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Musings on Story, Experience, & Choice…

“Power consists to a large extent in deciding what stories will be told.” –Carolyn Heilbrun

A lot of thoughts and ideas have been swirling together in my head during the last couple of days. I read a thought-provoking post from Navelgazing Midwife about choices and the prevalence of the phrase “‘If women knew their options, they’d make different choices.'” She continues by saying, “The first is the assumption that she doesn’t/didn’t know her options, the belief that if she just knew them, she would have made different (my) choices.”

I have at several points in my life had the realization that I persist in thinking that if only people were “enlightened” (i.e. like me), they would make different choices, but then I am confronted with the fact that many people ARE aware of their choices and actively choose differently.

I was then reading the book Sacred Circles (not about birth, about creating a women’s spirituality group) and was interested to come upon this section:

People can feel especially fragile about giving birth because they hate to think they ‘did it wrong.’ We may defend one way of doing it because it is too threatening to think that there might have been a better alternative to the way we gave birth…go gently, and avoid the impulse to polarize or convert. Encourage each person to speak of her own experience in ‘I’ statements…”

Having a miscarriage has led me into a whole new blog world of miscarriage/stillbirth blogs, which often overlap with infertility blogs. There is such vast and deep pain associated with childbearing losses of all kinds. It is staggering—the weight and variety and prevalence. One babyloss blog I have been enjoying recently is Knocked Up, Knocked Down and in a stroke of synchronicity, she also wrote recently about choice and birth advocacy and minding your own dang business. She writes about talking to a friend about her plans—lack thereof—for upcoming birth of her child (following miscarriage and stillbirth). The friend begins to “push” midwifery and other “birth choices” and the KuKd authors writes this:

“And the conversation sort of fizzles there, because by that point I’ve shut down. I mean, I sort of pretend to carry on in conversation, talking and not talking, smiling and not smiling, but my brain has gone elsewhere – because the person I’m conversing with has just morphed from friend-on-equal-footing into a Homebirth Amway Salesperson in a blue suit and tie, standing at my doorstep with a clipboard in arm. And suddenly I’m too busy to talk, with WTF’s swirling around inside my head.”

I think we really need to hear this. There are any number of women out there who are not waiting to be “enlightened” by our “superior” homebirth wisdom! She continues:

“WTF is UP with the homebirth salespeople, and W(hy)TF do does it matter to them how I choose to deliver this child? In what way does my personal choice of baby-delivery affect anyone else’s life besides mine, my husband’s, and my baby’s? WTF is up with anyone believing in something – a religion, a product, anything – so righteously and rigidly that they feel compelled to convert others into following their so-called enlightened path?”

And then she reaches into “choices” that brings us back to the theme of Navelgazing Midwife’s post:

“My friend Jen explained it like this: ‘…but a lot of women don’t know they HAVE other options besides just a routine hospital delivery.’ Maybe true – but so what? Let’em find out on their own! Let’em read about it, ask about it, think about it like the smart people they probably are.”

There is SUCH a difference between sharing your story and “proselytizing” or trying to convert others (i.e. how our dearly held “birth advocacy” efforts may feel to others :().

And a final quote from a much longer and very good post:
“Just know that childbirth for a KuKd momma is psychologically complicated, and there’s a reason for every choice we make. Do not be alarmed by the sinister terms ‘hospital delivery’ and ‘no birth plan,’ as these do not necessarily equate to ‘poor ignorant woman who needs to be saved in the name of Jesus Christ the Lord of Homebirth Wonderfulness.’ Relax: things will be okay.”

As one of the extra-enthusiastic myself, perhaps a bit uncomfortable to read, but also upfront and honest and really important. One of the most important lessons I learned from my miscarriage is that I finally get HOW and WHY some women just don’t care about the birth. I have new clarity as to why everyone isn’t all fired about the miracle of birth and the glorious rite of passage. And an understanding of why women say, “as long as I have a healthy baby.” I feel like one of the gifts my little Noah brought me was not to be smug anymore. While I feel like I have always had a fairly good capacity for empathy and compassion and also the ability to see other peoples’ points of view and perspectives, I can now see that I also retained some measure of smugness that I, I get it. If my third pregnancy had ended merrily in another full-term, triumphant birth at home, I would still have some smug satisfaction at my core. It’s gone. Smug no more. For some women—me included—the end result of pregnancy and birth is a dead baby (whether a full-term baby or an early second trimester baby like my own) and the simultaneous birth of unquenchable, indescribable wells of grief and loss (and your little three year old saying, “but I was going to be the big brother. Why did our baby die, Mama? We will never get to hold his hand. He will never crawl all around our house. We will never get to play with him”). It can be hard to get all fired up and excited and “GO Birth Energy!”  if this is your reality and your experience of birth. Because I have other healthy children and because, along with the grief and pain, I experienced my own miscarriage as another “empowering” birth, I retain much of my fascination with birth and my love of the subject. However, my heart, eyes, and compassion have been opened to the larger breadth, depth, and range of being female and the breathtaking spectrum of childbearing experiences contained therein.

