Author Interview: Sally Hepworth

At the end of last year, I reviewed a preview copy of an awesome new novel about midwives: The Secrets of Midwives.

Secrets of Midwives, the

The Secrets of Midwives is released for sale today and I’m excited to share an interview with the author, Sally Hepworth.

A Conversation with Sally Hepworth…

Q 1. How did you come to write the book?

Sally Hepworth and Family

Sally Hepworth and Family

There is a saying among writers “Write the book you want to read.” That’s what I did. Being the mother of young children (and pregnant while I wrote book), I was finding myself drawn to novels such as The Birth House by Ami McKay and Midwives by Chris Bohjalian. I have always thought there was a certain magic to midwifery—for a while, after I left high school, I even considered becoming a midwife. So, when it came time to start a novel, there was no choice to make.

I researched for months before I wrote a word. While I knew I was going to write about midwives, I had no idea what the actual story would be. I had a suspicion it would involve a mother and a daughter—particularly when I found out I was carrying a daughter—but it wasn’t until I read some fascinating stories about midwifery in the 1940s and 50s that Floss’s character (a grandmother) was born.

For me, the best plots start with a question, and the question I landed on for this book was: “Why would a woman hide the identity of her baby’s father?” I like books that have a big upheaval really early on—a “call to action” for the readers—so I knew that by the end of the first chapter, the reader would find out that Neva was pregnant, and that she wouldn’t reveal the identity of the father. At first, I didn’t know why she was hiding it, and I didn’t know who the father was, but as I wrote, I started to figure it out.

But when all is said and done, THE SECRETS OF MIDWIVES is a book about family. What makes a mother, what binds family together, and the role of biology.

In writing this book, I found answers to a whole lot of questions I never knew I had. And I suspect it is no coincidence that this book took me nine months to write.

In effect, in 2012, I gave birth to two babies.

Q 2. In the novel there are many differing opinions about the “right” way to give birth, even among the midwives. Why did you choose to include this in the book?

In my experience, there still exists a lot of debate over the “right” way to give birth so I thought it was important for December 2014 119authenticity to include this in the book. Also, the idea of “right” and “wrong” tied in with the novel’s theme: family. Unfortunately, there is still a commonly held belief that there is a “right” and “wrong” kind of family. Or at least a “good” and a “better” type. But these days, there are so many different kinds of families—blended, adoptive, single-parent, same-sex parents, communities of singles. Of course, there are a lot of (strong) opinions on this too! To me, this was all rich fodder for a novel.

As I started researching for this book, I read a lovely line in a book that said childbirth was a woman’s first battle as a mother, and it was this battle that made her a warrior, capable of protecting her child. I found this fascinating, but also troubling. If birth makes a mother a warrior, where did it leave adoptive parents? Step parents? Fathers?

It was also troubling on a personal level. My son had been born naturally and my daughter was due to be born by scheduled C-section. I had a sense that it didn’t matter how the baby was born, that the birth had no continued bearing on the relationship between mother and child, but the more I read about the transformative quality of natural birth, the more I wondered.

In writing this book, and in giving birth to my daughter by C-section, I was able to find answers to my questions. I have more respect for natural birth and midwifery now than I ever did, and I think a woman’s ability to provide everything her child needs through pregnancy and birth (and beyond!) is astonishing—even magical. And the idea of a home birth, I’ll admit, holds a certain appeal for me now that it hadn’t before. But I finally determined that there is no “right” way to give birth, because there is no “wrong” way. You don’t become a warrior because of the way you give birth. You become a warrior because of the depth of the love you feel for your child.

And while labor may be the first battle you’ll fight for your child, compared to the battles that still lie ahead? Even the most arduous birth is a walk in the park.

Q 3. What research did you do?

As I prepared to write this novel, I read everything I could get my hands on about midwifery—novels, memoirs, non-fiction books—and I watched every piece of footage that showed high-risk deliveries that YouTube had available. I subscribed to online communities and forums where I was able to ask questions about midwifery and birth and I touched base with several home-birth midwives and midwives alliance groups. I also have an aunt who is a midwife who was able to make suggestions and verify things for me.

Being pregnant, I also had easy access to my obstetrician for questions. It became common for my prenatal check-ups to consist of a quick blood pressure check, followed by twenty minutes of question time about my novel. In the hospital after having my daughter, I had a fantastic midwife who shared many stories with me about unusual or memorable births. I was stunned by the level of skill and expertise that was required, and the host of things to be prepared for during labor. But what I remember most about our conversations is her awe and respect for mothers in labor, and I attempted to weave this awe into all three of my POV characters, particularly Neva.

Q 4. What are some of the weird and wonderful facts you’ve learned about midwifery and birth during your research?

  • In the past, midwives were known to secretly harbor unwed mothers, perform abortions, baptize babies, and serve as pediatricians for the first year of the baby’s birth.
  • May Babies Are The Heaviest: Babies born in May are, on average, 200 grams heavier than any other month.
  • Centuries ago the midwife would catch the baby in her apron!
  • In the US, midwifery is only licensed or regulated in 21 states. In most states licensed midwives are not required to have any practice agreement with a doctor.

Q 5. One of your protagonists has issues with her mother. Did you draw on personal experience for this?

 Actually, my mother and I have a very close—verging on boring—relationship. Though we are quite different (she is private and conservative like Neva, and I am like Grace—pushy and talkative and loud) conflict between us is rare. So I wasn’t able to draw on that relationship from a dysfunctional perspective. That said, I was able to identify with loving someone who is very different (not just my mother, but also my husband and my son), and learning how to love them the way they need you to. Above all, the key is respecting the person for who they are, and always looking for the good they can offer.

Q 6. How can readers get in touch with you and support your work?

I am very active on Facebook, Instagram and Twitter. I have also started spending more time on Goodreads. My website is the place to go for book information, upcoming events and my bio.

Thanks for listening (reading)!

