Lann’s Birth Story–Baba Style!

Sep21

Today my firstborn son turns NINE! I can hardly believe it. I mean, I remember being nine. What happened?! And, as I thought about his birth and planned to share his birth story link as I always do, I suddenly remembered…I have his birth story from my mom’s perspective too! And, I’ve never shared it here (I also have my friend’s version and my doula’s version—this could keep me going for a while!). In our family, we call my mom Baba as her grandma name, so here is the tale of Lann’s birth, Baba Style:

The time for Lann’s birth was rapidly approaching, and I felt like I was fairly well prepared. My bag was packed, and I had been studying my labor support information. I needed to honor my commitment to demonstrate lace making at the Potosi Bisonfest, so I had driven a separate car, and had my newly purchased cell phone handy – I even made a test call to Molly and Mark to be sure it would work from that location. It was a long day – up at 5:45 a.m., drive 2 hours to Potosi, demonstrate for 6 hours, drive 2 hours home. I made it through without receiving “The Call”, and thought I’d go ahead and check in with them to see if the watched pot had begun to boil before falling, exhausted, into bed.

What a surprise it was to have Mark answer at about 7:30, and tell me that they thought something was happening. I couldn’t believe it, even though this was the moment we’d all been waiting for! Molly got on the phone, and expressed her concern that perhaps this was false labor. I tried to reassure her that it didn’t matter to me if I had to make 10 false trips, as long as I didn’t miss it. Her contractions were coming regularly and close together, but even so, she seemed reluctant to call in her support team without feeling more confident about what was happening. We decided to wait a little while, and see what developed. I used that time to change out of my demonstration costume, and begin gathering supplies I thought I might need (book, project, birth art, extra clothing, etc.). The phone rang within 45 minutes, and this time Molly said she wanted me to come. She told me that during contractions, she kept thinking it was time for me to come, but that between them she felt she was doing fine. I took that to mean it was time for me to get to Jefferson City!

I listened to soothing music in the car as I tried not to speed on my trip. I repeatedly visualized how the evening would progress, even though I knew that anything could happen, and that I needed to be open to whatever occurred. No amount of imagination could prepare me for I was about to experience.

I arrived at the Remer home at about 10 p.m., where Mark let me in and told me Molly was in the shower. When I got upstairs, and unloaded my belongings, I could hear Molly humming “Woman am I” from behind the bathroom door. When she came out, wrapped in a green towel, she was so adorable that I had to take a couple of pictures. She said she’d had 7 contractions while in the shower, and was glad I was there.

It’s hard to remember the exact chronology of events. After a while, we called the doula – but when she wanted to know the timing of the contractions, both Mark and I were vague. It was never clear to us if we were timing things correctly. What was clear was that the contractions were coming close together, and seemed intense to me. We called the birth center to give them a head’s up, but had to leave a message, and realized that we weren’t sure what the after hours procedure was supposed to do. We called S again to ask her how to contact the doctor, L, directly. It seems like around that time, L returned the call from Molly’s message, so apparently that’s their procedure – just leave a message and someone calls you back!

Meanwhile, Molly continued to have regular, intense contractions that barely ended before the next one began. She commented that she never seemed to get a break, and was a little fretful about things getting worse. I tried to let her know that she only needed to deal with each contraction as it came, and not to “suffer what she feared”, because maybe this was as heavy as they would ever get. I felt like I should be the voice of wisdom, even though I couldn’t really tell what was going on with her. My job was to soothe and support, and I had schooled myself carefully to remain cool and calm!

Throughout the contractions, Molly continued to hum “Woman am I”, and sometimes, as the humming began to speed up and get louder, I would hum along with her, hoping this would help to center her. We had various tricks that we had planned, like a foot massage, counter pressure, squeezing combs (hah!), but none of them seemed desirable or necessary. Occasionally, she would begin to question her ability to continue if it became more difficult, so I brought in her list of affirmations and read them to her between contractions – they were all familiar to her and seemed marginally helpful. Watching a woman labor makes the support people feel rather helpless, so it was good to find something that she could focus on, if only for a while. We also offered frequent drinks and food. Mark was extraordinarily in tune with her.

We tried various positions to ease her comfort. One mistake was suggesting that she lie down on the bed for a while. She said it made her feel terrible and trapped. She was amazingly calm and serene, otherwise. I had expected her to be irritable with me, or Mark, but she was very internal and focused. I had also expected to feel more protective than I did. I thought I’d want to take away her pain, and be the “mom” who fixes the hurts, but she was so in control the entire time that I didn’t feel the need to go into mom mode. Her strength was inspiring.

Around 2 a.m., we decided it was time to call S, who arrived in record time. It was a relief to have a more professional opinion available. Molly was in the bathroom at this time, and had quite a bit of pre-birth matter (to put it politely) that had been discharged into the toilet. To me, this looked like far more than the mucus plug and seemed to indicate that birth was imminent, but S didn’t seem to think so. I still don’t know, but it was definitely an indicator of big progress being made! Also, the contractions were very heavy and close together. S took us aside, and said that first-time moms take a really long time, and that we shouldn’t be jumping the gun – hindsight reveals that Molly was further along than any of us realized.

