Book Review: Giving Birth with Confidence

Jul6

Since I recently wrote a post inspired by a quote from The Official Lamaze Guide: Giving Birth with Confidence, I figured it was high time that I share the review I wrote of the book! The review was originally written in 2007 for CfM News.

The Official Lamaze Guide: Giving Birth with Confidence. By Judith Lothian & Charlotte DeVries. Published in 2005 by Meadowbrook Press (307p), $12.00. ISBN: 088166474X

Reviewed by Molly Remer, MSW, CCCE

Very few pregnancy books deliver the message that we think pregnant women need to hear most: Birth is a normal and natural part of life….We believe deeply that birth is a process you can trust just as millions of women before you have. This belief isn’t sentimental; it’s based on our thorough understanding of the physiologic birth process and research that confirms interfering in that process is harmful unless there is clear evidence that interference provides benefits.

So begins an opening section of the book The Official Lamaze Guide: Giving Birth with Confidence. The degree to which the book accomplishes its simple message can be summarized with a simple review: Excellent! The Lamaze Guide is digestible and reasonable for busy people to manage at less than 300 pages of text and it contains a simple, profound, and elegant message that women in the U.S. desperately need to hear.

The book begins with defining normal birth as “…a normal birth is one that unfolds naturally, free of unnecessary interventions.” It then briefly explains the history of birth and how and why normal birth is not actually the norm in our culture. The authors then clearly address the following areas in one chapter each: early pregnancy; choosing a caregiver and birth site; middle & late pregnancy; preparing for labor and birth; the simple story of birth; keeping birth normal; finding comfort in labor; creating a birth plan and a baby plan; communication and negotiation; greeting your newborn; and early parenting. The authors are clearly very supportive of midwifery and the Midwives Model of Care (though it is not referenced by name) as well as of the benefits of a doula in the birthing room.

The book is framed in the context of Lamaze International’s powerful foundation, the Six Healthy Birth Practices:

The book is also guided by Lamaze’s comprehensive and lovely philosophy of birth:

Birth is normal, natural and healthy.
The experience of birth profoundly affects women and their families.
Women’s inner wisdom guides them through birth.
Women’s confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.
Women have the right to give birth free from routine medical interventions.
Birth can safely take place in homes, birth centers and hospitals.
Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

After effectively bolstering the confidence of women in birth, The Lamaze Guide concludes with several useful appendices. The first is the excellent tool “Effective Care in Pregnancy & Childbirth: A Synopsis.” Though this information is easily available on the internet (see www.childbirthconnection.org), I find that many parents do not come across it on their own. How powerful to have it included for easy reference of indisputable evidence based practices. The Mother-Friendly Childbirth Initiative is included in another appendix as well as the always excellent text of The Rights of Childbearing Women. I was delighted to see all of these powerful documents in one place—and, in the hands of consumers who need to be aware of them.

This book is a refreshing presence on the shelves of my local bookstore (yes, there is only one retail book shop in my community and The Lamaze Guide is the only “alternative” birth book stocked in the store!). As I read the book, I kept nodding along and wishing it was in the hands of each pregnant woman in my community. Lamaze has a “name recognition” that gives this book the potential to have a wider and broader impact than other alternative birthing books which, though brilliant contributions, may only end up in the hands of “the choir.” The Lamaze Guide is written in such a matter-of-fact and comforting tone that I cannot see it being off putting to the average consumer as having “hippie” language or “extreme” ideas. The blueprint for normal birth that the book lays out is extreme compared to the standard practices at most hospitals, but the way in which the information is presented opens doors of communication, understanding, and exploration as well as providing the evidence basis to back normal birth. I would not hesitate to lend this book out as it will not scare anyone away with “weird” ideas. With the other books in my personal library, I have to carefully consider my audience before choosing which book has the right style and blend of information—not this one! It is good for everyone with its open, simple message. It is a good addition to lending libraries, personal libraries, to give as a gift, or to recommend to others. The Lamaze Guide is straightforward and clearly written with an unabashedly honest and truthful message of what normal birth is and how it can either be supported or undermined.

