Cesarean Awareness Month

Apr10

April is Cesarean Awareness Month! My favorite resources about cesareans are the International Cesarean Awareness Network (ICAN) and The Unnecesarean.

In honor of the month (and in recognition that the national cesarean rate has risen again–to 32.3%), I went back through some of my posts and pulled out some of the things I’ve written about cesareans:

One of my “pet” subjects centers around the question of, “why would someone be upset over a cesarean, at least she has a healthy baby?” and this post partially addresses that: Birth and Apples.

I believe that a cesarean is often an act of personal courage and wrote about this here.

I also wrote about the same in this post on when birth doesn’t go as planned.

And, finally, here is a post I wrote about cesarean trivia.

Book Review: She Births

Apr9

Book Review: She Births: A Modern Woman’s Guidebook for an Ancient Rite of Passage By Marcie Macari
Infinity Publishing, 2006
ISBN 0-7414-3390-7
255 pages, softcover, $23.95
http://www.shebirths.com

Reviewed by Molly Remer, MSW, ICCE

She Births is a book that “goes beyond” the average birth book. It is a particularly good read for mothers having subsequent children—perhaps for a woman who is well read in the physiology and stages of labor and who wants to dig deeper into the emotional and spiritual meaning of giving birth. It is also helpful for first-time mothers, though I felt that there was a lot of content that seemed to assume the reader had already given birth (and was perhaps reading this book to reflect, process, and prepare for future births).

The emphasis of She Births is on childbirth as a rite of passage and as an opportunity for spiritual growth and personal transformation. There is a lot of content that has a very “New Age” flavor. While I personally do not mind—and actually enjoy—this framework, other readers may consider some of the sections to be offputting.

Each chapter ends with a short chapter-topic meditation and several pages of related journaling exercises.

The book contains a higher than average number of minor typographical errors, as well as odd mid-sentence capitalizations, and too-short dashes between ideas. Persistent capitalization of words such as Birth and Spirit were a bit distracting. The book contains a variety of empowering birth stories, but none of them have attribution, making it difficult to identify who was giving birth. (The author? The woman in the previous story?) It was hard to grasp who was the “I” reflecting and sharing in each story.

She Births has several particularly wonderful passages that are well worth quoting and it also has a lovely cover. It is a passionately written book that is very dynamic and “alive” to read. The book is strongly written—the author does not mince words nor attempt to “balance” her perspective and this can be a refreshing approach. She Births also raises thought-provoking questions such as, “The way a society views a pregnant and birthing woman, reflects how that society views women as a whole. If women are considered weak in their most powerful moments, what does that mean?”

—

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

Two Birth Poems

Apr6

I shared these on my Facebook page recently too and as long as I was updating my birth quotes, I thought I’d post the poems as well. They could be good for a mother blessing or blessingway ceremony or just to print up for a mother preparing to give birth, to to one who has just given birth, or to a birthworker (another favorite birthing poem is posted here):

Being Born

by Carl Sandburg

Being born is important
You who have stood at the bedposts
and seen a mother on her high harvest day,
the day of the most golden of harvest moons for her.

You who have seen the new wet child
dried behind the ears,
swaddled in soft fresh garments,
pursing its lips and sending a groping mouth
toward nipples where white milk is ready.

You who have seen this love’s payday
of wild toiling and sweet agonizing.

You know being born is important.
You know that nothing else was ever so important to you.
You understand that the payday of love is so old,
So involved, so traced with circles of the moon,
So cunning with the secrets of the salts of the blood.
It must be older than the moon, older than salt.

—-

Ordinary Miracle

by Barbara Kingsolver

I have mourned lost days
When I accomplished nothing of importance.
But not lately.
Lately under the lunar tide
Of a woman’s ocean, I work
My own sea-change:
Turning grains of sand to human eyes.
I daydream after breakfast
While the spirit of egg and toast
Knits together a length of bone
As fine as a wheatstalk.
Later, as I postpone weeding the garden
I will make two hands
That may tend a hundred gardens.