Last fall I attended a performance of Birth, the Play in St. Louis. During the BOLD Talkback following, a volunteer with ICAN made a statement that had a profound impact on me: “We believe that every woman has the right to define her own experience.” This struck me deeply as a core truth and it is becoming a foundation of how I work with and speak to women. How would the world look if this is truly how all birthworkers believed and worked and lived our lives? Instead of “hearing” what could have been done differently or seeing how “if only she had made different choices then XYZ,” we could simply listen to each woman’s own experience as she defines it—whether or not her experience supports or defends or challenges or disproves our own philosophies, beliefs, and experiences. And, whether or not her story is a “good” or “bad” one. Guess what? This also removes the tendency to take responsibility for other people’s experiences (i.e. “she took my classes and she had an epidural, so I must not be a very good childbirth educator,” etc., etc.). Additionally, and sort of on the flip side, what if we could listen to other women’s experiences that are very different from our own without “hearing” a subtext of, “you should have made choices like I did,” or, “the way you did things was wrong” and what if we could share our stories—our experiences—without feeling a need to explain ourselves or to “prove” anything about “our side”?  I have written before about needing to be able to hold two truths simultaneously (see this post) and my current train of thought is a continuation of that idea. I define my own experiences of giving birth as the most transformative and empowering experiences of my life (and, as another point of definition that is perhaps not shared by everyone, I give my miscarriage experience of my third son full and equal weight as a “birth experience” in my life)—these are my experiences as I define them, but I can hold the space for the “opposing” truth simultaneously, that to some women giving birth really is “just another day” or “just get it out, I don’t care how!” and I do not need to convert them to the “wisdom” of my own “right way.” Every woman has the right to define her own experience.

As my opening quote indicates, I also believe deeply in the power of sharing stories—but sharing stories without promoting analysis or defense. This can be a tricky balance to maintain, especially because what we say and what the listener “hears” can be two very different things—another reason to come back to the right of each woman to define her own experience. If women do not talk about the power and transformation and rewards they have experienced in giving birth, then that story—that power—is lost. If women do not talk about miscarriage and childbearing loss because they do not want to be “negative” or “depressing” or “fear-based,” then that story and scope and range of experience is lost. Likewise, if we are unable to hear that another woman did NOT experience “birth power” and in fact DOES NOT CARE about birth, but solely wants a living child then that story and the lessons therein are also lost and so may be lost the very important, human element of simply relating to one another and listening deeply to our personal stories about our lives as women.

I think the sentiments and perspectives  from all the quotes I’ve shared in this post are extremely important and I think it boils down to the essential fact of a woman’s right to define her own experience (I could have made a much shorter post if I’d just said that!).

Spiraling back around into the language of choices and birth advocacy though, I have recently had the delightful experience of “talking birth” with my brother’s girlfriend. She is an aspiring writer and I finally shared some of my own published writing with her—said writing is almost all birth, midwifery, and childbirth education related, which is not her “world” and I wasn’t sure she would care about it or be interested in it at all. (She is a college student in her late teens, no kids.) I shared my articles because of our shared interest in writing, not because I had any plan whatsoever to “convert” her. Well, lo and behold, she read everything—cover to cover, not just my articles—and said…wait for it…”I had no idea there were other choices. You’ve really opened my eyes! If I had gotten pregnant, I would have just gone and done what everyone else does. I had no idea I had choices.” She also said she would like to give some articles to her pregnant friend because, “I don’t think she has any idea she has other choices.” (Sorry if I’m not getting the phrasing exactly right, as well as for writing about you without telling you I was doing so, J!) So, all of the sudden this brought me full circle from the posts quoted above about choices—and how as birth advocates we may be stuffing them—uninvited, unwelcome, and ineffective—down other women’s throats. I began thinking about how there is truth to the need for birthy folk have to share information about “options” so women can make “different choices” and that that sharing does have value after all…I also was reminded how perhaps the best avenue for birth advocacy is to back up and start talking to young women in high school or college, not in trying to “preach” to other adult women who in all likelihood have very complicated reasons for making the choices they are making (and not being “enlightened” as to the “empowering way!” is not one of those reasons). This brings me back to the first quote from Sacred Circles—if birth advocates are actually going to make meaningful changes (instead of enemies, or at least making women feel “unheard,” unacknowledged, dismissed, or misunderstood) they/we probably need to reach women before they are in that “fragile” or defensive state with regard to their own experiences.