My only critique of the book is that in contains no real acknowledgment of the several other well known and effective organizations that train and certify birth educators (other than Lamaze International itself). Conspicuously absent from the resources pages are any of these other organizations.

In conclusion, The Lamaze Guide is a source of information that women need to have and a message that women need to hear. I think Giving Birth with Confidence accomplishes its purpose skillfully and has the potential to be a transformative influence. I hope women read it, absorb it, and begin to Celebrate Birth!

Birth Feelings

Jul5

Those who push themselves to climb the last hill, cross the finish line, or conquer a challenging dance routine often report feelings of euphoria and increased self-esteem…women who experience natural birth often describe similar feelings of exaltation and increased self-esteem. These feelings of accomplishment, confidence, and strength have the potential to transform women’s lives. In many cultures, the runner who completes the long race is admired, but it is not acknowledged that the laboring woman may experience the same life-altering feelings… —Giving Birth with Confidence (by Lamaze International)

This is so true and so often overlooked or diminished in our modern birth culture. Comments such as, “you don’t need to be a martyr” or, “would you get a tooth pulled without medication?” or, “there are no medals for natural childbirth,” or, “in the end, all that matters is a healthy baby!” fail to acknowledge the transformative power birth holds in women’s lives. I think these comments (and the many others like them) often come from one of two places: the first being a place where birth did NOT hold transformative power in that speaker’s life (and, this is something I have to acknowlege as real—birth can be transformative, but it isn’t always, AND it can be a powerful influence in a negative sense as well [i.e. a woman who really did suffer during birth and/or was abused and/or experienced any variety of traumatic things, whether or not we, the listener, “know” that some of those things could have been avoided with different choices, etc., etc.]).

The second place, I believe is one that many medical care providers come from in that they do not want to look at the reality of the importance of birth because then they would have to confront the reality of how they may have interfered with or “ruined” birth for so many women. Perhaps that isn’t true or is a “bad attitude” or judgment on my part coming through, but that is how it looks to me from the outside. It is easier to dismiss natural birth advocates as “zealots” and mothers who wish to birth unmedicated as “martyrs” than to critically examine the institution’s birth practices and policies.

Related to the initial quote, here is a previous post about Birth and marathons…

As a side note, I really like the book I quoted—Giving Birth with Confidence—as a good “basic” birth book for pregnant women. I’m glad it is usually available in “conventional” bookstores as many other birth book treasures are not!

A Fantasy

Jul2

Several years ago, I requested permission to reprint an essay from La Leche League International’s book Learning a Loving Way of Life. The essay is a birth/breastfeeding parody and I realized I’d never shared it here (please do not reprint without permission!).

A Fantasy

By Melanie Axel-Lute

Time: The not-too-distant future.

Scene: A Doctor’s office.

Doctor: Yes, Judy, the test is positive—you are going to have a baby. Now I’ll just give your instructions for the artificial womb.

Judy: Well, doctor, I have been planning to be pregnant.

Doctor: (surprised) Oh! I do have a few patients who say they’d like to try that. It’s very difficult nowadays, though, so many pressures on the modern woman. Of course, I’m all for it. It is the best thing for the fetus, though the new artificial wombs are very good. Now—have you done any preparatory exercises?

Judy: I didn’t think about that.

Doctor: You’ll find it very hard then, especially at first. I usually have my patients do several months of sit-ups and leg-lifts.

Many women say they’d like to try being pregnant, but they have to give it up in a few weeks. They have morning sickness and are very tired. I always recommend that anyone with nausea switch to the artificial womb.

Being pregnant takes a lot out of a woman. You’ll need your strength for the baby. And you don’t seem very big through the pelvis. You may not be big enough to be pregnant. I’ll have to test your amniotic fluid to see if it’s adequate.

It’s very hard to judge the weight of the fetus when it’s in a human womb, too. Some women worry whether it’s gaining enough weight. I always like to start intrauterine feedings at about two months.

Now, how long had you planned to be pregnant?

Judy: I planned on letting the baby be born naturally.

Doctor: (shocked) Oh, my! That’s really not necessary, you know. Most of my patients go for about three months—that’s the critical period—although a few stick it out for six. More than that is definitely unnecessary.