Sally x

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


Guest Post: Pelvic Exams Need Rethinking

June 2014 045I almost never reprint any of the random articles, press releases, and news tidbits that find their way to my email address. However, this one was too interested to skim past. Conclusion: The pelvic exam has been a standard part of a woman’s annual checkup for decades — yet it serves no clear purpose and may do more harm than good.

Considering that I’ve written about Pelvic Exams I Have Known (watch for my eventual stand-up routine, 😉 ), I found this very interesting…

Jennifer O’Brien, Assistant Vice Chancellor/Public Affairs
Source: Elizabeth Fernandez (415) 502-6397 (NEWS)
Twitter: @EFernandezUCSF


UCSF Commentary: Pelvic Exams Need Rethinking

The pelvic exam has been a standard part of a woman’s annual checkup for decades — yet it serves no clear purpose and may do more harm than good.

That’s the conclusion of a new guideline by the American College of Physicians (ACP) based on a review of scientific literature spanning more than 60 years. In an article to be published July 1, 2014 in the ACP’s flagship journal, Annals of Internal Medicine, the national organization of internists strongly recommends against pelvic examinations for adult women who are not pregnant and show no signs of disease.

In issuing the new guideline, the nation’s largest medical-specialty organization contends that pelvic exams rarely detect “important disease” or reduce mortality. Under the new guideline, the ACP advises that pelvic exams are appropriate for women with symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems, or sexual dysfunction.

The recommendation is expected to be controversial, according to an accompanying editorial by George F. Sawaya, MD, a UC San Francisco professor of obstetrics, gynecology and reproductive sciences, and epidemiology and biostatistics; and Vanessa Jacoby, MD, a UCSF assistant professor of obstetrics, gynecology and reproductive sciences.

“The recommendation is based on a systematic review that found no data in support of the examination but did find evidence of harms ranging from distress to unnecessary surgery,” they wrote in the commentary.

Sawaya and Jacoby point out that tens of millions of pelvic exams are performed annually at well-woman checkups in the United States but whether the exams actually benefit asymptomatic women has largely been unstudied. To help fill the void, surveys recently have sought to establish the goal of clinicians in performing the exams: some physicians contend the exams help detect benign uterine and ovarian lesions while others mistakenly say they effectively screen for ovarian cancer, noted Sawaya and Jacoby.

The editorial called into question the nature of the medical literature review by the ACP because some of the research analyzed focused on older women and failed to evaluate “the most important goal of the pelvic examination cited by obstetrician-gynecologists – detecting noncancerous masses.”

“Thus, it is reasonable to disagree with using these findings to recommend a major change in clinical practice for women of all ages attending well-woman visits,” Sawaya and Jacoby wrote in their editorial. “Many will ask ‘Have all of the pertinent clinical questions been addressed?’”

“Deciding when evidence is sufficient to conclude that an intervention should be promoted, discontinued, or submitted to further study is challenging,” they continued. “The determination relies largely on judgment about evidence quality and the likelihood that more evidence will tip the balance in making either a favorable or an unfavorable recommendation.”

Numerous routine screenings, including mammograms and prostate tests, are being reevaluated for their medical and financial value.

In their commentary, the UCSF authors stress that whether or not the new guideline actually changes current practice, it could lead to a better evaluation of the benefits and harms of pelvic exams.

“The pelvic examination has held a prominent place in women’s health for many decades and has become more of a ritual than an evidence-based practice,” said the authors.  “With the current state of evidence, clinicians who continue to offer the examination should at least be cognizant of the uncertainty of benefit and the potential to cause harm through a positive test result and the cascade of events that follow.”

UCSF is the nation’s leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and two top-tier hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco. Please visit


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Rise for Justice

1497514_10153552346400442_1148387720_nOkay, so I knew I would enjoy The Vagina Monologues. How could I not, right?! Well, I did not expect to be SO blown away by the power, presence, and passion of my magnificent friends. They were incredible. Seriously incredible. It was an amazing show!  There were many powerful moments–some very funny, some sad, some horrifying. My friend, doula, and colleague did the piece on birth at the end and brought me to tears with her vibrance and passion. There was a moment in the middle where the teenage girl member of the cast read out some statistics on the One Billion women who are raped, abused, or assaulted. Each member of the cast began to rise in turn and as they did, their friends in the audience rose with them, until the whole theater was standing. We rose for justice.

I’ve mentioned several times that I came to birth work with a core foundation in feminism and social justice work, primarily in domestic violence. I remain firmly convinced that the way we treat women in the birthplace reflects an overall cultural attitude towards women in general. I believe that peace on earth begins with birth. I believe that we can change the world with the way we greet new babies and celebrate new mothers and see the deep, never-ending work of parenting our children. I believe in rising for justice and I keep vigil in my heart every day for women around the world.

In a stroke of coincidence that gave me chills, my independent study student who is working on a Breastfeeding and Ecofeminism course submitted her weekly reflections and in it she mentioned Eve Ensler, The Vagina Monologues, and One Billion Rising with no idea that I was going to the show this week. As I read her reflections, the connection between the personal and political was so tangible that I asked her if I could use her assignment as a guest post for my blog. Part of the reason I assigned the book Reweaving the World for this course was because of how it contextualizes the issues facing women so broadly and makes this undeniable connection between exploitation of the planet and exploitation of women’s bodies. While it might sometimes trigger a sense of hopelessness and distress, I think ultimately, the contextualization is empowering. The Vagina Monologues are based on the courage of women telling their stories and sharing their truths. Likewise, I appreciate Alea’s generosity and courage in sharing her reflections with my readers…

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Dancing for Change: A look inside a personal exploration of ecofeminism, sexuality, and social justice.

Guest post by Alea Scarff

I began reading The Politics of Breastfeeding which sparked a series of “hell, yes’s!” It also left me feeling inspired, excited and validated that I’m not the only one with these feelings and notions about women, breastfeeding, and the injustice I witness within this issue. Her kick-ass presentation of the truth among this profound cultural issue left me enlivened and ready for action sentence after sentence.