I’d like to close with another quote from Sacred Circles (again written with regard to women’s spirituality, not homebirth, though homebirth was actually also mentioned in the same paragraph):

“Once the imagination has been kindled, we begin to see choices  that we had never even seen before…but just seeing that we have different options and choices rarely gives us the strength we need to exercise these options. For this we need more than imagination. We need the courage to reach beyond ourselves, extending our hands to one another…” –Robin Deen Carnes and Sally Craig

Extending a hand–not judgment OR enlightenment–and listening to each woman as she defines her own experience

Birth & Culture & Pregnant Feelings

“Giving birth is not an isolated event in a person’s life. A woman births with both her mind and her body and participates in the attitudes toward childbearing of her culture and her family.”

This quote from the book Pregnant Feelings by Rahima Baldwin reminds me of two other relevant quotes about culture, birth, and women’s choices:

“Although pregnancy and birth is a richly intuitive and instinctive process, a woman will prepare her ‘nest’ and birth according to the style of her culture, in the same way that a particular species of bird will build its nest with whatever is available.” –Pam England

“One does not give birth in a void, but rather in a cultural and political context. Laws, professional codes, religious sanctions, and ethnic traditions all affect women’s choices concerning childbirth.” –Adrienne Rich

I think we get onto slippery ground when we start talking about how women just need to “educate themselves” and then they will make different (i.e. “enlightened like ours”) choices. If education was all that was needed, we would see much different things in our present birth culture (more on this later!). As Pam England would also say (paraphrased), thousands of factors seen and unseen go into the resulting birth experience, it is hard to point to one, two, or three factors and say “that was it! I have it all figured out.” (Reminds me of another quote that women birth as they live.) With regard to the second quote, I have to ask myself whether couples truly have a free choice of where to give birth? Ultimately speaking, yes they do, but according to my clients’ perspectives insurance companies and the political climate surrounding midwifery in our state dictate their birth location, as well as opinions of family, friends, books, and so forth. I do a “pain pie” exercise during my classes and after I do it, I always talk about how sometimes choices are actively stripped away from women and we need to keep that in mind when we hear “bad” birth stories—not, “she ‘failed’ or made the ‘wrong’ choices” but that her pieces of the pie were taken away from her (sometimes forcibly!).

The reason I initially marked Rahima Baldwin’s quote is because I am fascinated by how my birth experiences continue to inform the rest of my life–while not the defining moment of motherhood for me, I continue to draw upon the lessons of birth throughout the rest of  my life, as well as retaining a total fascination with the subject. I wonder why I’m so “stuck” on birth? Why fixate on this one element of a lifespan? Does it mean I’m not “moving on” somehow—like a high school football player still reliving the glory of that touchdown from 10 years ago? I think it is because birth touches something else. Something deep and raw and true and we glimpse something that we rarely glimpse in everyday life. A touch of the sacred perhaps. Magic. Mystery. Or is it a sense of personal power and satisfaction in being a woman? I know that the “birth power” experience is a rare one for me—I have never felt so powerful and capable and amazing as I did giving birth. I like to think about how this “birth power” sense could be drawn into the rest of my life—how can I live a powerful and affirming and amazing life, not just as a birth giver, but as a woman? Lately, I am finding some answers in feminine spirituality, but it is a question I love to consider and hope to write more about in the future.

Okay, moving back to Rahima and the quotes from Pregnant Feelings:

Anthropologists’ reports of women working the fields, going to a sheltered spot to drop their babies without any ‘preparation’ and then returning to work describe a kind of mythical natural childbirth that is nearly impossible for Western women. We are far too cerebral, and our twentieth-century consciousness intrudes between us and our instinctual selves. The fact that we question both how to birth and how to parent shows how awake our consciousness is. We must of necessity involve our minds in understanding what we do and create, for it is impossible to turn them off. Nor can we simply erase, or afford to ignore, our culture’s view that giving birth is a dangerous and painful event requiring intervention and technology. Rather, we must consciously replace that view with new knowledge and new images if we are going to be able to reclaim our ability to birth with harmony of mind and body.

Loved this. The mythical woman giving birth by the side of the road and popping back into the field to work is strongly ingrained amongst “natural birth” advocates. Some women draw strength from the image—“if she could just squat in the field, so can I!” Others make a joke of it—“are you one of those nuts who encourages women to just squat in the field?!” And others are doubtful that it has any basis in reality. I also suspect that if said women did ever exist they did not return quickly to the fields because they wanted to do so, but because of the framework of their culture and those seen and unseen factors that shape our lives—perhaps their other children would starve if they didn’t run back to the field, perhaps the overseer would beat them, etc., etc. It doesn’t mean those women were stronger or more capable, but perhaps less valued and less cared for than they should have been.