Have you thought about what people will say? Most people don’t mind seeing a woman pregnant with a tiny fetus, but when it gets to be more than six months—well! It’s just very unusual.

Besides, have you thought about how tied down you’ll be? You’ll have to take that fetus everywhere. Women really need to get out alone once in a while, you know. I feel that most women who prolong pregnancy like that do so for very selfish reasons.

Judy: I want to go ahead with it anyway.

Doctor: (patronizing) Well, I guess I just have to let you try it for a while and see how it goes…

This essay was reprinted with permission from the book Learning a Loving Way of Life, published by La Leche League in 1987. The essay reprinted was originally written in 1978. LLLI is the world’s foremost authority on breastfeeding. For a wealth of breastfeeding information, support, resources, or to purchase a copy of the book referenced, visit: www.llli.org.

Practical Ways to Enhance Knowledge for Birth

Jun24

Related to my previous posts about information vs. knowledge, I want to share a couple of ideas from an article I wrote some time ago for the International Journal of Childbirth Education. Obviously, I don’t have all the answers, but these are some of my ideas/tips about transferring information into knowledge that will be meaningful to parents when their birthing time comes:

Use “The Ice Cube Minute” exercise from Family-Centered Education: The Process of Teaching Birth. In this exercise, couples hold an ice cube in one hand for one minute and see what coping measures spontaneously arise for them. I do this exercise fairly early in my class series, before we’ve done a lot of formal talking about coping measures. It is very empowering for couples to discover what tools and resources come from within as they try the ice cube minute.
To illustrate the potency of the mind-body contraction, practice two pretend contractions while holding ice. One contraction has an accompanying “stressful” paragraph read with it (“your body fills with tension…it hurts! Oh no!”) and the second contraction has a soothing paragraph read with it (“you greet the wave….it is YOUR power….”). This illustrates the fear-tension-pain cycle viscerally.
Use a five minutes series of birthing room yoga poses to begin the class—birth happens in our bodies, not our heads. Practicing the poses opens space to simultaneously discuss and practice: squatting, pelvic rocks, optimal fetal positioning ideas, healthy sitting, pelvic floor exercises, leg cramp prevention, back pain alleviation, and more.
Role playing cards-—talk through various scenarios. I’ve found that couples are more receptive to talking through the cards than actually getting into a role and playing it through. The activity that seems to work best for actual role play is the labor simulation series available on the Transition to Parenthood site.
Values clarification exercise—participants cut out values from a list and arrange them in a grid to help them figure out if they are in alignment with each other and with their caregivers.
Leg stretch exercise to explore the use of vocalizations and other coping mechanisms during labor.
Ask plenty of open ended questions that stimulate discussion and ideas, “what have you heard about XYZ?” or “what is your experience with…?”
Use birth art processes to “switch” parents from linear, logical, left-brain thinking into the right-brain mode they will also enter in “laborland.”
Media portrayals of birth—show two contrasting clips, such as a birth from a popular TV show (I often show Rachel’s birth from the show Friends) paired with an empowering birth from a film like Birth as We Know It and then have students discuss the two. Sometimes this more clearly brings into focus the influence of our culture on birth practices than a simple discussion does. Since I originally wrote this, the film Laboring Under an Illusion was released which does exactly this—contrast media portrayals of birth with how birth can be. It is a great resource for birth classes.

In classes, I also incorporate the idea of mother-baby symbiosis through:

The use of affirmations—“my baby and my body work in harmony to make birthing easier.”
A discussion of cardinal movements with an emphasis on how the baby moves to help itself navigate the pelvis (thus, helping you have a smoother birth).
Visualization exercises that encourage “seeing” and connecting with the baby while in the womb.
“Belly Mapping” to get a sense of the baby as a person positioned in the uterus. Talking about what baby is like in the womb—when does it kick more, when is it quiet, does it like music, poke you back with you touch it, etc.
Impressing upon participants that it is not selfish to want both a good birth and a healthy baby (I actively challenge statements about, “well, in the end, all that matters is that the baby is healthy”). Laboring women have a basic right to humane care, which supports both a happy, satisfied mother and a healthy baby. I use examples during class to show how these are intertwined—for example, a stressed, unhappy, unsupported, tense mother may have a baby with heart decels and accompanying distress.