I need ten full moons exactly
For keeping the animal promise.
I offer myself up: unsaintly, but
Transmuted anyway
By the most ordinary miracle.
I am nothing in this world beyond the things one woman does.
But here are eyes that once were pearls.
And here is a second chance where there was none.

—-

(hat tip to Birth True for posting the Kingsolver poem—Barbara Kingsolver is one of my favorite authors, but I had never read the poem before seeing it on the Birth True blog.)

Birth Quotes and More Birth Quotes

Apr5

Time for my semi-regular birth quotes update post!

“Birth is the doorway for integration of body and mind.” –Gayle Peterson

“Good timber does not grow with ease; the stronger the wind, the stronger the trees.” – J. Willard Marriott

“Most mothers are instinctive philosophers.” – Harriet Beecher Stowe

“Sometime in your life you will go on a journey. It will be the longest journey you have ever taken. It is the journey to find yourself.” – Katherine Sharp

“Sometimes when you think you are done, it is just the edge of beginning. Probably that’s why we decide we’re done. It’s getting too scary. We are touching down onto something real. It is beyond the point when you think you are done that often something strong comes out.” ~ Natalie Goldberg

(This is something I try to convey in my birth classes–that when it seems “too much” and you manage to “dig deeper,” you find so much strength that you didn’t know you had and that knowledge of strength can continue to inform the rest of your LIFE!)

“When a woman has a child, it is equivalent to taking life vows.” –Stephanie Demetrakopoulos

“You do not know how a pregnant woman comes to have a body and living spirit in her womb.” –Ecclesiastes 11:5

(I guess tecnnically we “know,” but I think this is talking about the mystery of how we get from no where to now here…)

“Childbirth is a rite of passage so intense physically, psychologically, emotionally, spiritually, that most other events in a woman’s life pale next to it. In our modern lives, there are few remaining rituals of initiation, few events that challenge a person’s mettle down to the very core. Childbirth remains a primary… initiatory event for a woman.” –Maren Hansen

“Birth is an active, completely engaging process and requires that a woman be actively engaged, not only physically and emotionally but also in the decision-making process (before and during the birth).” –Awaken Your Birth Power e-newsletter

“Although women have been giving birth since time began, the lack of cumulative female knowledge and sharing in our society has led us to seek information about birth in books and classes rather than from the native wisdom of community experience.” –Elizabeth Noble

“…many women see the experience of birth as mystical, something they turn over and refocus on all their lives.” –Stephanie Demetrakopoulos

“Confront the dark parts of yourself, and work to banish them with illumination and forgiveness. Your willingness to wrestle with your demons will cause your angels to sing. Use the pain as fuel, as a reminder of your strength.” ~August Wilson

“You know being born is important to you. You know nothing else was ever so important to you.” –Carl Sandburg

“Spring has returned. The earth like a child that knows poems.” –Rainer Maria Rilke

“Hope is like a bird that senses the dawn and carefully starts to sing while it is still dark.” ~Anonymous

“Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom.” –Harriette Hartigan

“Giving birth is a transformation and it doesn’t matter whether you’ve had eight babies before. It’s still a transformation the next time you have another baby, because you are no longer the same woman you were before you had that baby.” –Penny Handford

“When a woman births without drugs…she learns that she is strong and powerful…She learns to trust herself, even in the face of powerful authority figures. Once she realizes her own strength and power, she will have a different attitude for the rest of her life, about pain, illness, disease, fatigue, and difficult situations.” –Polly Perez

“It is certainly true that for an increasing number of women, the birth experience is ecstatic. But it’s very important to keep in mind that, from a global perspective, the birth experience is still not a positive one for millions of women.” –Judy Chicago

“Woman is the first environment. In pregnancy our bodies sustain life. At the breast of women, the generations are nourished. From the bodies of women flows the relationsiop of those generations both to society and the natural world. In this way the earth is our mother, the old people said in this way we as women are earth.” –Katsi Cook Mohawk midwife

“When we let our light shine, we unconsciously give others permission to do the same.” –Marianne Williamson