Okay, back to Rahima again:

Our task is to integrate our minds and bodies, so we can give birth in a way that feels whole and nurturing—to ourselves as parents and to our babies…We cannot go back to ‘natural childbirth’ in which we just let it happen. There must be knowledge of birth and an assumption of responsibility for our own health care and for decisions affecting ourselves and our children. There exists for us the exciting possibility of giving birth with full awareness, participating in the joy and exhilaration of working in harmony with the tremendous energy of creation. But it does not occur automatically or unconsciously…

The potential for conscious birthing can exist independently of the place of birth, although some places require more watchfulness than others….Let us just say that it is actively giving birth in an environment which is woman-centered and child-centered, in which the cues are taken from the birthing woman while she experiences fully the sensations and emotions of new life coming into the world through her. She is not medically managed or manipulated, but is supported with the knowledge, love and experience of her attendants (doctors, midwives, husband, other support people) to birth in a way which is safe, yet does not deny the intense physical, emotional, and spiritual aspects of giving birth.

Birthing in this way is rare in today’s culture…less than 5 percent of women in this country today experience ‘purebirth’ [positive birthing/conscious birthing]…

Given the wealth of images of birth that surround us, our task is to recognize that none of them adequately denies or exhausts the potential of birth. Perhaps their infinite variety can help to free us from any one fixed idea of giving birth and help us to realize our freedom to birth in the way that is right for us. We cannot control the energy of birth, but we can control our response to it by deciding to be open, relaxed positive, noisy, grouchy, whatever. We don’t need to behave in a certain way and we can accept ourselves and our births without self-judgment.

What caught me about this section was the mention of not being able to go back to a time when we could just “let it happen.” Though I feel like getting out of my own way and “letting it happen,” was a personal key to my own births—that the surrender is what gets the job done—I agree with her point that there is no letting it happen in today’s culture. A long time ago someone mentioned in an online forum that they were not planning to take birth classes or read any birth books because they felt like they should just let it happen and not have any preconceived notions; that cluttering up their heads with this other information would cloud their ability to do so. While I hear the motive and feeling behind this sentiment and believe there is some (perhaps idealized) truth to it, I simultaneously feel like it is impossible to do this, because women do not give birth in a void or outside of their culture. Women give birth in a context, usually involving other people (even with unassisted births, there is usually someone else there). If you enter the birth room (the aforementioned woman was planning to give birth in a hospital, not unassisted) without any ideas or pre-knowledge about what to expect or what you want, the stories and dramas and ideas and myths and preconceived notions and reading and media-exposure of all the other people present DO enter the room and impact your birth. You cannot just “let it happen,” because they will not just let it happen. Right or wrong, this is the environment in which many of us our building our birth nests.

I’d like to close my thoughts with another quote. This one is from one of my favorite birth books, Transformation Through Birth by Claudia Panuthos. In giving birth, regardless of our nest and our choices and all the seen and unseen elements shaping our lives, perhaps we can simply, “…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 your birth, where you birth, or what the outcome?'”

Book Review: 25 Ways to Awaken Your Birth Power

In September, I wrote a post about Awakening Your Birth Power based on  the book 25 Ways to Awaken Your Birth Power. I figured it was about time I actually posted my whole review of the book! I also subscribe to the Awaken Your Birth Power e-newsletter and find it very enjoyable.

25 Ways to Awaken Your Birth Power
By Danette Watson and Stephanie Corkhill Hyles
Watson & Corkhill Hyles, 2004
Hardcover, Book & CD Set, $24.95.
ISBN: 0-646-44337-2
www.awakenyourbirthpower.com

“If you have heard enough birth ‘war stories,’ advice, and medical information… If you are beginning to doubt yourself and to feel confused and worried about giving birth… It is time to focus on something simple, positive and inspirational. It is time to come back to center and listen to your own inner wisdom. It is time to Awaken your Birth Power.”

I was experiencing my third pregnancy when I received the book and CD set 25 Ways to Awaken Your Birth Power and was able to read and listen as both a consumer and a reviewer. I found both the book and CD very nurturing, enriching, and affirming. The book is a collection of 25 short breathing meditations each accompanied by a beautiful (and whimsical) drawing. The final section of the book contains brief sections exploring the body-mind connection, “what actually happens when you awaken your birth power,” a chart of characteristics awakening power and those that block power, and specific suggestions for how to use each of the 25 meditations in the book.