S altered the room lighting with little gentle lamps that gave off a dim blue light, very much like candles. She whipped out rice socks, and offered various suggestions for position changes. It was good to have someone else to offer support, although we were doing pretty well without her. Molly kept saying that she felt different inside, like something was happening, but she wasn’t too clear on what it was. She said that during contractions, she wanted to race to the birth center, but between them she didn’t. I remembered her saying something similar about my arrival, earlier, and wondered if maybe we should heed this and get straight in the car……

S suggested another shower, but Molly was quite resistant to this, and then announced that we should go to the birth center. I was glad to be at this point – in the hands of professionals! The original plan had been to transport in 3 cars – Molly and Mark in theirs with the carseat, me, and then S. It became obvious that Molly would be much more secure if she could have Mark’s attention during this 40 minute drive, so we switched the carseat to my vehicle, got everyone loaded, and sped away. It must have been at about 3:15, because we got to the birth center at 4. By this time, I was running on adrenaline, having had no sleep, and having already driven nearly 6 hours, but I felt charged and clear. My grandson was on his way, and I was the driver. This was an important task! I tend to drive a tad fast in ordinary circumstances, but this event led me to be a regular lead-foot. I kept it at about 75 mph, although S says I went faster. The road between JC and Columbia is very “swoopy” – there are lots of dips, and then bumps that the car sort of chunks over. Molly was moaning, and seemed especially agitated as we bumped and swooped. I don’t think slowing down would have helped, so I just kept the pedal to the metal and got her there as fast as I could. I couldn’t tell what was happening in the back seat at all, and just concentrated on my driving.

We pulled into the parking lot of the center, and there was nobody there! As I began to question this, a car pulled in, and out stepped V [midwife], very calmly, carrying a cup of coffee. She opened the door, asked a few quiet questions, and then casually went off to brew more coffee. We unloaded some things, including Molly, who seemed a little confused and tired. Mark called friend Kate, who we had called before, leaving a message. Little did we know that she was standing by waiting for the follow-up call for hours! She arrived about a half hour later, beaming and fresh. It was good to see another caring face. We all wanted to do something – anything – for Molly. However, Molly was in complete command of herself, so it was left to us to stand quietly by.

We were placed in the room Molly had hoped to have, and I came in, no doubt thinking we had plenty of time. She checked Molly and said that she couldn’t find a cervix. I found this unnerving. Did she mean no progress had been made? How could that be?!? Did Molly have some bizarre disorder that caused her cervix to disappear? I was working hard on being quietly serene, so I finally just asked what she meant. V said Molly was fully dilated, and could begin pushing whenever she felt the urge. I’ll never forget Molly’s face, disheveled hair, and wide eyes as she looked questioningly at V and said, “Are you telling me the truth?” Well, she was telling the truth, and Molly soon began to push. At this point, I remembered the car ride, and realized that Molly had gone through transition while swooping along the highway.

At one point during the pushing, Molly was standing by the bed with her arms and elbows supporting her. She gave a tremendous grunt, and her water broke with an audible report, splashing Kate and lots of the floor. It seemed like a lot of fluid! At this juncture, V said she’d better call the doctor, so we helped Molly into the bathroom.

Molly was concerned about making huge messes, so she was fairly comfortable in the bathroom – that way, everything just dropped handily into the toilet. The age-old concern about excreting a wee amount of feces was there, so being on the toilet alleviated that problem. Mark was with her all the time. I should take a moment to mention how wonderful Mark was throughout this entire event. He never left her side, and was completely attentive to every move she made or word she spoke. He never lost his calm demeanor for a moment, and was a pillar of strength and support.

Dr. L was now present, and she added to the overall feeling of having a competent team in place. It also helped to know that things were moving right along, and Molly would soon have her tiny son.

I had made sure to bring along Molly’s birth necklace from the Blessingway, as well as her needle felted birth art. I took a moment to hang the necklace at the foot of the bed where she could see it, and I place her felted ladies on the table where they could look on. Molly was wearing a cotton-knit nightgown, and had on an amulet bag with the fused glass touchstone a friend had given her. We all knew that things were happening, and became very energized by the birthing energy.

While in the bathroom, as we stood outside the door, I could hear Molly humming her song – I hummed along with her so that she would know that I was still with her, even if I wasn’t in the same room. I didn’t know if she could hear me (she could), but I thought it might help.

Molly and Mark were still in the bathroom when L came out and told us that they wanted some privacy, and ushered us all out into the lobby. Before I left, I told everyone that Molly didn’t want to give birth on a toilet, and they seemed to hear me. We sat there – V, Kate, S and I – chatting a bit, and wondering what was going on in there. I voiced my trepidation that maybe I wouldn’t get to see the birth after all, but that I also realized that I wanted it to happen the way they wanted it. That meant they might not want me (or anyone) there, and I knew I needed to be at ease with that. V had some stories to tell of her own children not needing her. I wasn’t comforted, but was fully aware I needed to get over it! I later discussed this with Molly, who told me that L had asked if they wanted privacy, and when they said yes, she took it upon herself to move us out.

Not too much time elapsed (maybe 30 minutes), and L came out to invite us back into the birthing room, but that no talking was allowed. It was really hard to not utter any words of encouragement to Molly, who was now lying on her side on the bed. It was very dimly lit, so L shined a flashlight to show us the tiny tuft of hair emerging as the baby began to crown. Once again, I later found out that Molly had not requested complete silence – but at the time, I was afraid to make a peep for fear they’d kick me out and I’m miss everything. They had us place a mirror so that Molly could see the baby, and shifted her position so that she was sideways on the bed. If I’d been allowed to speak, I would have suggested placing something under her heels to give her purchase for pushing. Instead, I moved around a bit, and put my leg under her foot to try to help. Then, I had to move to allow room for L and V to get ready for the Lannbaby.

Molly expressed amazement that she was “really doing this” and repeated that it didn’t feel real. She kept saying things like, “This is really me! I’m really doing this!” She was astoundingly together the entire time.

Molly pushed and pushed, still serene and still in command. There was a great deal of stretching discomfort that alarmed her, but L put her mind at rest by telling her that her body was made to stretch like that. After a few more pushes, and Lann’s head emerged, crying loudly, and spluttering. Before this, I was recalling a birth support video that I’d watched, in which the baby wasn’t breathing and was shockingly limp and white. I was girding my loins to be calm and supportive if this happened – but no need! A very vibrant and squalling head greeted us! His body slithered out directly afterward, and we had a whole, crying baby boy in the room with us. What a miracle! The joy was intense. Kate and I burst into tears.