Then I read several pages of Reweaving the World: The Emergence of Ecofeminism. Yikes. This was heavy. I suddenly found myself caught between two worlds of inherent optimism excited for positive social change, and the deep dark issues of ecology and the longstanding reality of suffering and inequality of women on this planet. I felt my body overcome with anger. A feeling of helplessness ensued. I felt those women in third world countries starving and overheated, overworked and just trying to sustain the lives of their children on top of enduring mental, emotional, physical, and sexual abuse. I felt all the children who suffer because of this. I felt all of the gender imposing rules children in the western world are conditioned by, thus tainting our hearts and souls with limitation and sharp edges surrounding who we are allowed to be in this society. All of the emotionally repressed men; all of the objectified, degraded women who have never known what it feels like to feel good in their bodies.

I began to feel my grandmother’s oppression she suffered from my grandfather in the 60s. The abandonment, the sexual abuse, the use and re-use of her as a resource and service for himself. I felt my mother’s experience of an emotionally abusive relationship, and finally my experience of sexual molestation as a child. Where was all of this coming from? A deep sadness came over me as I desperately tried to figure out my own issues with sexuality and my relationship to the world as I sat amongst strangers in this warm coffee shop. Was I angry about what happened to me? Was I angry at my partner? Past partners? Was I angry at the world? I really couldn’t identify where the anger came from, or where it was directed. I had to stop, refresh, and start over. Maybe this shit is too intense for me. Maybe I need to change my course of study.

No, no. You can’t run away. I realized I had been running from this issue my whole life and it’s finally time to recognize it. I stopped, took some deep breaths, did some yoga asanas to release the sticky tensions of injustice lurking in my joints throughout my body. Ok. Begin again.

So I went back to my childhood, with my deepest memories of the frequent encounters of gender inequality. My mother, to this day, credits me for bringing to light her own femininity and capturing her attention to the inequalities of men and women. Something that went unnoticed until I came along, however she still was not interested in changing the ways of the world to the extent I was. She had her own social change she was working on. It was entrenched in art and consciousness. Luckily, I picked up on this, and found my own desire for changing the world through consciousness. Consciousness through equality for women. How could anyone else NOT be outraged by the fact that 8 out of 10 songs on the radio were sung by men? As a twelve year old, I began writing letters to radio stations. I couldn’t understand how no one seemed to care about this absurd injustice constantly happening on the radio. Something so simple yet so powerful as radio permeated our culture – and no one seemed to notice. There were a plethora of female musicians that I favored at this age. How could I not hear them on the radio? On top of an array of social issues such as this, I always HATED those older men who would make random, confusing, degrading comments to me for others’ and their own amusement. What the hell was up with that?

I began reading an interview with Eve Ensler, the creator of The Vagina Monologues and the global women’s campaign, One Billion Rising. The figures quoted from the UN in this interview left me in a deeper outrage. One billion women on the planet today are beaten or sexually assaulted. I reflected on an article I had read earlier that week, as well about how to talk with your children about their private parts and to help prevent them from being sexually abused. The article stated that one in five girls are sexually molested and one in six boys are. I never identified with the label “sexually molested” nor did I want to admit I was affected by this, but just in the last few years when I looked at the definition, I realized, even my few small inappropriate experiences are considered just that, and they have, in fact, affected me.

I had to take a few days off. This all needed to settle inside and I had to figure out what to do with it. I spent days pondering, how do I continue to explore this crucial subject and maintain a positive outlook? How do I channel this anger into solutions for helping others? How can I continue researching and hold my strength and goddess energy as a female role model, an inspiration for my two little boys, my partner, men and women, and the planet?

This is a tall aspiration I set for myself, I realize. I suppose this is simply what I aspire to be.

I began speaking with my mother about my sexuality from a young age and my exploration of it now. It was both comforting and disheartening to discover my mother had similar inappropriate sexual experiences as a child that I endured, as well as finding she’s still on her journey of understanding this taboo topic herself, female sexuality. Perhaps a running thread in my family of women? Or is this prevalent everywhere? Why is no one talking about it? Even after being so close with my mother, and being able to talk about anything for as long as I can remember, it took some courage to bring up this subject with her. Regardless, I am so glad I did.

I began to read again. I decided I had to begin with an open heart and mind, as I swim right through the obstacles of understanding the depths and spaces of the world of women and the planet. There is a lot to be grateful for, and a lot that needs changing. Positive reflection throughout this journey can only bring more light. Letting go and forgiving my past experiences, and the oppression the women I know and love have endured, I take a step into a new beginning. I can move forward continuing to understand my path of my sexuality growing up, and what this means for me now. I feel I’ve got a long way to go, and I can sense a gap of mystery and unknown feelings sitting somewhere inside. But I’m ready to embrace and heal whatever decides to reveal itself.

I am now in the process of releasing fear and letting go. Letting go of being afraid to speak up and stand up for what’s right; of being viewed as a bitch, uptight, or simply being exposed. We as women need to start somewhere within this realm in order to ignite change. Rather than accepting these old cultural paradigms and letting them continue to thrive within this patriarchal society, it’s time to change this tired, destructive trend. As Ensler quotes in a recent interview with Deccan Aitkenhead for The Guardian, “We have one in three women on the planet being raped or beaten…We’ve all learned to be so well behaved and polite. We should be hysterical.”

Ensler launched One Billion Rising which, on Valentine’s Day in 2013 brought close to one billion women out on the streets to protest against violence towards women. Ensler’s goal is to have one billion gather on February 14th outside buildings that represent justice – police stations, courthouses, and government offices – and dance. That’s it. Where and how they dance is up to them; each is organized at a local level. In this, I found tremendous uplifting relief.

Through this personal revelation, I’ve decided to remain free – and not restrained by anger or resentment of injustice. I simply cannot move forward or flourish from that space. We must find liberation through the endurance, triumph and the celebration of womanhood. Simply. This is the only way to encourage and create change. I must release the tensions that like to creep up and burrow inside my joints and muscles. I no longer will walk around carrying this stuff – I’d rather be dancing than dwelling. This is the only way I will find my way to living up to my goddess vibration of inspiration for social change for my two little boys, my partner, women and men, and the planet collectively.