The enclosed CD has 3 tracks–the first is called “awaken your birth power for pregnancy” and consists of the relevant meditations from the book read aloud. The woman reading has a pleasant, soothing voice with a slight Australian accent. The second track on the CD is “awaken your birth power for labour and birth” and consists of 48 minutes of the relevant meditations from the book read aloud. The third track is an abbreviated almost 8-minute guided meditation. The CD would be perfect to listen to while in labor.

With its gentle illustrations and relaxing words, 25 Ways to Awaken Your Birth Power is a nurturing, confidence-inspiring, birth-power-enhancing, reflective, time-out for use during pregnancy or birth.


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

Tips for Emotional Well-Being During Pregnancy

I got a lot of wonderful responses to my question about emotional well-being during pregnancy (associated with my giveaway of the book Birth Space, Safe Place). So, courtesy of a lot of wise women, here are some top tips for supporting your emotional well-being during pregnancy and birth:

  • Peaceful Beginnings doula services shared “I think my best tip for emotional well-being during pregnancy (and life in general) is to let go of guilt. We can only do the best we can with the information we have at the time, no more, no less.”
  • Yasmel shared that her most helpful tip, “would be to find whatever gives you positive thoughts and use it, a lot. I loved the book Ina May’s Guide to Childbirth and whenever I started second guessing my homebirth decision, I would open it up and just read the birth stories in it.”
  • Heather appreciated a helpful tip from her sister: “I was having alot of people question my birthing choices and telling me that my baby and I were going to die. None of which happened. She told me that ‘you can’t expect people to agree with your choices or behave respectfully about them. All you can do is know that you are doing what’s right for you and your child and that is all the matters. Don’t let them change your mind with fear. It has no place in childbirth.’”
  • And I especially enjoyed Ahmie’s advice: “remember that cats purr while giving birth. Figure out what makes you ‘purr’ while you’re pregnant and find ways to do more of that as well as to bring those tools to the birth-space with you.”
  • One of the most simple and yet important tips was shared by bubbledumpster, “Trust yourself,” and echoed in several other comments, such as earthmothergypsy who said, “I think one of the best helps emotionally is to encourage mamas to trust in themselves, their bodies and their babies. By giving them support in a way that they don’t feel undermined they can build the above trust in themselves.” And inoakpark who said, ” learning to trust your body (and trusting the people who will be with you at your birth to hold that space), is vital for an emotionally secure pregnancy and birth.”
  • bee in the balm offered another elegantly simple tip “to breathe, just take the time to come back to center and be and breathe.”
  • Nicole d shared that her best tip is “meditation on good/safe birth… the normalcy and miraculous nature of it. So much of pregnancy stress is uncertainty and fear of the birth process. The more you can trust in the process of pregnancy and birth, the more joyful and peaceful pregnancy can be.”
  • For Lee-Ann, “emotional wellbeing came with knowledge, the more I read and the more I normalized the birth process in my mind, the more research I did, the more confident and at peace I became.”
  • Rebekah made an excellent point about honest during pregnancy: “I think being open and honest with yourself and talking to your baby openly helps. It benefits no one to ‘pretend’ like everything is perfect and is okay to have trials, doubts, and fears.”
  • Jessica benefited from midwifery care: “One of the things that helped me a lot was having a midwife that I knew and trusted implicitly. I knew that my body and my baby would know what to do, and that I had a wonderful woman who would let it all unfold!”
  • And whoz_your_doula pointed out the benefit of taking time for yourself: “For me that took the form of meditation and prayer. The early morning is my time for deep reflection before the house begins to stir.”
  • A similar tip was shared by Gentle Beginnings: “I feel it is very important for a woman’s emotional well being to take a few minutes each day to spend time alone. To sit quietly and think about the precious child growing inside them, to disconnect from the world, to envision how peaceful they want their birth to be, to take a stroll in nature and to connect with their inner self. I think we can all benefit from these simple suggestions, but feel it is especially important during pregnancy and childbirth.”
  • Helpful for birth educators as well as couples, Janet shared that her favorite tip is “teaching the mom and her partner to work together towards open and honest communication before hand. I find a lot of the mothers I teach think, ‘Oh, well we talked about it once and I think we are on the same page,’ only to be completely blind-sided afterwards. Keeping these lines of communication open before, during and after pregnancy makes for a much better emotional state for all.”
  • Jamie moved us back to the trust theme: “Trust yourself. Trust that your body knows how to be pregnant and how to give birth. Be positive in the changes your body is going through and how you are being prepared for motherhood in all facets of your being. Know that you can do this—you are doing it!”
  • And another excellent and simple tip was shared by Heather Richins: “My tip is to make sure you stay well fed and hydrated. It is hard to feel good emotionally if you don’t feel good physically.”
  • Deborah had more than one to share: “1) Eat well: increase protein and raw fruits & veggies, and drink lots of water. Decrease refined foods, white flour products and sugars. 2) Exercise: walk, swim, yoga, etc. 3) Talk: find someone you trust and be honest about how you are feeling.”
  • And finally, Kathy offered a comprehensive collection of tips: “to be conscious of their needs each day. This includes physical,emotional, and spiritual. For the physical; Eat well. Whole foods, including whole grains, fruits, vegetables. Protein intakes needs to be adequate for a pregnant woman on a daily basis. Eating often to keep your blood sugars level is especially important for warding off mood swings. For the emotional; Trust yourself and others who care about you. Surround yourself with positive people who support you in what your doing. Communicate your needs and wants. Be willing to be honest and vulnerable. Pregnancy can often ‘stir the pot.’ Being willing to work out your feeling and talk to someone you trust and bring about personal growth and sometimes, bring about healing the past. For the spiritual; It is just as important for the spirit to be fed, as it for the body. Fellowshipping with others of the same faith is uplifting to the spirit. Take time for reflections and meditations each day. Keep a journal.”