“Awe enables us to perceive in the world intimations of the divine, to sense in small things the beginning of infinite significance, to sense the ultimate in the common and the simple; to feel in the rush of passing the stillness of the eternal.” –Abraham Joshua Heschel

“Loss makes artists of us all as we weave new patterns in the fabric of our lives.” –Greta W. Crosby

“Pregnant woman, at once universal and individual, lives the compelling force of creation within her whole being.” –Harriette Hartigan

“Childbirth is a rite of passage so intense physically, psychologically, emotionally, spiritually, that most other events in a woman’s life pale next to it. In our modern lives, there are few remaining rituals of initiation, few events that challenge a person’s mettle down to the very core. Childbirth remains a primary initiatory event for a woman.” –Maren Hansen

“Male science disregards female experiences because it can never share them.” –Grantly Dick-Read

“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

(Personally, I LOVE books–of all sorts–and reading is THE top way for me to learn about anything. I think the best prep I did before having my first baby was to read and I always give a recommended reading list to my clients. However, I also “hear” what he is saying here and wanted to share the quote. 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]).

“No matter what your size, shape, percentage of body fat, or BMI, you and I…can start right this minute to express gratitude to our bodies for being home to our souls and allowing us to express our uniqueness on the earth at this time.” – Dr. Christiane Northrup, The Wisdom of Menopause

“In pregnancy’s sculptured beauty, one body grows within another. Energy becomes human in the alchemy of the womb.” –Harriette Hartigan

“The experience of birth is vast. It is a diverse tapestry woven by cultural customs, shaped in personal choices, affected by biological factors, marked by political circumstances. Yet the nature of birth itself prevails in elegant design of simple complexity.” –Harriette Hartigan

“Stress hormones are contagious–if someone in your birthing space is stressed, you will feel it and become stressed.” (Awaken Your Birth Power)

DVD Review: Dance of the Womb

Apr3

DVD Review: Dance of the Womb: Belly Dance for Pregnancy and Birth
By Maha Al Musa, 2009
Red Polar Pictures
164 minute DVD, $49.95 (AUS)
http://www.bellydanceforbirth.com

Maha Al Musa has created a remarkable treasure for the birth world—an easy-to-follow, beautifully presented, step-by-step instructional bellydancing DVD called Dance of the Womb. Maha’s interest in Middle Eastern Dance was sparked by her Palestinian/Lebanese roots and she brings a lot of love and authenticity to her presentation of the dance techniques. Maha has also published a gorgeous companion book, Dance of the Womb (see previous review).

Dance of the Womb contains a 45-minute dance stretch warm-up. The exercises are comprehensive, gentle, and easy to follow. There are also six instructional dance technique chapters that cover specific beginning bellydance movements.

One of the special treats of this DVD is the included 50 minute video about Maha’s own homebirth journey with her third child (at age 46!). It also contains interviews with several homebirth midwives. The still photographs and birth footage are beautiful and brought a tear to my eye several times! Another bonus feature is a seven minute guided relaxation exercise.

Dance of the Womb is a great introduction to the basic physical elements of prenatal belly dance and also to some the spiritual and rhythmic aspects of giving birth. The DVD is a gentle and nurturing experience for both pregnant women and the women who serve them.

—
Disclosure: I received a complimentary copy of this DVD 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.

Consumer Blame

Mar31

Two things came to my attention today that made me think about how ironic it is that the medical system “lets” or doesn’t “let” women do so many things with regard to pregnancy and birth care and yet if something goes wrong, the locus of control shifts suddenly and it is now her fault for the situation. I see this often with things like “failure to progress”—“she’s just not dilating”—and even with fetal heart decelerations (“the baby just isn’t cooperating”). With induction—“her body just isn’t going to go into labor on its own”—and with pain relief—“she’s just not able to cope anymore” (yes, but is she also restrained on her back and denied food and drink?!). There are other ugly terms associated with women’s health that blame the “victim” as well such as “incompetent cervix” and “irritable uterus” and even “miscarriage” (and its even uglier associate, “spontaneous abortion.” And then for women with recurrent pregnancy losses we have the lovely, woman honoring term, “habitual aborter.” EXCUSE me?!). And then today, via The Unnecesarean, I read about a doctor inducing “labor” and then performing a cesarean on a non-pregnant woman.