Just born!

L handed the baby to Molly, who immediately, with Mark behind her throughout, began crooning and talking to her tiny son. She instinctively put him to her breast, and he calmed as he began nursing. They cut the cord, and then needed to take him from her for checking, and diapering – it was time for the placenta, which slid out as nice as you please. They told Molly that she had a small tear, and didn’t recommend stitching it.

There was an uncomfortable follow-up moment, when some blood clots needed to be manually removed to that the uterus could properly contract. Mark had the baby, and it was hurting Molly, so she called to me. S got there first, but I soon took her place, and we went through a few more rounds of “Woman am I”.

We also joked with Molly about getting an A+++ on labor and birthing. I’m not sure what the staff made of that. They probably thought I was some pushy, overachieving home school mom that insisted on academic excellence. It was definitely an A+++ event!

This is about when I got a chance to hold my peacefully sleeping grandson – what a perfect little guy! It was such a wonder and an honor to be present at his birth. I’ll forever be grateful to Molly and Mark for allowing me to share this experience with them. It forged a new bond between us, and made me understand the reality of life everlasting. Little Lann is my immortality.

Baby Lann with his Baba!
(I couldn’t find a newborn one with Baba. Surely I have one?!)

With Baba nine years later! (and Aunt Nancy too!)

Thanks for being there, Mom! 🙂

—

My First Birth

Alaina’s Birth Story–Baba Style!

DVD Review: The Big Stretch

Sep13

DVD Review: The Big Stretch

By Alieta Belle & Jenny Blyth

60 Minutes, includes 20 page booklet

www.birthwork.com

Reviewed by Molly Remer, Talk Birth

Jenny Blyth the author of the book Birthwork, is also a filmmaker who co-created the film The Big Stretch with another mother. The particularly special thing about this film is that it is all about women sharing their own experiences and feelings–unlike many current birth movies there are no “experts” present in the film (other than the true experts–women themselves!), the focus is on the families preparing for birth or reflecting on their past birth experiences. The many topics addressed are insightful.

The film’s emphasis is on, “Women in different stages of pregnancy and preparing for a natural birth reflect on how they and ‘stretched’ in everyway – emotionally, physically and spiritually” and I enjoyed this “stretch” theme that ran throughout.

Introducing new scenes/topic is neat artwork and the images in this film in general are particularly gorgeous. In one exception, I was taken aback by footage at the close of the film of a totally naked man riding a bicycle and feel I should warn other viewers to be prepared for that!

The DVD is accompanied by a 20 page booklet full of questions that carries the themes from the film into personal questions to increase self-awareness during pregnancy.

The Big Stretch is a unique and beautiful film in which women’s voices are clearly represented. There are no titles, no degrees, no qualifications listed. This film is a perceptive “motherful” look at the many stretches of birthing: physical, emotional, mental, and cultural.

—

Disclosure: I received a complimentary copy of the DVD for review purposes.

Review previously published at Citizens for Midwifery.

Where are the women who know?

Sep6

Ames, Iowa 1960

Pregnant and
no female friend to confide in
Scared and
no woman to tell it to
A male doctor who patronizingly
calls me by my first name
while I’m supposed to
respectfully
call him Dr. So-an-so

A husband so afraid of
his own fear that
He’s unwilling to know it’s there
not the person
to listen to mine

Where are the witches, midwives
and friends
to belly dance and chant
while I deliver
to hold me and breathe with me
as I push
to touch me and comfort me
as I cry?

Where are the womyn who know
what it’s like
to give birth?

–Antiga in The Goddess Celebrates, p. 152

This poignant poem spoke to me from the pages of an anthology of women’s rituals recently. It made me think about my plans and visions for the birthwork I’d like to offer to my community. Some friends/colleagues and I launched a local Birth Network this year and one of my primary hopes for it is that it will provide easy access to the women who know. And, that in simultaneously creating access for pregnant women to each other, the opportunity arises to uncover their own deep knowing, rather than needing expert advice or opinions. To that end, we’re planning a series of birth workshops (more details soon!) and hopefully a birth circle.

In the novel The Heart of the Fire recently I marked these two quotes:

“A woman who has borne children…loses many of her terrors.” The character speaking goes on to explain, “…for a Priestess it is, a path. A path of opening.”

Later the main character is attending the birth of one of her siblings and observes, “[the midwife] says the most important thing is to never bring fear into the room of a laboring woman. ‘A woman must be completely open to birth a child,’ she says, ‘and so she is unable to defend herself from the thoughts of those around her.'”

I’ve written about birth fear several times before. I think many women underestimate the potent impact the emotional condition of birth witnesses of all kinds (including doctors, nurses, grandmothers, doulas, and friends!) can have on their own birthing times. Women in labor enter a timeless, liminal space, and use their right brain–the primitive brain, the “birth brain” as I call it or “their monkey” as Ina May calls it–to dig deep and access the inner resources they need to birth their babies. When other people in the room are fearful or agitated or even just too talkative, the laboring woman has a heightened vulnerability to and awareness of those emotional states. This is what the fictional midwife quoted above means about being “unable to defend herself from the thoughts of those around her.” This is an important understanding. While to the birth attendant, this is just one more birth in a lifetime career, for the mother giving birth this is potentially a peak experience and definitely something she will remember for the rest of her life. This is a sacred moment and one deserving great care, tenderness, and respect.