I appreciated all the responses and think that emotional well-being is such an important subject. I feel like, especially with a first baby, it is an often overlooked element of birth preparation—a lot of time and energy is spent on the physical health of the pregnant woman, but the emotions are assumed to kind of take care of themselves, to perhaps be no one’s business, or to be dismissed summarily as “crazy pregnancy hormones” and “mood swings of pregnancy!”

Book Review: Birth Space, Safe Place

Birth Space, Safe Place: Emotional Well-Being through Pregnancy & Birth
By Adela Stockton
Findhorn Press, 2009
ISBN 978-1-84409-165-2

102 pages, paperback, $14.95
http://www.findhornpress.com

Reviewed by Molly Remer, MSW, ICCE

Appropriate for first time mothers as well as women having subsequent children, Birth Space, Safe Place is a slim and succinct little volume with a sole center: emotional well-being throughout pregnancy and birth. This very specific purpose is what makes the book special. It focuses on creating the emotional space for a gentle birth as well as a physical environment conducive to gentle, physiological birth. However, there is a broad range of topics covered within this specific focus including pain, fear, support, the “cocktail” of labor hormones, avoiding physiological disturbances of the birth process, optimal fetal positioning, and blessingways.

The chronology of the book flows from “conscious conception” through making decisions about birth location, preparing for labor, support during birth, “the spirit of birth,” and “early parenting joys and griefs” which addresses birth processing and postpartum recovery. The chapter on “cleansing the past” briefly addresses prior loss and bereavement, difficult previous birth experiences, and issues of abuse. Each section contains brief personal anecdotes, some from the author and some from mothers she has worked with. The exploration of each topic is brief, but is an adequate overview.

The author is a “childbirth homeopath” and so there are several sections about homeopathic remedies for specific symptoms or concerns. Aside from the homeopathic content, I did not feel as if I learned anything particularly new from the book, however it was very nice to have information about a specific element of pregnancy and birth preparation all pulled together into one nurturing place.

Birth Space, Safe Place is very supportive of doulas—for both labor and postpartum—and also of midwifery care and homebirth.

The book contains three appendices, endnotes, references, a glossary, and resource listing. The book is written in the UK (author is in Scotland), so National Health Service care is assumed and that system of maternity care, midwifery, and homebirth. The first appendix briefly addresses differences in US and Australian midwives compared to the UK.

And, make sure to check out my giveaway of Birth Space, Safe Place here!

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

Heroin and Labor…

I recently finished reading the new book Birth Space, Safe Place by Adela Stockton (watch for my full review and a giveaway on the CfM blog next week!). The author lives in Scotland and something in the book’s glossary jumped out and caught my eye. The word was “diamorphine” and the definition was: “a semi-synthetic opoid for labour—only adnimistered in Scotland; another name for heroin.”

The irony that giving heroin to women in labor is considered a medically acceptable practice, but that “letting” a woman labor without an IV or in water—as some of many examples—is considered unsafe or risky is so boggling my mind that I can’t even comment any further!

Does Water Slow Down Labor?

il_570xN.684257213_8rjiA concern commonly expressed about using water during labor is that immersion in a tub of warm, soothing water has the potential to slow down or even stop labor, particularly in the early stage. For many women, this is not a desirable effect!

The Waterbirth International website (www.waterbirth.org) shares this information about choosing when to get into the water:

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.

There is some physiological data that supports this rule, but each and every situation must be evaluated on its own.

Some mothers find a bath in early labor useful for its calming effect and to determine if labor has actually started. If contractions are strong and regular, no matter how dilated the cervix is, a bath might be in order to help the mother to relax enough to facilitate dilation.