Next year on Valentine’s Day, I think I will be dancing.

“But when you suddenly understand that violence against women is the methodology that sustains patriarchy, then you suddenly get that we’re in this together. Women across the world are in this together.” –Eve Ensler


Guest Post: The Land of Colour

In a lovely synchronicity with the Carnival of Creative Mothers coming up on Wednesday, I got a surprise message this weekend from one of my Facebook page’s fans. She shared a beautiful story of self-discovery through birth art and she offered the story to me to share with others. It is my great pleasure to share her voice and her art with you now.

by Amanda Wolf Hara

I started a painting 6 years ago- I was reading about the transformative power of birth art- creating art to capture the energy of pregnancy.

I remember the power I felt creating such bold lines and stark contrasts.

The shape of her flowed. The huge swell of her belly, the small legs—because that’s how they felt! The breasts, shaped like mine, not just stock representations of breasts. I was proud of myself as she emerged!

Then I became unsure–afraid.

I didn’t want to go any further—I believed I would add too much and take away her potential & power. I wasn’t sure how to finish her head… Could I do a face? Would that ruin the rest of her?

So I hurriedly made an impersonal head shape–no face, and gave her black short hair–nothing like mine, but, I told myself, maybe we can go for elegant?? Then, did a quick grey background behind her, to fill the blank space & choosing grey, thinking I had to keep the monochromatic quality for her to be “art”.

It was my serious go at sophisticated expression. And I had my inner critic telling me my Birth Art had to be a certain kind of primal. Stark. High contrast. Simple.

But, I hated it.

The grey was depressing. It lacked any technique or skill.

I felt timid and trapped when I looked at her.

All this awesome power, and I caged her in with some hurried attempt to keep her subdued- safe- not “too much” so she would be accepted by her audience.

When I was done, I hung her- mostly out of a determination and obligation to display her.

To show off her powerful form.

But, I never revered her. Celebrated her.

She was in a room only I went into.

When we moved, I kept her in the closet.

I thought about taking off the canvas, rolling it up & storing it, and using the frame to stretch another canvas and create “better” art.

I avoided her for years.

But then, yesterday, I had to paint.

A canvas.

A piece came to mind- a design of the feminine using a prayer I found and love.

I searched my stacks for the right canvas.

I found Her. I looked at her again. Again, hating the grey.

I thought, “If only I could change it; cover the grey. Even just a white background has got to be better.
“But, no, that’s gotta be cheating. That breaks the “rules” of birth art. You can’t go back once it’s done- I’m not pregnant anymore-” blah blah blah went my list.

I kept staring at her, wishing the grey was different.

Then, a thought came like a tickle.
What if?
Why the hell not?
It was MY work, after all.
Why should this have to be a snapshot?
Why can’t I change it?
Why can’t this be a story??
Maybe an ongoing one, if I want?
Who’s going to know?
There are no birth art police, for heaven’s sake!

“Yeah!” I encouraged myself-
“Motherhood is an ongoing story!
I’ve developed, I’m constantly pregnant with myself- learning to birth myself in a myriad of ways!
I want this piece to be a tribute to my ongoing process, not just a one time shot!”

And as I looked at her, giving myself permission to alter her, she started coming alive.
She instantly began calling for bright pinks, blues, purple, red, yellow!
I began to “see” where colours wanted to be.

So, I took the dive and set up to do it.

And, I hesitated.

All those same fears I’ve carried with me.
What if I mess her up?
What if she gets lost under new paint?
What if go totally too wild and end up somewhere in this process where she is unrecognizable, and I exceeded my skill to be able to “fix” it?

What if I regret it??

All these questions are so very familiar.

I ask myself variations of them every time I feel myself called by my passions and intuition to do something.
It’s a contest between my Muse and my inner Critic.
My confidence and my insecurity.

Sometimes I let the Critic win.

So, brush full of white paint, ready to cover the grey, I paused. Waited. Debated.
Then looked at her.

I hated how sad I felt looking at her.
How limited.

I connected with my own feelings of my pregnancy: wanting to burst with empowerment, celebration, Creative force!
feeling obligated to bear the responsibility of all the emotional BS and baggage that surrounded me during that time.

I hated how she was stuck there.
In that time.
I had done amazing work- liberating myself from that energy. I had escaped into the land of Colour.

She needed to, too.

So, I took the plunge.
I did it.
Colours flowed onto her, taking shape and coming home.
She began to come alive!
She began to claim her power.
Celebrate it!
She suddenly became infused with all the vitality I wished I could have articulated before.

I revisited parts of her that never looked like me–I gave her wild curls, more hair, red lips, a blush on her cheeks, a colourful womb, and, as the colours spoke, a baby took shape.

I paused.

My daughter.


All the creative projects waiting inside me to be birthed and claimed as my Work.

She began to claim her power.
Celebrate it!
She suddenly became infused with all the vitality I wished I could have articulated before.

So, why didn’t I do this before?

I don’t think I had the skill- the experience- I have now- this wouldn’t have come out of me the way it did yesterday.

I don’t think I would have trusted her wisdom in calling for the colours the way I did yesterday.
No, I’m certain of it.

I needed time to develop.

To allow my exploration and development.

I look at her now, and instead of feeling like I covered up that first painting, I have the exhilarating feeling like I built a bridge.

Then to now.

All the colours and lines, considerations and the process are all there for me.

Not either/or like I believed.

So, I ask myself, “Is she done?”
I dunno.

I think, so…
For now….



Amanda Wolf Hara’s web site and etsy shop, Wild Priestess, is coming soon. She is an Artist, Writer, Single Mom (to an absolutely dazzling 5 yr old daughter!), Intuitive, and Shamanic Minister… among a few other things. She can be contacted for commission work.