In my ideal vision of the world, pregnant women would have ample access to other women who know what it is like to give birth under their own power and self-authority. And, these women who know would likely be women who have lost many of their “terrors” in the process. Access to women who know would render most traditional forms of childbirth education unnecessary, offering instead what Michel Odent would deem “new style childbirth education”:

“…for the most part, these are mothers who have no special qualification but, having given birth to their own children, feel the need to help other women who could benefit from their personal experience. They organize meetings, often at their own homes. They do not usually encumber themselves with any particular theoretical basis for their teaching, but may find it useful to give this or that school of thought as a reference. Their aim could most accurately be described as being to provide information and education, rather than specific preparation.” (previously quoted in thoughts on epidurals, risk, and decision making)

So, this is really what I’m hoping to be a part of creating for the women of my own community. I want to help open the door so that the women who know and the women who are preparing themselves to know can meet in safe space and in so doing lose many of their terrors and joyfully uncover their own unique strengths. I believe I’ve already seen it working.

—

The Value of Sharing Story

Information ≠ Knowledge

How Do Women Really Learn About Birth?

Becoming an Informed Birth Consumer (updated edition)

Sep3

“Birth is life’s central mystery. No one can predict how a birth may manifest…Our dominant culture is anything but ‘natural’ so it is no surprise that childbirth, even with the most natural lifestyle lived by an individual family, sometimes needs intervention and medical assistance. This is not to say that any one mother’s efforts to have a natural childbirth are futile. Just that birth is bigger than one’s personal desires.” –Jeannine Parvati Baker (in The Goddess Celebrates: An Anthology of Women’s Rituals, p. 215)

It’s Labor Day and it is also the start of Empowered Birth Awareness Week! A blog carnival is in full swing at The Guggie Daily and I’ve been having some thoughts about birth as a consumer issue. Very often, it appears to me that responsibility for birth outcomes is placed on the mother—if only she’d “gotten educated” she would have made “better choices.” Many people have a tendency or overlook or minimize the impact of the context in which she makes her choices. In that way, I appreciate Baker’s observation about that birth is bigger than one’s personal desires. That doesn’t mean that we can’t take vital steps to alter the larger culture of birth in which we make our choices, however, and one of those ways is to remember to think about birth as a consumer issue.

Though it may not often seem so, birth is a consumer issue. When speaking about their experiences with labor and birth, it is very common to hear women say, “they won’t let you do that here” (such as regarding active birth–moving during labor). They seem to have forgotten that they are customers receiving a service, hiring a service provider not a “boss.” If you went to a grocery store and were told at the entrance that you couldn’t bring your list in with you, that the expert shopping professional would choose your items for you, would you continue to shop in that store? No! If you hired a plumber to fix your toilet and he refused and said he was just going to work on your shower instead, would you pay him, or hire him to work for you again? No! In birth as in the rest of life, YOU are the expert on your own life. In this case, the expert on your body, your labor, your birth, and your baby. The rest are “paid consultants,” not experts whose opinions, ideas, and preferences override your own.

There are several helpful ways to become an informed birth consumer:

Read great books such as Henci Goer and Amy Romano’s new book Optimal Care in Childbirth or Pushed by Jennifer Block.
Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital. (I’m sure there are lots of great educators who work in hospitals, but in order to make sure you are not getting a “co-opted” class that is based on “hospital obedience training” rather than informed choice, an independent educator is a good bet.)
Consider hiring a doula—a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include CAPPA, DONA, and Birth Arts.
Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National or International Cesarean Awareness Network.
Check to see if you have a local birth network in your own community or even start your own (I recently co-founded one in my town!)
Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different. Pay attention to their experiences and how they feel about their births. If they are dissatisfied, scarred, unhappy, and disappointed, don’t do what they did.
Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn’t a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don’t dismiss concerns your may have over the care you receive or decide that you can make different choices “next time.”
Find a care provider that supports Lamaze’s Six Healthy Birth Practices and is willing to speak with you seriously about them:

These care practices are evidence-based and form an excellent backbone for a solid, mother and baby friendly birth plan.

Why “evidence-based care” though?

Because maternity care that is based on research and evidence for best practice is not just a nice idea or a bonus. It isn’t just about having a “good birth.” Evidence-based care is what mothers and babies deserve and what all birthing mothers should be able to expect! Here is a great summary of pregnancy and birthing practices that the evidence backs up:

Remember that birth is YOURS—it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants—hired by you to help you (and what helps you, helps your baby!).

“As long as birth- metaphorically or literally-remains an experience of passively handing over our minds and our bodies to male authority and technology, other kinds of social change can only minimally change our relationship to ourselves, to power, and to the world outside our bodies” – Adrienne Rich (Of Woman Born p185)

Birth class handouts

Can I really expect to have a great birth? (updated edition)

What to Expect When You Go to the Hospital for a Natural Birth

Active Birth in the Hospital

The Illusion of Choice

Musings on Story, Experience, & Choice…

—

This post is updated from a previous edition.

Can I really expect to have a great birth? (updated edition)

Aug22

“Given my limited situation, can I really expect to have a great birth today?” For the woman who asked me this question a homebirth, a birth center, a midwife, and a doula were all not remotely feasible options. My answer to her question is a qualified “yes!” and it really got me thinking about ways to help yourself have a great birth when your overall choices are limited. In fact, there is a long list of ideas of things that may help contribute to a great birth!