Therefore, it has been suggested that the bath be used in a ‘trial of water’ for at least one hour and allow the mother to judge its effectiveness. Midwives report that some women can go from 1 cm to complete dilation within the first hour or two of immersion.  The first hour of relaxation in the pool is usually the best and can often help a woman achieve complete dilation quickly.

In the book, Birth Day: A Pediatrician Explores the Science, Mystery, and Wonder of Childbirth, Dr. Mark Sloan explores the biochemical reason why water immersion can slow down labor. I found the explanation interesting as well as logical:

When a laboring woman climbs into a bath, the refreshing buoyancy she feels sets off a chain of physical and hormonal events. As her muscles relax, her catecholamine levels—the ‘fight or flight’ hormones that rise in labor—decrease. This can actually help her labor progress, as excessive levels of catecholamines are known to slow down uterine contractions.

But countering that lowered-catecholamine labor boost is the effect that water pressure has on other maternal hormones. When a mother sinks deep into a tub, the weight of the water on her body forces fluid contained in her tissues into her bloodstream, thus increasing her blood volume. Sounds like a good idea—increased blood volume means increased cardiac output and oxygen-carrying capacity, and oxygen is a good thing to have coursing through your arteries when you’re trying to have a baby.

But the weight of the water on a woman’s body also causes a ‘pooling’ effect in the blood vessels inside her chest, because the rib cage protects the lungs from the water-pressure squeeze exerted on the softer tissues of the limbs and abdomen. Over time this leads to a complicated hormonal chain reaction that results in decreased secretion of oxytocin, the uterine-contraction hormone, from the pituitary gland within the brain. With less oxytocin circulating than before she climbed in the tub, a woman’s labor can slow down significantly.

The labor-slowing effect of taking a bath seems to be a problem only if the bath is taken early in labor, though. Once a woman is in active labor, the oxytocin surges are strong enough that no bath in the world can derail them.

The author goes on to explain that current research isn’t clear on when exactly oxytocin levels are high enough to prevent labor from slowing down, but suggests that it is “prudent to hold off on baths until the cervix has dilated to about five centimeters.” He also notes that water immersion during labor does not increase the infection risk for either mother or baby, and that as long as water is kept at body temperature, there is no risk to either of overheating.

I also decided to ask the real experts—birthing women—what their experiences were with water in labor. I posted the question to my Facebook Talk Birth “fan” page and received a few responses:

“I feel like it definitely helped me. I couldn’t find a comfortable position, but when I got out of the water it was definitely worse. It didn’t seem to slow anything down; C was born a few hours after I got in. I plan to blow the ol’ gal up again for the next baby.”–SE

“I have such fast, easy labor that I only get in the water for transition and delivery. I will not do it any other way and kick myself for not doing it with all my births!!! It definitely takes the edge off for me (and no ring of fire either). I think it actually does slow me down a bit, but my births are crazy fast, so that is a good thing.”–NA

“I feel like for first time moms it’s hard to know how to push when you don’t have all of the pressure. I labored in the water with Ashton but delivered him out of the water when things just weren’t finishing. With Brice I knew what I was doing so had no problems pushing Brice out in the water. I really liked the water but haven’t labored without it for transition. My [midwife] also has found that first time moms many times need to get out of the water to deliver and that it can slow down labor.”–RK

“I had a waterbirth with my 2nd, and due to her malpositioning it was by far my most painful birth. Most people say the water really relaxes them and eases pain, but that was not the case with me. Also, one thing I did not realize about water birth babies is that often they are not full of color when they are born. Some people say this is because they have an easier transition into the air. I’m not sure of the reason, but this was very startling for my husband. I just talked to her and rubbed her vigorously, and she pinked up soon after.”–GC

Personally, think the laboring woman should be the guide. If she feels like getting into the water, then it seems like the right time to me! With my second baby, I had a birth pool on hand thinking I may like to try it, but my labor progressed so rapidly that there was no time to blow up the pool, let alone fill it up or deliberate about when to get into it. As midwife Judy Edmunds says, “Waterbirth is one of many lovely ways to enter the world.”

Originally written for the FoMM newsletter.

