marathon talk reminds me of something one of the doctors in the Business of Being Born film said that made me really outraged. He said something to the effect of: “in three months you’re just going to be pushing a baby in a stroller, so what difference does it make how you gave birth?” What difference does it make?! Would anyone even THINK to say something like that to a marathon runner or Olympian—“in three months, you’ll just be pushing a baby in a stroller, who cares that you won a gold medal?” (analogy side note, feeling good that you won a gold medal [gave birth in a triumphant and empowering way] does not invalidate or cause guilt in those who did not run the marathon, or had to quit early, or needed help finishing. There is no shame in not running, but there is also rightful PRIDE and “glory” in finishing the “race” you set out on.

Okay, back to the actual book! Another good quote, but one I have a mixed reaction to:

“Women who birth joyfully do so because of who they are, what they believe, and how they live.”

While I like the sentiment, there is an unintended subtext of—if you did NOT birth joyfully, it must be because you have a sucky life in general and does not take into consideration the millions of factors that go into any one birth (it isn’t JUST about what the individual believes and how she lives, it is also about what those around her believe and how they live, and also what our culture believes about birth).

That said, the book is very compassionate with regard to cesarean birth experiences, stating:

“For the woman who delivered surgically, her task is to see that she was attempting to save her baby’s life through an act of personal courage.”

I love this re-framing—it isn’t a failure to have a cesarean birth, it is often an act of personal courage.

The final element I love from Transformation Through Birth is the author’s concept of encouraging and preparing for postpartum EXPRESSION instead of postpartum depression (the theory being that stuffed down, unexpressed feelings, moods, conflicts, emotions contribute to depression by repression of expression. That’s my own bit of alliteration there–I’m so catchy! 😉

Pushed Thoughts

Feb23

If you are looking to get fired up about about birth activism, I recommend reading the book Pushed by Jennifer Block. This book is seriously GOOD! Lots of weighty, meaty information, scathing critiques, astute observations, and clever commentary. She has plenty of scientific backup for her claims and the book is written in an engaging, fast paced style that skillfully weaves facts into descriptive commentary and personal, illuminating interviews. I originally checked this book out of the library, but after seeing all of the data contained within—she pulls together vast quantities of data about effectiveness of “routine” practices, etc. and makes it accessible to the average reader—I quickly ended up acquiring two copies (one hardback and one soft cover, both autographed from when Jennifer was our featured speaker at FoMM‘s annual Cookie Day event!).

Yes, I was a geeky fangirl in the Capitol rotunda in 2009 when Jennifer Block spoke at the annual Friends of Missouri Midwives Cookie Day event.

Pushed is a thorough critique of obstetrics as an industry and how women and babies are being HURT by the systems ostensibly in place to “protect” them. Especially thought provoking is Block’s descriptive exploration of the cesarean epidemic. She points out on one occasion when discussing the whole uterine rupture straw man used to deny women VBACs, that people must prefer “controlled uterine rupture” (i.e. cesarean) than the small chance of natural uterine rupture. Later, in a separate section regarding blood loss during birth, she mentions that average loss is 300-500 mil and over 500 is considered a hemorrhage. She then notes that during a cesarean the average loss is 1000 mil. Reading that, I thought so essentially with a cesarean you have a 100% chance of a uterine rupture AND a 100% chance of a hemorrhage. ::sob:: 😦

The information about blood loss wasn’t new to me, but I did learn something I hadn’t known at the time–300-500 mil of blood is approximately 8-9 menstrual periods worth. Isn’t the female body thoroughly awesome?!

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Some assorted random thoughts and quotes from Pushed:

Re: EFM (external fetal monitoring): “For the natural childbirth movement, the emergence of the monitor was unfortunate timing. Just as activists were urging women to get up and birth, hospitals reined them back down in bed and strapped them, both physically & psychologically, to a machine that falsely promised a safe birth.”

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While my feelings about unassisted birth have been “refined” and tempered somewhat since first reading Pushed in 2008, I did find the sections about UC to be frustrating and annoying. Quoting a midwife re: unassisted birth: “‘That’s not why you’re hiring a midwife. You’re hiring a midwife because you want her there for complications’ Some of Linda’s clients are such believers in birth that they toy with the idea of going unassisted. To this, Linda is fond of telling the story of a birth she attended where the baby had its umbilical cord wrapped around its neck three times and need resuscitation. ‘You never know when you’re going to have a problem,’ she says. ‘It’s like playing Russian roulette.'”

This makes me frustrated because those kinds of scare-tactic comments and implied “you must not really love your baby” subtext is EXACTLY the same as the conventional medical system’s attitude toward homebirth. The midwife quoted seemed totally oblivious that her remarks are virtually identical to the things OBs say say about homebirth and, regardless of any other personal opinions, I think they are just as demeaning and restrictive to women as the anti-homebirth sentiments are.

Okay, brief rant aside for another quote, this one while the author was observing a home water birth:

“It is at this point that I begin to fathom what supporting normal birth really entails. Linda is on her knees, sleeves pushed up, gloved hand in a soiled kiddy pool up to her bare elbow, gleaning diarrhea wisps with a spaghetti strainer by flashlight. I try to imagine a doctor doing this work and have great difficulty. This is not medicine. This is birth. It is messy, backbreaking, humble work.” [emphasis mine]

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During the conclusion of the book after a discussion about the NAPW and whether childbirth is a reproductive right or not:

To her [a doctor who thinks it is not], it is a medical issue, one that may need reform, but one that belongs under the purview of physicians. ‘To my mind, I’m all for people having a pleasant and safe birth experience,’ she says. ‘But my highest priority would be for them to have a safe birth experience.’ But what’s considered safe is political. What’s safe changes. Thirty years ago obstetricians said VBAC was dangerous. Then they said it was safe. Now they’ve gone back to saying it’s dangerous. ACOG says out-of-hospital birth isn’t safe, but the research has consistently suggested that for women with normal, uncomplicated pregnancies it is not just safe, but safer, because those women are far more likely to have a normal, spontaneous vaginal birth and far less likely to experience harmful, unnecessary interventions….”

“…The goal is to have a healthy baby. ‘This phrase is used over and over and over to shut down women’s requests,’ she [Erica Lyon] says. ‘The context needs to be that the goal is a healthy mom. Because mothers never make decisions without thinking about that healthy baby. And to suggest otherwise is insulting and degrading and disrespectful’…What’s best for women is best for babies. and what’s best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the kind of experience that most women have. In the age of evidence based medicine, women need to know that standard American maternity care is not primarily driven by their health and well-being or by the health and well-being of their babies. Care is constrained and determined by liability and financial considerations, by a provider’s licensing regulations and malpractice insurer. The evidence often has nothing to do with it.

This the TRUTH and I hope women hear it.

The only critique I have of this book is one I echo from several other reviews. The book fires you up and has a lot of passion and energy, but provides no outlet or ideas for where to channel that energy. There is no “resources” section, no suggestion to join Citizens for Midwifery or your state midwifery advocates, no list of birth-positive organizations who are working diligently for birth change in our culture, etc.

For some ideas that address the above, read my small-stone birth activism article 🙂