Okay wow. So much could be said about that, but the kicker for me is that the woman was blamed—“The bottom line is the woman convinced everybody she was pregnant.” Huh?! So random surgery is totally acceptable if the person is “convincing” enough? What happened to diagnosing something first? Or, for taking responsibility for an inaccurate diagnosis?

The final thing that happened is that I got a completely unexpected refund check for over $400 today from my own local medical care system. While I’m not complaining about $400 that I thought I’d seen the last of, I had to shake my head in disbelief at the reason for the refund—“you overpaid”—excuse me, but I think the real reason is, “you overcharged me.” I checked back through my bills and I paid what I was billed (which, now that I think about, did seem like a heck of a lot for services NOT-rendered. If I had been in less of a state of grief and shock perhaps I would have questioned it more!), but now it has become “my fault” (in a sense) by switching the language to my overpaying vs. them overcharging.

What interesting dynamics these are…

Thoughts About “Let”

Mar28

“The effort to separate the physical experience of childbirth from the mental, emotional, and spiritual aspects of this event has served to disempower and violate women.” –Mary Rucklos Hampton

Related to my recent birth consumer post, I wanted to write a little bit more about the word “let.” One of my strongest birth-related pet peeves is the use of the word “let” when applied to birthing women. Women and providers and even doulas and CBEs often use terminology like “well, they let me get up for a while and walk around” or “my doctor is going to let me go to 41 weeks” or “the nurse let her get off the monitor for about 30 minutes” or “my husband won’t let me have a homebirth.” I do not like this phrase because of the “victim” mentality I feel like it conveys—-that women are passive and things are being “done to” them and they have no power of their own. I feel like it removes autonomy and empowerment and women’s control over their own bodies and births.

I often remind people that birth is not a time in a woman’s life when she should have to fight for anything. I also like to gently remind clients that no one can “let” them do anything. With colleagues, I occasionally have to clarify or explain my perception of the term as disempowering. Though in the end, sometimes I need to let (!) it go and realize that some people are perfectly satisfied with the term. And, I also have to acknowledge that the word DOES accurately describe many women’s experiences-—they are “let” or “not let” to do things even if I think it should be different and think they should have more power and control during their own births!

Review: Moby Wrap

Mar27

Several months ago, I was sent a sample Moby Wrap. I was absolutely delighted to receive the Moby, because amongst my friends and LLL Group members, a Moby Wrap is hands-down the number one pick for babywearing with an infant. I have a variety of slings and other baby carriers available in my demonstration bag to show parents during the final week of classes, but I did not have a wrap-style carrier (though I was always sure to mention that parents rave about wrap carriers!). I’m so pleased to actually have one available for parents to practice with.

The Moby Wrap is very versatile and can be used in a variety of positions from birth until over two years old. The fabric is soft and nice and hugs the baby closely and securely into your body. The knit of the fabric is also lightweight enough that you do not get roasting hot while wearing the carrier. A Moby Wrap is a long piece of breathable cotton fabric that is “wrapped around the wearer to create a safe, custom-fitted and versatile baby carrier.” Another benefit is that it can be used for “kangaroo care” with premature babies or any baby needing special care.

Babies that are “worn” cry much less frequently and parents can be hands-free to go about daily tasks while still being in close contact with their babies. When my first son was a baby, I was only half-joking when I would say that I would not be able to live without my baby carrier. With my second baby, I greatly appreciated being able to grocery shop while comfortably nursing him and still having both hands available to push the cart!

Recent negative press about slings has made me all the more determined to share the benefits and joys of babywearing with parents in my birth classes. (Reports about sling dangers are referring to a specific type of “bag” type sling [see more here], not to carriers like the Moby Wrap.) I am currently working with very young parents for a series of prenatal classes and I am eager to introduce them to babywearing and to show them how a Moby Wrap can help them bond with their baby!

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!).