Choose your doctor carefully—don’t wait for “the next birth” to find a compatible caregiver. Don’t dismiss uneasiness with your present care provider. As Pam England says, “ask questions before your chile is roasted.” A key point is to pick a provider whose words and actions match (i.e. You ask, “how often do you do episiotomies?” The response, “only when necessary”—if “necessary” actually means 90% of the time, it is time to find a different doctor!). Also, if you don’t want surgery, don’t go to a surgeon (that perhaps means finding a family physician who attends births, rather than an OB, or, an OB with a low cesarean rate).
If there are multiple hospitals in your area, choose the one with the lowest cesarean rate (not the one with the nicest wallpaper or nicest postpartum meal). Hospitals—even those in the same town—vary widely on their policies and the things they “allow” (i.e. amount of separation of mother and baby following birth, guidelines on eating during labor, etc.) Try checking with Cesareanrates.com for local information!
When you get the hospital, ask to have a nurse who likes natural birth couples. My experience is that there are some nurses like this in every hospital—she’ll want you for a patient and you’ll want her, ask who she is! If possible, ask your doctor, hospital staff, or office staff who the nurses are who like natural birth—then you’ll have names to ask for in advance.
Put a sign at eye level on the outside of your door that reads, “I would like a natural birth. Please do not offer pain medications.” (It is much easier to get on with your birth if you don’t have someone popping in to ask when you’re “ready for your epidural!” every 20 minutes.)
You might want to check out either or both of these two books: Homebirth in the Hospital and/or Natural Hospital Birth
Work on clear and assertive communication with your doctor and reinforce your preferences often—don’t just mention something once and assume s/he will remember. If you create a birth plan, have the doctor sign it and put it in your chart (then it is more like “doctor’s orders” than “wishes”). Do be aware that needing to do this indicates a certain lack of trust that may mean you are birthing in the wrong setting for you! Birth is not a time in a woman’s life when she should have to fight for anything! You deserve quality care that is based on your unique needs, your unique birthing, and your unique baby! Do not let a birth plan be a substitute for good communication.
Two resources I particularly enjoy that shake up the notion of a birth plan are, 1. the birth as a labyrinth metaphor from Birthing from Within and 2. this article about how does one really PLAN for birth.
When making a birth plan, use the Six Healthy Birth Practices as a good, solid foundation.
Cultivate a climate of confidence in your life.
Once in labor, stay home for a long time. Do not go to the hospital too early—the more labor you work through at home, the less interference you are likely to run into. When I say “a long time,” I mean that you’ve been having contractions for several hours, that they require your full attention, that you are no longer talking and laughing in between them, that you are using “coping measures” to work with them (like rocking, or swaying, or moaning, or humming), and that you feel like “it’s time” to go in. If you’re worried about knowing when you’re really in labor, check out this post: how do I know if I’m really in labor?
Ask for the blanket consent forms in advance and modify/initial them as needed—this way you are truly giving “informed consent,” not hurriedly signing anything and everything that is put in front of you because you are focused on birthing instead of signing.
Have your partner read a book like The Birth Partner, or Fathers at Birth, and practice the things in the book together. I frequently remind couples in my classes that “coping skills work best when they are integrated into your daily lives, not ‘dusted off’ for use during labor.”
Practice prenatal yoga—I love the Lamaze “Yoga for Your Pregnancy” DVD—specifically the short, 5-minute, “Birthing Room Yoga” segment. I teach it to all of my birth class participants.
Use the hospital bed as a tool, not as a place to lie down (see my How to Use a Hospital Bed without Lying Down handout)
If you feel like you “need a break” in the hospital, retreat to the bathroom. People tend to leave us alone in the bathroom and if you feel like you need some time to focus and regroup, you may find it there. Also, we know how to relax our muscles when sitting on the toilet, so spending some time there can actually help baby descend.
Use the “broken record” technique—if asked to lie down for monitoring, say “I prefer to remain sitting” and continue to reinforce that preference without elaborating or “arguing.”
During monitoring DO NOT lie down! Sit on the edge of the bed, sit on a birth ball near the bed, sit in a rocking chair or regular chair near the bed, kneel on the bed and rotate your hip during the monitoring—you can still be monitored while in an upright position (as long as you are located very close to the bed). Check out the post Active Birth in the Hospital for some additional ideas.
Bring a birth ball with you and use it—sit near the bed if you need to (can have an IV, be monitored, etc. while still sitting upright on the ball). Birth balls have many great uses for an active, comfortable birth!
Learn relaxation techniques that you can use no matter what. I have a preference for active birth and movement based coping strategies, but relaxation and breath-based strategies cannot be taken away from you no matters what happens. The book Birthing from Within has lots of great breath-awareness strategies. I also have several good relaxation handouts and practice exercises that I am happy to email to people who would like them. One of my favorites is: Centering for Birth.
Use affirmations to help cultivate a positive, joyful, welcoming attitude.
Read good books and cultivate confidence and trust in your body, your baby, your inherent birth wisdom.
Take a good independent birth class (not a hospital based class).
Before birth, research and ask questions when things are suggested to you (an example, having an NST [non-stress test] or gestational diabetes testing). A good place to review the evidence behind common forms of care during pregnancy, labor, and birth is at Childbirth Connection, where they have the full text of the book A Guide to Effective Care in Pregnancy and Childbirth available for free download (this contains a summary of all the research behind common forms of care during pregnancy, labor, and birth and whether the evidence supports or does not support those forms of care).
When any type of routine intervention is suggested (or assumed) during pregnancy or labor, remember to use your “BRAIN”—ask about the Benefits, the Risks, the Alternatives, check in with your Intuition, what would happen if you did Nothing/or Now Decide.
Along those same lines, if an intervention is aggressively promoted while in the birth room, but it is not an emergency (let’s say a “long labor” and augmentation with Pitocin is suggested, you and baby are fine and you feel okay with labor proceeding as it is, knowing that use of Pitocin raises your chances of having further interventions, more painful contractions, or a cesarean), you can ask “Can you guarantee that this will not harm my baby? Can I have in writing that this intervention will not hurt my baby? Please show me the evidence behind this recommendation.”
If all your friends have to share is horror stories about how terrible birth was, don’t do what they did.
Look at ways in which you might be sabotaging yourself—ask yourself hard and honest questions (i.e. if you greatest fear is having a cesarean, why are you going to a doctor with a 50% cesarean rate? “Can’t switch doctors, etc.” are often excuses or easy ways out if you start to dig below the surface of your own beliefs. A great book to help you explore these kinds of beliefs and questions is Mother’s Intention: How Belief Shapes Birth by Kim Wildner. You might not always want to hear the answers, but it is a good idea to ask yourself difficult questions!
Believe you can do it and believe that you and your baby both deserve a beautiful, empowering, positive birth!