I try to build a sense of confidence through:

Opening each class with a brief series of “birthing room yoga” poses to help couples become comfortable using their bodies and moving from “head space” into “body space.” Birth is a physical process and I am convinced that it is vital to include physical movement during every class to bring that message home. Additionally, the poses I teach can all be used while in labor (thus, building confidence in coping “tools” for labor).
Emphasizing active birth—freedom of movement through labor helps baby rotate and descend and helps mother feel more comfortable.
Encouraging active birth on all levels: First, the physical level–being active during the actual physical process of birth. Second, the mental level–mentally engaged with labor. Third, a cultural level—a perspective that sees women as active birthgivers, not victims of birth. Birth is something women do, as opposed to something that “gets” them.
Giving couples plenty of time for hands on practice of labor support and coping measures. I have a personal motto for classes of, “talk less, learn more.” Practicing support tools in class helps them develop a sense of confidence in having a well-stocked toolbox for labor, instead of being a victim of pain.

How Do Women Really Learn About Birth?

Jun16

“I usually claim that pregnant women should not read books about pregnancy and birth. Their time is too precious. They should, rather, watch the moon and sing to their baby in the womb.” –Michel Odent

Related to a previous post about the difference between information and knowledge, I have been pondering how women really learn about birth. Where does birth knowledge they can really use when they need it come from? Is it from birth classes, reading, or from other sources? Though I teach birth classes and believe that childbirth education has important value, I continue to return to thought that what women truly need to give birth does not come from (traditional) classes and it doesn’t come from books either.

Ever since I posted the above quote from Michel Odent on my Facebook page, I have been reflecting back to my pregnancy with my own first baby. Personally, I love books–-of all sorts-–and reading is the top way for me to learn about anything. I think some of the best preparation I did before having my first baby was to read and I always give a recommended reading list to my clients. And, while I “hear” the sentiment in the quote and honor it, my personal opinion is that in our current birth culture it is nearly impossible to go into birth just planning to “go with the flow” and let labor unfold without expectation (if you are birthing in the hospital that is—because the hospital is FULL of expectations and those will often run right over your flow).

When I was pregnant the first time and approaching my first birth, I was hungry for birth information and keenly felt the mystery and unknowableness of the challenge I was about to face. I described it as feeling like I was preparing for the biggest test of my life, but without knowing what the test was. So, how did I learn what I needed to know about giving birth? AND, perhaps most importantly, what had I learned before birth that actually spoke to me while in labor? What did I use and how did I learn about that? Obviously, women are different and have different learning styles and each birth is different, but reflecting on these questions, several things arise as most helpful for me in real preparation:

Other women’s experiences—these were frequently what floated through my head during labor and were what I drew on for information and guidance, not “technical” childbirth books, but the stories and opinions and reflections I had read in birth stories and from the participants of the newsgroup misc.kids.pregnancy.
Birth art—I created a series of needle felted birth goddess sculptures during my pregnancy that had a “message” for me (that what I needed to give birth—that wild, intuitive knowledge—was already inside me).
And yes, reading (and to some extent, classes). I didn’t necessarily use or remember things that I’d read (other than other women’s “voices” through birth stories), but reading definitely helped me prepare—so, while I was not necessarily conscious of book or class-knowledge when I was actually in labor, I was informed by it, yes. During all my reading what I really wanted to to figure out and know was, how am I going to do this? This is the same question that most women who come to my classes have (and my answer is really, “you just will”). The books that were of most value to me were Birthing from Within and An Easier Childbirth. These were the books that had “right brain” lessons to share, even though it was the “left brain” books that I “studied” harder.
Yoga—I spontaneously adopted poses used in prenatal yoga during my first labor without even knowing it was “prenatal yoga.” It was an example of how the knowledge already existed inside my body and spontaneously arose when given the space to do so. I also used yoga poses during my other births—not consciously (“I think I’ll try child’s pose now”), but spontaneously and instinct-driven.
My blessingway experience/memories—particularly the chant Woman Am I, which I hummed over and over again during my first labor.
Voice—talking to myself (inside my head or our loud), verbally coaching myself.
My husband—his presence just there with me. I felt like we were one person. This isn’t something I feel like you can “train” for. It too was naturally arising and just pure.
Holding a fused glass touchstone and having my favorite pillow (in my third labor, it was holding my goddess of Willendorf pendant).