Guest Post: Infertility Doula

Infertility Doula:  Infertility and the Natural Birth Community

by Kristen Hurst

Okay, so you’ve wanted to have kids since you emerged from the womb. You had your dolls enact your birth plan before you could write it down. At some point, you adopted the title birth junkie, no shame attached. You studied to become a midwife or a doula. You finally get to the age at which you could conceivably conceive…and then you can’t. November 2013 019

For some women suffering from infertility, waiting the year before they can have access to IVF and other medical interventions isn’t the answer. It’s not that they don’t want to wait that long, it’s just that some women don’t feel comfortable with pumping your body full of hormones in order to conceive when you have made an effort to rid your home of hormone-altering plastics and chemicals. Yet when it comes to natural “solutions” it can be just as frustrating to be handed a garden full of herbs and told to wait. You’ve been waiting your whole life—the wait was supposed to be over.

In my experience, natural birth communities tend to do an excellent job supporting mothers who have experienced miscarriages, but are less certain about the role of would-be mothers who can’t conceive. It’s not that we don’t welcome them, especially if they are midwives and doulas, but we assume that they have another place to go: there are a significant number of infertility support groups in the world that even have their own lingo! Nevertheless, midwives and doulas that have experienced infertility are an integral part of our community, and their needs—and perspectives— shouldn’t be ignored.

For women who have only recently discovered their infertility, we can support them through natural treatments and even more conventional fertility treatments. We can offer acupuncture, fertility massage, and a variety of herbs and dietary changes.  We can accompany these women to difficult appointments. We can offer to be an infertility doula, a concept that, as far as I can tell, was coined by Ebru B. Halper to describe the profession she created as a result of her struggles with infertility. Halper guides women through the overwhelming maze of fertility treatments, providing whatever kind of support they may need. I’m not sure why this concept hasn’t caught on, but I think it’s a helpful frame for how we can approach infertility in our communities.

Since training to become a doula, I’ve often thought about how we can be doulas for the women in our communities no matter what they’re experiencing. I often feel as though I am a doula to my children, helping them birth their best selves. But that process has to extend beyond the treatment process into whatever grief or celebration might follow. Ultimately, there is no one “right” thing to say to a birth worker who cannot have her own babies. What we need to do is to listen and be present because we know that birth is a gift. I can’t know what it feels like to be denied that gift, but there are many women who can share their perspective.

The point of this conversation isn’t to make me feel grateful for the fact that I have been able to give birth—it is to celebrate grief as an end in itself. “Grief is neither a disorder nor a healing process: it is a sign of health itself, a whole and natural gesture of love,” says Dr. Gerald May. He continues, “[n]or must we see grief as a step towards something better. No matter how much it hurts–and it may be the greatest pain in life–grief can be an end in itself, a pure expression of love–“  As a birthing community, we must bear witness to this painful love rather than assure the woman that it’s “meant to be.” We can’t stop being infertility doulas once the treatment is over. Making space for both the love within birth and the love within grief can only make our lives richer.

Kristen Hurst is a mother, a writer, a yogi, and a doula. She received her bachelor’s degree in fashion marketing, and writes often about pregnancy and maternity fashion for Seraphine Maternity.   When she’s not trying to juggle the lives of  her sons, she enjoys painting and catching up with a great Jane Austen novel.

Guest Post: Squatter’s Rights

October 2013 024

Squatter’s Rights

A couple of posts ago, I mentioned I’d made a new sculpture that I titled after a friend of mine and an article she wrote several years ago. She originally sent me the article to review, because she was thinking of sending it to a magazine. Several years passed, several more babies were born, her computer got fried, and the article was lost. However, it stayed with me anyway. It stayed with me when I prepared for the birth of my rainbow baby girl, it stayed with me as I created birth art to prepare for her birth, and it stayed with me as I reached down to catch my baby’s whole pink wonderful self in my hands as she was born in one smooth reflex almost three years ago. So, I created my figure and I emailed Shauna about it and then I went digging. Deep in the ancient, archived messages in my Outlook Express folder on my old laptop that now belongs to Zander (age 7), I found it. I found Shauna’s squatter’s rights article that had so touched my birth consciousness in such a way that I never forgot—even though babies, computers, friendships, and time have all marched on. I was already a childbirth educator when I read it, had already given birth myself, and was deeply immersed in birth work and childbearing. However, that doesn’t mean that certain descriptions cannot reach us and grab our attention in new ways. I’m delighted that Shauna gave me permission to publish her article here and to share her insights and experiences in this way!

Squatter’s Rights

by Shauna Marie

Would the new child coming from me be slippery like soap? I rubbed my fat belly. I loved each pound I gained, each craving I had, and every trip to the bathroom. Okay, maybe not every trip to the bathroom. But, I loved this growing baby. Tucked away like a pearl in the sea just waiting to be discovered. I was in a constant state of marvel.

Would I be able to physically do this? No, I don’t mean the labor, nor do I mean the birth. I knew I could do that. I got lost in thought as I planned in my head every moment that would come after my body did the work of labor. The moment would come once my body was ready and the crown of a child’s head pushed itself from me, the moment the child would emerge. That’s what I was planning for; I planned to catch my own baby.

I imagined opening my legs and squatting, I even practiced. I wondered where I’d put my hands, how I would have my legs, and if this little wet creature would be so slippery that I’d drop him or her. In December of 1999 this would be my second birth, but my first time catching a baby.

Like many people from a young age I was led to believe that women didn’t and couldn’t birth outside hospitals. The ones who did were radical or even dangerous. I was led to believe that the birth doesn’t matter, the baby matters. For my own personal sanity, due to cultural birth fear, I had to just come to the conclusion that as long as my baby was okay I could endure anything and that it would all be over soon.

Now rewind a little bit here, because there is something to be said about being at the right place at the right time; or knowing the right person. As a person who now tries to make a difference by being a strong home birth and natural family living advocate, I know who you know can sometimes make all the difference. For some people they just need that connection with real birth; they need to know someone who will talk about what birth really is about from a natural and physiological point of view. Above all people need to be exposed to home birth because it normalizes birth.