I realize that some of these strategies may seem unnecessarily defensive and even possibly antagonistic—I wanted to offer a “buffet” of possibilities. Take what works for you and leave the rest!

I posted on my Facebook page asking for additional thoughts and suggestions and I appreciated this one from doula and educator, Rebecca:

“I think I’d tell people to stop closing doors on themselves you know? Stop making assumptions about what is possible and be open to creating new possibilities – maybe not perfect and exact but inviting in opportunity. No money doesn’t mean no doula in most cases.”

She’s right! A lot of doulas-in-training will offer free birth services, many doulas and midwives do barter arrangements or other trades, and many non-traditional birth professionals also have sliding scale rates.

Great births are definitely possible, in any setting, and there are lots of things you can do to help make a great birth a reality!

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This post was revised (from this one) to participate in… And the Empowered Birth Awareness Blog Carnival!

Birth Customs

Aug14

“Pay attention to the pregnant woman! There is no one as important as she!”

(Chagga saying, Uganda)

The book Mamatoto is a look at birth in a variety of cultures (including the US) that was published by The Body Shop in 1991. Even though it is “old” it isn’t really dated since it is a brief overview of different customs and rituals and so forth and not a lot of statistics. There are a lot of absolutely fabulous (and fascinating) pictures and illustrations and these are the highlight of the book. Each chapter is followed by a “black page” of “facts you don’t want to know” about such things are reproductive health care policies in Romania and things like that.

One of the things that struck me about this book was that there is little distinction made between the customs of other cultures and the customs of the US. For example:

“People in Tibet believe that whether or not labour is due, a child won’t come out into the world unless the star under which it’s destined to be born is shining. Western medicine has developed a way of starting labour artificially, by injecting into a woman’s blood a simulation of the hormone oxytocin, which triggers contractions. For several years during this century, an unusual number of women laboured between the convenient hours of nine and five on weekdays…As the Malaysians say, a baby is like a fruit; it will be born when it’s ripe.”

I absolutely love seeing Western culture put into the proper context like this. Too often we see our way as THE way and forget that much of what the dominant culture views as normal for birth is not necessarily truly normal, but is instead an artifact of, or custom of, our culture. Viewed from a distance, the routines of birth in America are just interesting customs—in Tibet, born when the proper star is out, in the US, born when artificial hormones are injected…

(Since first reading this, I use the baby is like a fruit quote regularly.)

I may not be explaining myself clearly, but I find this distance in perspective refreshing and interesting. It reminds me of the work of anthropologist Robbie Davis Floyd whose book Birth as an American Rite of Passage explores the “ritual” elements of hospital birth in America and compares and contrasts the “technocratic” model of care with a holistic, woman-centered model of care (an example of which would be the midwives model of care). She asserts that there are many elements of hospital births that serve as rituals to reinforce the technocratic model (rather than to serve actual purposes, but instead to send cultural messages as well as to initiate the baby into the technocratic model). Examples of ritual elements include putting on a hospital gown, riding in a wheelchair, and having a routine IV. These elements serve to enculturate the woman and baby into a particular model–a ritual function–rather than an individually appropriate method of care.

Another example from Mamatoto that I enjoyed is as follows:

“‘Home birth’ can mean different things to different people. It can mean a bedroom, dimly lit and scented with myrr; a sweatbath perched on a Guatemalan hillside, or a birthing pool in an English flat; a warm fireside in a Himalayan kitchen; the packed-snow sleeping platform of an Inuit igloos; or a one-room shack in Jamaica, with a washing line dividing the family bed and the children waiting on the other side for a first glance at the baby who will be held up for them to see. When a woman gives birth at home, she and her family have a degree of control over the event; it’s their domain.”

In short, at home the family is in their own personal culture rather than having to adapt to the customs, culture, and “ritual elements” of an out-of-home environment.

When I think about American birth customs and culture, the first thing that comes to mind is this potent illustration from Mothering Magazine’s powerful article Cesarean Birth in a Culture of Fear, which was then published in booklet form by Childbirth Connection:

In this image we see a woman immersed in the hospital birth culture found in many hospitals in the US.* She is hooked up to a potential of 16 different attachments. When I see this image, I instantly see why women might not want to “be martyrs” and thus go ahead and have any medications offered to them. It can be very difficult to stand in her personal power and embrace her own body’s rhythms and rituals when she is literally strapped down in this manner. I also think of this quote:

“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

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*Note: I am fully aware that this may not be what birth looked like in your hospital, but I’m speaking generically about many hospitals in the nation.

Modified from a post originally posted at Citizens for Midwifery

Amazon affiliate links included in book titles.

Book Pre-Review: Embodying the Sacred

Jun20

Book Pre-Review: Embodying the Sacred

By Peg Conway

Reviewed by Molly Remer, MSW, ICCE, Talk Birth (http://talkbirth.me)

This week I was excited to have the opportunity to review a new book, not yet released. Publication is anticipated within the next couple of months and I will re-post then with the actual cover image and pricing details.

Embodying the Sacred is a beautiful new book with roots in the Catholic faith. It seeks to answer the questions, “how does birth connect with faith? How can we speak of it in religious language that lives up to the intensity of giving birth? How can spirituality be a resource for childbearing? And why are the churches, deeply concerned for the unborn, so silent about normal childbirth?” The book helps pregnant women build their “spiritual birth bag” through cultivating their inner resources and their embodied connection to spirit.

Written clearly and with a lyrical and intimate style, the book contains a variety of reflections, prayers, and activities to help women make a personal connection with their sense of the divine and sacred. Something I found particularly enjoyable about the book was that not only did the author touch on the labyrinth as a metaphor for birth, she includes literal, purposeful labyrinth walks in the suggested activities for expectant mothers.