For me, it all came down to FREEDOM and space for me—I was not in an institutional setting, I was in my own “nest” and that was very key for letting my own body’s wisdom unfold and find expression.

——

A powerful pre-birth lesson in my body’s wisdom actually came from an assassin bug (of all things!). Assassin bugs have very potent, poisonous bites (and in some countries carry hideous diseases). During my first pregnancy I was bitten multiple times in the night by one of them. I had bites on my face (lip) as well as in a row on my arm. The bites caused swelling, ongoing stabbing pain, and joint aching (as well as intense palm-of-hand and sole-of-feet itching when they first occurred). I turned this into a practice experience for myself in coping with labor—figuring that, like labor, this was something uncomfortable and out of my control, but that would eventually pass and that my body would take care of without my needed to actively do anything about it. The stabbing pain was also intermittent (like a pulse), so I thought that was good practice too. I practicing “softening” around the sensations and “being” with the discomfort. I reminded myself that my body knew what to do and that it would heal itself. And, guess what? It did. Each day as the bites healed, I would marvel, “look how much my body knows! Look what it can do without me even knowing what or how it is doing.” Of course, it took several days of stabbing and aching pain for this process to occur, whereas my first labor involved only 5 hours of intense sensation as well as several preceding hours of totally manageable sensation and my subsequent labors only involved 2 hours each of fairly intense sensation. This experience in watching my body take care of itself using its own inherent wisdom was a potent (and unexpected) lesson for me in approaching my first birth.

150 Word Birth Story

Jun11

Birthing Magazine had a contest recently involving birth stories in 150 words. I edited my second son’s story down and submitted it and it was published in their summer issue. I wanted to go ahead and share the super-abbreviated story of Z’s birth here also:

Open channel
Feeling a familiar sharper edge to my contractions, I woke my husband and got my birth ball. The contractions suddenly picked up to one minute apart. I hung on my husband during contractions and felt some pressure. I reminded myself to be a clear, open channel for birth. I said, “It’s okay baby, you can come out!”

I dropped to my hands and knees, saying, “This is MAJOR!” I talked myself down out of feeling out of control with an ongoing chant of, “It’s okay, I’m okay, it’s okay.” I pushed a little and my water broke.

Zander’s head was fully crowning as our midwife came in. I pushed him out and as I held him, I saw that he was a boy. I could barely believe that after two hours of labour, my baby was here! Zander weighed nine pounds, two ounces.

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The much longer version of his birth story is here.

The benefit of participating in the contest is that I discovered what a super-cool resource Birthing Magazine is. It has TONS of great content and I’m excited to read the whole issue!

The Birth-Breastfeeding Continuum

May28

Birth professionals have long been aware that there is a connection between birth and breastfeeding, but in recent years experts are making this link more explicit and the inextricable nature of the two experiences is becoming clearer. Birth and breastfeeding exist on a continuum. They are not discreet events. As speaker and author Dia Michels says, “we need a new word—birthandbreastfeeding.” Human women are mammals and the same things that disrupt bonding and breastfeeding for other mammals also apply to women. Darkness, quiet, no disruptions/interruptions, safe, upright, mobile, easy access to food and drink as they choose….these things support healthy births for female mammals! In brief, a normal, healthy, undisturbed birth leads naturally into a normal, healthy, undisturbed breastfeeding relationship. Disturbed birth contributes to disrupted breastfeeding.

New mothers, and those who help them, are often left wondering, “Where did breastfeeding go wrong?” All too often the answer is, “during labor and birth.” Interventions during the birthing process are an often overlooked answer to the mystery of how breastfeeding becomes derailed. An example is a mother who has an epidural, which leads to excess fluid retention in her breasts (a common side effect of the IV “bolus” of fluid administered in preparation for an epidural). After birth, the baby can’t latch well to the flattened nipple of the overfull breast, leading to frustration for both mother and baby. This frustration can quickly cascade into formula supplementation and before she knows it, the mother is left saying, “something was wrong with my nipples and the baby just couldn’t breastfeed. I tried really hard, but it just didn’t work out.” Nothing is truly wrong with her nipples or with her baby, breastfeeding got off track before her baby was even born!