I was almost connected at one small point during my first pregnancy, just weeks before my first birth a friend of a friend was having a baby. I asked where she was having the baby at and when. My friend said she was in labor now, and having the baby at home. A jolt of sudden uncomfortableness and worry struck me, “At home! Why?” (Thinking oh my gosh there is no epidural at home!) My friend responded with a rather obvious sounding answer, “Well her mom is a midwife.” “Oh,” I said in an understanding tone. Somehow this made total sense now. If her mom is a midwife then it’s okay for her.

Quickly all home birth thoughts were intercepted with other conversations of non-birth related content. To this day I feel that should have been my contact with home birth. Instead I missed my first calling and just two months later I was induced two weeks before my due date against my own wishes (along with two other women from my OB’s office) to fit into the OB’s schedule.

I learned an awful lot that night. I learned I would never give birth to a healthy baby in a hospital again. I learned that in a hospital it is okay for others to look at your body, touch you, reach into you, and deliver your baby; but it’s not okay for you to do so.

I also learned that birth does matter, not just a healthy baby. Healthy empowered moms matter and instincts are stripped away by technology and birth colliding. This often even includes the instinct to breastfeed.

I was shocked at how disconnected I felt from the waist down. These strangers were in charge of me. There is something about being tied to IV’s and monitors, naked from the waist down in a hospital bed, legs in stirrups, that takes your power away. Even though some one at some point said, “Here comes your baby, look at your baby come” I felt like I wanted to reach over my belly and feel, or catch. I’d seen that in a birth video once –a nurse said something like ‘you can touch your baby’s head and feel’ to a mom giving birth flat on her back. I waited for someone to say that to me, but no one did.  Be it because of hospital policy, or be it because of shame, it was a no-no to touch or even catch what was mine. I felt so disconnected as I tried eagerly to see over my belly, knees being held up to my ears by three sets of hands to the chants of, “Push, push, pushhh…. good girl.”

I wondered so much about just staying home. I had what I thought was an unexplainable and unfounded desire to hibernate in a dark corner like an animal.

Around the same time that I got pregnant with baby number two I heard a doctor on television actually say that women are physiologically unable to catch their own babies. Already committed to having a home birth that comment further sealed the deal. I was catching my own baby this time. Not only do I dislike someone telling me that I can’t do something, I didn’t believe a woman would let her baby just fall to the floor (many mammals are born that
way though). Surely even if a woman didn’t squat with intent to catch her baby the child would be born slipping onto bed or floor without assistance or harm. My research lead me to discover that women have given birth effortlessly while in comas, unassisted and unmedicated. We’ve all heard the stories of scared teens giving birth suddenly, alone in a bathroom. The body just gives birth when it’s time. Not to mention National Geographic taught me from a young age more than just that women in tribes go topless; they also sometimes give birth to babies unassisted and catch them.

Shauna’s eighth baby, born into her hands this summer.

I was also somehow sure a woman could give birth in total control; in control of her thoughts, feelings, and use of good judgment. I was no longer buying into the stereotypical out of control agony portrayed in movies. I didn’t know, but I deeply believed a woman giving birth, if allowed, could totally be in control and instinctively know how to give birth.

I figured that squatting would give me the best angle to catch my baby. Being in a squat, on bent knees, or even on all fours is clearly the most natural and easiest way to birth a baby. Squatting has roots in ancient history as far as birth goes back. It is only within the last 100 to 150 years, since physicians took control of birth, that women have been required to have babies laying their backs in the lithotomy position. Lying on the back (or semi lying) has obvious benefits from the doctor’s perspective as it provides a good view and way to manually remove a baby, as well as use a scalpel to cut a wider opening to the vagina. The use of gigantic tongs (forceps), vacuum suction extraction on the baby’s head, and even manually pulling on the baby’s head have all been routinely practiced by physicians.

Elizabeth Noble, author of Childbirth with Insight, states, “Women who squat for birth can generally deliver their babies without any manual assistance at all. Gravity and the free space around the perineum allow the baby’s rotation maneuvers to be accomplished spontaneously.”

There are vast differences in giving birth in a squatting position rather than lying down. Well over half of all the births in this country currently involve some type of surgical or operative procedure such as; cesarean section, episiotomy, vacuum extraction, or the use of forceps. These interventions and their accompanying risks could be avoided if women would just adopt a squatting position for birth. Aside from working with rather than against the body and gravity the birth canal depth is shortened during a squat, and the pelvic diameter is increased. In fact just the simple act of squatting can open a women’s pelvic outlet by up to 28 percent. All of these benefits can shorten the second stage of labor and the need for interventions. Squatting also reduces the risk of tearing. Dr. Michel Odent writes in Birth Reborn that, “This position assures maximum pelvic pressure, optimal muscle relaxation, extensive perineal stretching, and minimal muscular effort. It also provides the best safeguard against serious perineal tears.”

Routinely birthing moms are put on their backs or reclined in beds which center the mother’s weight on her tail bone, narrowing the pelvic outlet and compressing major blood vessels which reduce proper circulatory function. This in turn reduces oxygen to the baby and to the uterus making contractions less productive and more painful. Less oxygen to the baby signals distress in the infant, which if in a hospital could cause a whole round of interventions. Combine an oxygen deprived baby with a mother trying to push uphill with a baby that cannot move into a good birthing position because of restricted pelvic room, and ultimately you have mothers who are very good candidates for a birth that must be forcefully assisted by forceps, vacuum extraction or the ever so common routine C-section. The Centers for Disease control states on their website that cesarean sections are now at 32.8% in North America (2011).

Delivery of the after birth in an upright position also has clear advantages. When the placenta isn’t compressed there is less chance of blood pooling up and creating large clots, and gravity aids in placental expulsion.