Embodying the Sacred speaks to the chord of the holy and sacred in all pregnant women, but readers should be aware that it uses language and prayers strongly rooted in the Abrahamic religions and uses predominantly masculine imagery and language for God. Women from a variety of faith backgrounds will find material to connect with in the book, but may find it necessary to substitute or modify the prayers to suit their personal beliefs and practices.

Pregnant women who are intrigued by the idea of building a spiritual birth bag and who are ready to dig deep and to go beyond the scope of traditional pregnancy and birth books will find a rich resource in Embodying the Sacred.

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

Birth Culture

Jun13

Birth is cultural, the way eating is cultural. We don’t just eat what our bodies need to sustain us. If we only did that, there would be no reason for birthday cake. Birthday cake is part of our food culture. The place you are giving birth in has a local culture as well. It also partakes of our national birth culture. Not everything doctors do regarding birth makes the birth faster or physically easier for you or the baby. Some things are just cultural. For example, most hospitals do not offer enemas to birthing women anymore, yet a few years ago, most women who labored in hospitals were required to have an enema whether they wanted one or not. Enemas are sometimes helpful at birth, but not always…But they used to be part of the birthing culture… –Jan Mallack & Teresa Bailey in Doulas’ Guide to Birthing Your Way (p. 32)

I don’t feel like I have time to construct a big blog post about this subject, but I’ve been having big thoughts lately about birth culture and also how we think about and treat women’s bodies in pregnancy, labor, birth, and postpartum. So, this collection of quotes will have to do for now!

In the short book Birth on the Labyrinth Path by Sarah Whedon, I also marked this passage to share: “In the context of modern medicine, the childbearing year is often treated as a healthcare problem and we are alienated from the natural and holy processes of our reproductive bodies. Let us seek more and more ways to reframe pregnancy as a natural part of the human experience and to honor the holiness of this work that brings a pure and tiny spark of the divine into the messy, beautiful drama of life on Earth. Let us guard mothers, fathers, and babies as they grow families. Let us celebrate our sexy, dangerous, bloody, beautiful ability as people to make and love more people…” (emphasis mine)

Later on, Whedon makes these lovely observations about postpartum bodies:

A body that is curvier than it was before, maybe bearing stretch marks or scars from surgical procedures or tearing, maybe producing milk, is a body that bears the signs of delivering a human being into this world. We may mourn our smooth, skinny, unmarked maiden bodies, but at the same time we can celebrate the beauty of our storied, productive, and strong mama bodies….

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You may have seen images of new mothers as mama goddesses, resplendent in their fertility, effortlessly suckling a new babe while woodland creatures graze nearby. This is a lovely scene to aspire to, but my personal experience is that new mama goddesses are more likely to be found pinned to a couch by a ravenous infant, wearing pajamas and a messy ponytail, and surrounded by the remains of hastily grabbed snacks and partially read motherhood memoirs. Those mamas are no less goddesses. In fact, a careful Pagan theology of embodiment will recognize that the true mama goddess must include the range of experience of new motherhood, with all the sleepless nights, messy lochia, and milky-sweet sleeping babes.”

I also came across this quote from Sister MorningStar in the Spring 2011 issue of Midwifery Today: “Every mother has a culture. Every mother is a culture. She is born into an ocean of language, traditions and rituals around how she eats, sleeps, poops, makes love or births a baby.”

And, then from Ani DiFranco’s great introduction to Birth Matters: How What We Don’t Know About Nature, Bodies, and Surgery Can Hurt Us by Ina May Gaskin:

“The pains associated with menstruation and childbirth (even the emotional pain) are the price of having agency with the bloody, pulsing, volcanic divinity of creation, and they lie at the core of feminine wisdom. The literal experience of my body is your body your blood is my blood holds great insight into the way of things. A self-possessed woman in childbirth can be a powerful teacher for all (including herself) on the temporality, humility, and connectedness of life.”

I honestly believe that if modern birth culture rested in perspectives like this, our whole world would change!

The Gift of Giving Life: Interview with Sheridan Ripley

Jun8

This interview with Sheridan Ripley is a stop on the Virtual Book Tour for The Gift of Giving Life.

Q1: Many people liken the writing of a book to giving birth to a baby? Did you find this an apt analogy?

YES! We (the co-authors) brought this up a lot. It was like we were gestating together and ideas were growing and growing. The first trimester I actually felt like I missed as I joined the group at the beginning of the 2^nd year. It was a 3 year process so the trimester analogy works well.

The 2^nd trimester we had plenty of energy and got a lot done and things moved forward quickly. We had that happy, easy 2^nd trimester.

That 3^rd trimester felt SO SLOW!!! It was the editing, book layout, more editing. Details and more details and felt so long. I know I felt so heavy and weighed down by the process. Luckily we had each other for support and we made a great team.

Finally we were pushing the baby out and while there were little hold ups along the way, it was so exciting. The triumph we felt as we finally held our book in our hands was pretty amazing!

Q2: I’m fascinated by the concept of Heavenly Mother and really enjoyed the sections of The Gift of Giving Life that touched on the relationship with Her. Can you explore more about how LDS women might find strength and connection in this image of the Feminine Divine and how she might aid in giving life?

I believe I am a literal child of a Heavenly Father and knowing that he is a partner with a Heavenly Mother and together they are able to love billions of children, helps me to have faith in my ability to love and raise my boys.

Knowing that our bodies are patterned after their bodies also gives me faith that my body can grow and birth babies! We are mortal and there are instances when medical intervention is needed, but the majority of the time birth is safe. Our bodies are created to create!

As we connect with other women in a supportive loving way we can feel connected to Her because we are each created in Her image. Maybe that is why when women gather around women in childbirth we feel so uplifted, powerful and humbled at the same time.