Problems with breastfeeding often start before baby is born. According to Linda Smith, BSN, FACCE, IBCLC, co-author of the book Impact of Birthing Experiences on Breastfeeding (2004), birth practices that impact breastfeeding include:

Mechanical forces of labor (positioning of baby, positioning of mother, etc.)
Chemicals (drugs) used in labor
Injuries to mother or baby
Treatment of mother during labor
Treatment of mother after birth
Separation from mother after birth
Procedures that alter behavior

Linda Smith also notes that a mother’s confidence and trust in her body’s ability to give birth is related to her confidence in her body’s ability to breastfeeding. There are several birth related risk factors for breastfeeding problems (please note that not all babies with risk factors will actually have problems):

Induction of labor
Epidural and/or narcotic medications
Cesarean
Instrumental delivery (forceps or vacuum)
Post birth suctioning of baby’s airway

Additional procedures that affect baby’s ability to breastfeed if they are done before baby’s first breastfeeding include:

Separation of mother and baby for any reason.
Weighing and measuring
Vitamin K injection
Metabolic tests
Circumcision
Infant hypothermia

According to the Academy of Breastfeeding Medicine (www.bfmed.org), “unmedicated, spontaneous, vaginal birth with immediate skin-to-skin contact leads to the highest likelihood of baby-led breastfeeding initiation.” Immediate skin-to-skin contact restores the biologic continuum begun during conception.

When I was in graduate school, one of my professors used the following analogy to make a point and I now use it with my own students:

There is a river running through town. Daily, emergency workers are called upon to rescue people from the river who have fallen in and are floating downstream drowning. Day after day they pull the gasping people back to land until one of the workers suddenly realizes, “maybe we should go see what is happening upstream and try to stop these people from falling in to begin with?”

My professor then encouraged us to always remember to go “upstream” when working in the helping professions rather than only addressing the immediately presenting problem. Childbirth professionals are in an “upstream” position when it comes to protecting the birth-breastfeeding continuum!

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For more about the value of keeping mothers and babies together following birth, check on Healthy Birth Practice Six: Keep Mother and Baby Together – It’s Best for Mother, Baby, and Breastfeeding from Lamaze.

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References:

If my mom were a platypus: what we can learn by studying mammal lactation, presentation by Dia L. Michels, La Leche League of Missouri Conference, November 2007.

Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum. Mary Kroeger and Linda J. Smith, Jones and Bartlett Publishers, Inc.; 1 edition (February 2004). ISBN-13 978-0763724818.

Mother-Baby Togetherness, presentation by Dr. Nils Bergman, La Leche League International Conference, July 2007.

The Power of Touch, presentation by Diane Wiessinger, La Leche League of Missouri Conference, November 2007.

Winning at Birth, presentation by Linda J. Smith, La Leche League International Conference, July 2007.

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This article is adapted from “Celebrating World Breastfeeding Week and the Birth-Breastfeeding Continuum” by Molly Remer, MSW, ICCE, published in the International Journal of Childbirth Education, June 2008.

Film Review: Natural Born Babies

May13

Film Review: Natural Born Babies

South Coast Midwifery, 2009
DVD, 24 minutes, $24.95

www.naturalbornbabies.com

Reviewed by Molly Remer, MSW, CCCE

This lovely short film produced by a midwifery service in California, is a great “ad” for the benefits of homebirth and of midwifery care. Natural Born Babies has a very clean, fresh, and contemporary feel and features a multicultural collection of homebirth families talking about their experiences in front of a white screen. Something that is particularly striking is that some of the people speaking with love and enthusiasm about their midwives and their birth experiences include a cardiologist, an anesthesiologist, and an ER physician!