When the day finally came for me to catch my baby I talked myself through the contractions. I told myself I could do this. I said over and over I can do this, because as a pregnant mammal it’s what I was put here to do. When I felt it was time I squatted over a mirror and saw the crown. I told myself to enjoy this moment, not everyone gets to catch their own baby, and I didn’t want to miss one second of this experience. I swirled the thick wet black hair that was presenting around in a circle with my fingertips. Any and all pain was gone, it was amazing. I focused on this new life that was unfolding from my body. I waited for contractions and I let my body do the work without forceful pushing or feeling agony. When the baby slid into freedom and the room was engulfed with newborn smells and newborn cries I cried out, “It’s a boy, it’s a baby boy!”

The impact of that birth was powerful and amazing; so much so that I have caught five more children from my body since then. There is a saying about the “thrill of the catch,” and midwives and doctors know this. It’s intoxicating and it’s very powerful to catch a baby.

So much harm has been done to cloud the process of childbirth. Birth isn’t just about babies, it’s about mothers too. It’s about how they work together. Catching your own baby puts you focused on your birth, and without trying you take the control and suddenly you feel and know what you need to do. Focusing on the important task of birth made an impact on me a very positive way as a mother. True freedom over my body gave me independence, confidence, and self-control.

Not every woman may want to catch her own baby, but every woman should be encouraged to do so, or at the very, very least know they can if they do wish to. Most women I have spoken with actually say they have never even thought of it.

The state of birth in this country lies squarely in the hands of birthing women. Until we start demanding more respect and more variation in our birthing options we have no one to blame but ourselves. We must first credit ourselves with being able to birth safely the way nature intended before anyone else will give us that credit. The seeking out of safe and natural birth options will slowly continue to influence and change how birth is perceived.

There are specialized hospital beds that can be converted in a way that women are more upright. If you will be giving birth in a hospital request them, demand them. Hill-Rom makes such a bed; the Affinity Three Birthing Bed aids a woman to side lie, squat, kneel, sit, and lean in various positions. It has a labor bar and position controls that are quite impressive. The bed can be lowered or raised up, down, back, and forth

There are birth balls, birth bars, and birthing stools that can aid in more natural upright positions in whatever birth setting you choose. There are showers and tubs to soothe a mother.

I share my experiences with catching my own babies, and have even shared very private birth photos and even one video with others in the past; because I have been told by so many women it has empowered them. I also hear from lots of women who say how strong both me and my legs must be to squat down like that. I assure that it’s not my legs that are strong; it’s my heart and my passion, and the willingness to open up and catch what is mine.

Shauna Marie is happily married to the man of her dreams. They live in the Midwest where they juggle eight energetic children while homeschooling and developing upon a one acre hobby farm of veggies, fruits, chickens, geese, and the dream of a dairy goat. She blogs about her life at Life with Eight Kids. Shauna is very passionate about family with an emphasis on childbirth and healthy, happy moms and babies.

Postscript: Shauna’s most recent birth story, excerpted below, is an excellent description of a squatting birth!

I was standing there in the still of the labor lull a rush of hormones hit me and the baby’s head slipped fully into the birth canal. I squatted down instinctively. I was then super indecisive: I flip-flopped between on my hands and knees to squatting, then squatting with one leg up and one leg down, then a leg up on the side of the tub, then standing upright, then a squat-stand and finally then back to the other positions all over again. This baby was going to start to seriously crown in a big way and I had no idea where I wanted to be! Having done this so many times I had way too many choices in my head and I knew what they all felt like. Later Ricky told me he got nervous that I was moving around so much in the tub; he was worried I’d slip and fall. I however felt firmly planted like a rock. I told him later I felt like I had sticky gecko pads on my limbs and slipping never crossed my mind.

Our baby was starting to crown as I finally squatted down low with one leg higher than the other (I was out of time to change things up. I’ll just squat and do it the same ‘boring’ highly effective way I always do it I thought lol.) I used some counter pressure on her velvety head to help ease her head out but it wasn’t really needed and a painless contraction inched her head fully out.

via Life With Eight Kids: Beatrice’s Unassisted Birth Story (half hour labor and birth -with extra info on my favorite topics of vernix, cord cutting, and not pushing).

Related Talk Birth resources:

Active Birth in the Hospital

Spontaneous Birth Reflex

How to Use a Hospital Bed without Lying Down

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


(Elizabeth Noble, Childbirth with Insight, 78). See also Golay, J., et al., “The squatting position for the second stage of labor: effects on labor and maternal ad fetal well-being,” Birth 20(2) (June 1993):73-78.

Postpartum outcomes in supine delivery by physicians vs nonsupine delivery by midwives.Terry RR, Westcott J, O’Shea L, Kelly F. J Am Osteopath Assoc. 2006 Apr;106(4):199-202. Conclusion: Nonsupline positions during labor and delivery were found to have clinical advantages without risk to mother or infant. Enhanced maternal outcomes included improved perineal integrity, less vulvar edema, and less blood loss.

Dr. Martha Collins D.C., Pregnancy and Chiropractic

Russell JGB. Moulding of the pelvic outlet. J Obstet Gynaec Brit Cwlth 1969;76:817-20

Squatting can enlarge the pelvic outlet up to 28 percent (Russell, J.G., “The rationale of primitive delivery positions,” Br J Obstet Gynaecol 89 (September 1982):712-715

Paciornik M; Commentary: arguments against episiotomy and in favor of squatting for birth. Birth 1990; 17(2): 104-5.

The total U.S. cesarean delivery rate reached a high of 32.9% of all births in 2009, rising 60% from the most recent low of 20.7 in 1996 Martin JA, Hamilton BE, Ventura SJ, et al. Births: Final data for 2009. National vital statistics reports; vol 60 no 1. Hyattsville, MD: National Center for Health Statistics. 2011.