Some women really feel a need for a connection of a mother figure, especially while pregnant. I have an earthly mom who I am very connected to and she was very helpful during my pregnancy, so I didn’t personally have a desire for a connection with a Feminine Divine at that point.

However there are women who may be missing that mother figure in their life and we all have a deep desire for such a connection. Knowing that there is a Heavenly Mother who stands beside Heavenly Father to help guide us and protect us especially during this time of pregnancy and birth is powerful.

Meditating and pondering on the idea of a Heavenly Mother and how that can help us as we give the gift of life and then raise our children is the best way for me to connect to her. I actually just took time to do this as I hadn’t really thought of this question until you asked it.

That is the great thing about our book and having so many contributors is it will speak to different women, because so many view points are included.

Q3: Do you have any specific tips for women wishing to incorporate more spiritual practices into their pregnancies?

We actually have a newsletter that moms can sign up for where they get a free 20 minute meditation MP3 as well as 5 tips to have a more spiritual pregnancy/birth. I think for each mom it may look different. Prayer and meditation are great places to start, as you will often get inspiration on where to go from there. I also love Mother’s Blessings as a way to have the strength of other women buoy up the pregnant mom. She can benefit from feeling their love and spiritual support

Q4: When women in the birth stories say they asked their husband for a blessing or that their husband gave them a blessing, what does that mean?

A blessing is similar to a prayer. All male members of the Church who are prepared receive the priesthood, which is the authority to act in God’s name. One of the ways they can serve others with the priesthood is by giving blessings by the laying on of hands. They can give blessings of healing or for comfort and guidance. In some cases a wife might ask her husband (or other priesthood holder) for a blessing before or during birth.

I know for me in my first birth, it was so comforting because with my first birth my husband gave me a blessing when I was concerned about the Thing 1’s lack of movement. In the blessing he said he would be born when he was ready. When we discovered that he needed to be born by emergency cesarean immediately even though I was only 34 weeks, I had peace knowing that my husband had just blessed me that “he would be born when he was ready.” I knew everything would be OK.

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Thanks for the interesting interview and the review copy of The Gift of Giving Life, Sheridan!

Visit The Gift of Giving Life site to sign up for their newsletter and to receive a free Meditation MP3 as well as tips to help increase spirituality in your pregnancy and birth.

For my readers I have a coupon code for 10% off a copy of The Gift of Giving Life. Click here and after you add the book to your cart use this coupon code. GWFWXR3F This code is good until Father’s Day 2012.

Sharing Stories

May29

Mother-to-mother birthtelling is easy at blessingways!

In an excellent article by Rachel Reed in the Autumn 2011 issue of Midwifery Today, Sharing Stories, Reclaiming Birth Knowledge, she makes this important point: “Women not only learn practical information about pregnancy, birth, and motherhood through exchanging stories, but also gain emotional and social support…Through sharing stories, women created a sense of connection to other mothers and to the ‘universal nature of birthing’ …”

Despite the everyday miracle of birth and potent role in women’s lives and self-identity, “women’s birth stories are largely ignored in mainstream childbirth education programs. Instead, the approach consists of an ‘expert’ transmitting standardized information sanctioned by the maternity system. This approach does not adequately meet the needs of mothers, nor reinforce mothers’ expertise and knowledge. Building childbirth education around mother-to-mother story sharing would reinforce mothers as the experts in birth.”

What do you know about birth that other people don’t know?

As I read this article, I thought of several experiences in my own childbearing experiences that varied from “standardized information sanctioned by the maternity system” and that includes the alternative care system of which I was a part. Things that, for me, were not available from those systems around me—books, professionals, or media, but that nevertheless came through and are part of my own stories:

Being able to feel my babies practice breathing in the last 8-10 weeks of my pregnancies.
“Skipping” transition–no “freaking out” required to have a baby after all.
Tearing “up” into the labia/clitoral area instead of the more common or expected perineal tearing
Experiencing a spontaneous birth reflex
No bloody show/mucus/fluid until shortly before pushing
Long “strings” of post-birth mucus. So tough and sinuous that they are almost like membrane.
Experiencing a second trimester miscarriage clearly and potently as a birth event.

I’m curious to know what other women have experienced like this. What happened to you that you had never heard about before? What is a part of your story that isn’t a part of birth books? What do you know about birth that other people don’t know? How does your story enhance the collective culture of women?

The role of story in midwifery education

Reed goes on to explore the role of story in midwifery care and the education of midwives, explaining, “It is time for midwives, informed by being ‘with woman’ and experiencing birth in all its complexities, to reclaim their own unique birth knowledge. Sharing birth stories represents a rich source of knowledge and develops the ‘collective culture of women.’ Mothers are already doing this well, and childbirth education should reinforce this mother-to-mother expertise. Midwifery education also needs to embrace the power of storytelling as a means of developing woman-centered knowledge and practice.”

One of the most valuable elements of La Leche League for breastfeeding mothers is the mother-to-mother support and information sharing. This is irreplaceable. We need a means of providing this type of mother-to-mother support for birth as well. Not in swapping horror stories or “enlightening” others, but in authentic connection based on our own unique birth wisdom.

Birthtellers

In another article in the same issue of Midwifery Today KaRa Ananda shares the following gem in her article about Birthtellers: “…the stories women tell to each other privately–shape cultures, beliefs, choices and lives. Women used to learn about birth and motherhood through the stories of their mothers, sisters, grandmothers, midwives and friends. Today, that knowledge is transmitted primary through television, movies, peers and the internet. Now is the time for the Birthtellers to arise and once again share our inspirational birth stories–both within our communities and globally through new media technology.”

One of the midwife-authors that makes my heart sing with her lyrical, magical writing, is Sister MorningStar (author of Power of Women). She shared her daughter’s birth story in the autumn 2011 edition of Midwifery Today and it is just beautiful.

My own article on the value of sharing story also appeared in the same issue of Midwifery Today.