The first part of the film is titled Interventions and features both men and women speaking about birth, referencing how pregnancy and birth are treated like medical conditions and including a lot of discussion about the prevalence of cesareans. The point is made that, “no epidural can replace human touch.” The second part is titled The Birth Specialists and points out that OB/GYNS are pathology specialists, whereas midwives are trained in normalcy—“we take low-risk women, and keep them low-risk.” Midwives are specialists in normal pregnancy and birth. Because of the film’s emphasis is wholly on out-of-hospital birth and hospitals are critiqued very soundly, hospital-bound couples viewing the film may find that it causes their defenses to rise.

Several of the parents are holding their babies as they speak and a CNM speaks briefly as well (citing both ACNM and MANA). The CNM manages Orange County’s only accredited birth center. I enjoyed the presence of a bio-physicist dad originally from Holland saying, “everyone I know was born at home” and noting that “you give birth the same way you live.” Several of the couples speaking do refer to the father as “delivering” the baby, which is a long-term pet peeve of mine.

Special features include a 10 minute version of the film, an outtakes section, and a look inside the South Coast Birth Center. At the end of the film we see that one of the couples is the director/producer of the film.

Natural Born Babies is a fast-paced film and though it is filmed in a “talking heads” format, it cuts quickly from person to person, thus keeping the viewer engaged. If you are looking for an informative video that is homebirth and midwifery friendly, but that does not include any birth footage, this would be a good addition to your library.

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

Following Your Body’s Urges to Push…

Apr2

Sense and Sensibility is having a blog carnival around Healthy Birth Practice #5: Avoid giving birth on your back and follow your body’s urges to push.

For this blog carnival, I feel like sharing my own personal experiences with following my body’s urges to push. I gave birth to my first son over six years ago in what was the only freestanding birth center in the state (related side note: when I told my landlord that my new baby was born in a freestanding birth center, she said, “oh, so does everyone there have them standing up?”;-D). When I arrived at the birth center, I was surprised to be ten centimeters dilated already. Fortunately, the midwife on duty said, “go ahead and push when you feel the urge,” and went about her business, rather than encouraging me to push simply because I was at ten or exhorting me to push with loud counting and the near-aggression as is so frequently depicted in the media. After some time, I decided to experiment with the “pressure” feeling I’d been feeling for several hours—as soon as I gave a couple of small, experimental pushes like that, my water broke. I stayed on my knees on the floor for some time—head and arms on the bed—and eventually the doctor suggested that I get up on the bed, where I ended up giving birth to my son in a semi-sitting position.

During this birth, I was very sensitive to suggestion and to “being good,” and so when the bed was mentioned, I felt I had no choices even in such a gentle birth setting. I feel if left to my own urges, I would have stayed kneeling on the floor.

With my second son, who was born at home, I was alone with my husband for nearly the entire labor. As I got closer to giving birth, I felt “driven” to my hands and knees where I began to push spontaneously (and again my water broke with the onset of pushiness). It was a very wild and rapid birth and I barely had conscious thought of whether or not I felt like pushing—it just happened! After several pushes on hands and knees, my son eased out where he was received by my midwife after her arrival five minutes prior.

My third son (second trimester m/c), was born at home with just my husband present. My labor was again extremely rapid and I found myself kneeling on the floor in child’s pose. This position felt safe and protective to me, but I finally coached myself into awareness that the baby wasn’t going to come out with me crouched on the floor in that manner. I told myself that just like with any other birth, gravity would help. So, I pushed myself up into a kneeling position and my water broke right away. I crouched forward again—feeling fearful—and then told myself to move upright again. As soon as I was back on my knees, some blood clots emerged. I stood then, with knees slightly bent, and my baby was born.

For me, being nearly alone is the best way to follow my body’s own promptings. I feel it can be difficult to heed our bodies’ own wisdom when other people in the room are encouraging directed pushing or are “cheerleading” loudly. Freedom to move as desired and to push spontaneously according to the body’s own urges is a mother and baby friendly approach to birth.

Some of my other posts about second stage labor include: pushing the issue of pushing; waiting before pushing; and thoughts about pushing.

For more information about spontaneous pushing check out this video from Mother’s Advocate.

And, don’t forget my handout: helpful ways to use a hospital bed without lying down.

Becoming an Informed Birth Consumer

Mar26

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’s The Thinking Woman’s Guide to a Better Birth 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, Bradley, 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.
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.
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:

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!).