Marion Sousa writes: “[Squatting shortens and widens the pelvic outlet.” (Childbirth at Home. New York: Bantam, 1976 in Judith Goldsmith, Childbirth Wisdom from the World’s Oldest Societies, 153)

Several studies have reported that in the majority of women delivering in the lithotomy position, there was a 91% decrease in fetal transcutaneous oxygen saturation (Humphrey et al. 1973, 1974)

Robertson, Empowering Women: Teaching Active Birth in the 90s, (105)

Dr. M. Odent Birth Reborn, (101)

Hill-Rom Affinity Three Birthing Bed educational video and website. Online user manual

Guest Post: Paid Menstrual Leave?

Paid Menstrual Leave – it’s time!  

by DeAnna L’am. Reprinted with permission.

A Russian lawmaker has asked parliament to give women two days paid leave a month when they menstruate… Mikhail Degtyaryov, a member of the nationalist LDPR party, wrote on his website “During that period (of menstruation), most women experience psychological and physiological discomfort. The pain for the fair sex is often so intense that it is necessary to call an ambulance”… Scientists and gynecologists look on difficult menstruation not only as a medical, but also a social problem…” ~ Standard Digital, August 2013

Fascinating! Lets look at how good things are turned on their heads, yet again, to result (unsurprisingly) in women’s dis-empowerment.

Indeed, a paid monthly Menstrual Leave would be an honoring, empowering option for women worldwide. Yet proposing it for all the wrong reasons diminishes us, and our cyclicity, to “a social problem.”

Campaigns have been initiated over the years under the guise of empowering women, which ended up diminishing, dis-empowering, and ultimately killing us! Marketing guru Edward Bernays was hired in 1928 by an American Tobacco Company president to increase sales of Lucky Strike cigarettes. Sigmond Freud’s work was utilized to expand understanding of ‘What Women Want’ and capitalize on it for marketing purposes.

Realizing that women were motivated and empowered by the suffrage movement, Bernays manipulated a real need – into a persuasive sales tactic. He hired women to march in the Easted Sunday parade smoking what he cleverly named their “Torches of Freedom.” Bernays succeeded overnight: he persuaded women to pick up an unhealthy habit, and commit to spending their hard earned money for years, by equating cigarettes with personal freedom and equality to men. Smoking among women exploded into unparalleled heights. Their personal freedom and equality to men continued to suffer…

Similarly, women were encouraged by manipulative campaigns to start giving birth in hospitals after countless generations of home births. Many new hospitals were built as a result of Second World War, to accommodate the staggering number of injured soldiers returning from battle. It took a few years for most hospitals to empty, as wounded soldiers either recovered or died. Faced with many large vacant hospital buildings and idle staff, administrators procured and released ad campaigns, which sinisterly manipulated women to believe that giving birth at home was ‘primitive’ and unsafe, while birthing at the hospital was promoted as safer, ‘modern’, and a highly intelligent choice.

Women bought into these campaigns, and many others like them, all over the world. They started smoking and felt ‘glamorous’. They started giving birth in hospitals and felt ‘modern’. They started using disposable menstrual products and felt ‘progressive’ and ‘in control.’ All along they have also been developing an array of respiratory diseases and dying of lung cancer; They have been cut open in cesarean sections (1 in 4, to accommodate doctor’s convenience); They have reached an all-time-high maternal and infant mortality rates following hospital birth; And they have been contributing to our planetary ecological crisis by damping 12 billion “feminine hygiene” products into landfills every year, in the U.S.A. Alone!

And here we are: In the midst of a pioneering worldwide movement of women reclaiming menstruation as the heightened state of awareness for which it was recognized in all indigenous cultures; In the process of inspiring women to honor their menstrual blood and their body’s needs, by taking time off to rest and renew themselves on the first day of their period — we are faced with a legal initiative which is both revolutionary and reactionary at the same time!

Wouldn’t it be revolutionary for the workplace to grant Paid Menstrual Leave to women? Wouldn’t we feel validated in our need for rejuvenation, honored for our body’s monthly regeneration, and empowered by the cultural acknowledgment of our rhythm?

We certainly would, if it weren’t billed as a response to “a social problem” of the “fair sex” who suffers “psychological and physiological discomfort.” Our menstrual cycle is neither a social problem nor a mere discomfort. Our menstrual flow is profound and life affirming work performed monthly by our bodies. We need to rest and renew in response to it, or we develop symptoms labled “psychological and physiological discomfort” by our culture (and frequently by us, too…)

Cigarettes, hospital births, and disposable menstrual products were sold to us through clever manipulative tactics, yet we never needed them… We DO NEED Paid Menstrual Leave!

We have stopped smoking in drovers. We have been reclaiming home births, and have started using sustainable menstrual products (such as cloth pads, sea sponges, and menstrual cups). It is time to claim for ourselves, and demand from our culture, a monthly PML to replace PMS!

PML (Paid Menstrual Leave) is the deeply deserved rest our body, mind, and spirit need monthly. In its absence, our body screams in PMS pain, and will continue to do so until we listen to its needs and honor them.

This is a call for action! Lets unite in demanding legaly-bound Paid Menstrual Leave — not as a patronizing gesture designed to send us home for being a “social problem.” But rather as the honoring of a deep need, which springs from our depth, to renew our body, our emotions, and our spirit – monthly – while preparing for another cycle in the ever turning wheel of our lives.  

© 2013, DeAnna L’am, Red Moon – Cycles of Women’s Wisdom™

DeAnna L’am, (B.A.) speaker, coach, and trainer, is author of ‘Becoming Peers – Mentoring Girls Into Womanhood’ and ‘A Diva’s guide to Getting Your Period’. She is founder of Red Moon School of Empowerment for Women & Girls™ and of Red Tents In Every Neighborhood – Global Network. Her pioneering work has been transforming women’s & girls’ lives around the world, for over 20 years.

DeAnna helps women & girls love themselves unconditionally! She specializes in helping women make peace with their cycle; Instructs Moms in the art of welcoming girls to empowered womanhood, and trains women to hold RED TENTS in their communities. Visit her at:

Disclaimer: I am a Red Moon program affiliate. However, the only affiliate link in this post is the one included here!