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Birth Symbol

At the very end of August, I went to see Birth, the play in St. Louis. I was about 5 weeks pregnant at the time. Following the play and “talkback” event, there was a BOLD Red Tent (birth stories sharing circle). Right before the birth stories portion of the Red Tent, we did a birth art project. The Birthing from Within Mentor who was facilitating the Red Tent asked each of us to draw a symbol on a card that communicated what we would want to share with other women about birth—not in words, but a visual representation of the message we’d like to share. We then painted our symbols onto prayer flags to be strung together as a whole “language of birth” in symbols. We left the flags with her to be taken to births to share the symbols with other birthing mamas. I drew a spiral and explained that the message I was sharing was, “You can do it. You’re okay. Let it happen.” I also added a little birth goddess with wild hair that to me represents the intuitive birth wisdom women carry with them (when I was pregnant with my first baby I was worried about being too “in my head” to give birth powerfully–I created a series of needled felted sculptures of birth goddesses with wild hair and worried that the hair showed that I was too in my head. After he was born, I realized that my sculptures were telling me about the wild, natural, birth wisdom I had in my head, not the “book learning” that was also there and was what I had worried about interfering with the flow of birth).

A few days following my miscarriage in November, I received a Facebook message from the BfW mentor (and friend) who had facilitated the Red Tent session. She attached a photo of the flag I had painted during the Birth Art session and asked me to “allow the gift to come and sit with you” (as well as gifting me with “no response necessary”).

It was amazing to have my own birth symbol come back to “speak” to me in this way during such a painful (and also transformative) time.

“You can do it. You’re okay. Let it happen.”

New Blog

I am a writer by nature and I have many things I’d still like to share, say, and explore about my third pregnancy which ended in miscarriage at 14 weeks. I keep hesitating to let the words come though, because this doesn’t feel like the right place to do it. Writing is healing for me–it helps me process, to learn, and to work through my emotions and thoughts. I HAVE to do it. I’m compelled. But, I’m not going to do it here. I started a new blog here instead. I will continue to write about birth and childbirth education via this blog and I’m not keeping the two—experiences or blogs—“secret” from each other. There will be overlap and shared links, I’m sure. I’ve just realized that if I’m going to be able to share openly in the way that I wish to, I must separate those posts from business website/blog. And, I need for only those who are interested to read it—rather than being “forced” to here or feeling like I’m “dwelling” too much.

I need to separate it too so that I don’t feel as if I’m continuing to ask my friends, my Facebook fans, blog readers, and clients to show sympathy for me or try to bolster my self-esteem by telling me how “great” I am (;-D) or being sort of forced to continue to reassure me. I have really appreciated the supportive comments on Facebook, but I almost feel like my pass on telling this story is expiring to the average person and I’d rather that they only read what I continue to need to say about this of their own free will, rather than having it piped into their Facebook feed. Why not just write in my journal then? (Indeed, I did write 19 pages in my journal about this birth/miscarriage.) Because, most of the time when I write, I write to share—“gathering and sharing information” is part of my life purpose and writing and sharing about this miscarriage experience is no different than my desire to share other birth information and experiences. So, follow me as you will…

Lavender & Letting Go (Warning: Miscarriage/Baby Loss)

My life has taken a sad and unexpected turn. I was 14 weeks and 4 days pregnant with my third baby and we found out on Friday afternoon that the baby had died. Very early Saturday morning, he was born at home. Though it was different in some ways than a full-term birth, my experience of miscarriage was very much a birth–my water broke, I had normal contractions for about two hours, the baby was born (about 4 inches, well formed with eyelids, fingers, toes, mouth that opened, etc.), we saw the tiny umbilical cord, and so forth. I was surprised to discover that some of the same feelings of empowerment were also present after a “natural home miscarriage” as with a natural home birth–I felt strong and brave and like “I did it myself!” as well as amazed at how well my body worked and knew what to do. We learned the baby was our third boy and named him Noah.

I have a number of feelings and observations that I would like to share about this birth experience, but I’m not sure if this blog is the “appropriate” place to do so, because this is also my business website and I don’t want to “scare” any prospective clients away by being sad. There are a lot of losses that accompany the loss of a baby and one of the ones that is hard for me is that my life is devoted to helping women give birth with confidence, strength, and joy and to embrace pregnancy and birth as wonderful events. It is sad to me to now be a source of fear/elevated perception of risk—“if it could happen to her, it could happen to me!” Kind of like I’ve become a “bad omen” instead of a source of encouragement. 😦

One thing I do want to share about the birth of my third baby is that earlier that afternoon I’d received a package from Taylor’s Scarlet Thread. I had ordered a bonnet and apron from them for a Kirsten costume (Kirsten is an American Girl doll) for myself. They sent along a little lavender sachet as a free gift with my order. When my labor began, for some reason I wanted the sachet and held and smelled it throughout my labor. I also used it to kind of revive myself when I felt like I was fainting several times afterwards. I talked to the baby and to myself before I started having regular contractions telling myself and the baby that we need to “let go” of each other and that it was time to let go. During the labor, I chanted to myself, “let go, let go, let go” and smelled my sachet.  Several days later, I was reading a book about miscarriage and it had some aromatherapy suggestions in it. It listed lavender for “letting go”…